Altea Physiotherapy + Wellness Blog

Frozen shoulder and rotator cuff tendonitis

Frozen shoulder and rotator cuff tendonitis

Written by Carly

Carly Chuby is the vestibular therapist at Altea Physiotherapy and Wellness. She has been a certified vestibular therapist since 2017.

March 3, 2022

Frozen shoulder and rotator cuff tendonitis- what is the difference?

Frozen shoulder or adhesive capsulitis is a condition where the capsule of the shoulder, stiffens and thickens up so much that it causes significant pain and reduced range of motion over time.

The capsule for the shoulder is important for a number of reasons. It deepens the socket, which makes the shoulder more stable and protects the shoulder from dislocation and provides area for muscles, tendons, and ligaments to attach.

What causes frozen shoulder?

It is not entirely clear what the exact cause is but it has been noted to occur more in people who have diabetes, post surgical, post fracture, or having the shoulder immobilized for an extended period of time. Women age 40 and older are also more likely to develop frozen shoulder.

Phases of frozen shoulder:

Freezing: This is where people will note a lot of pain and progressive loss of range of motion. It will seem like the shoulder just starts to stiffen up and you’re not sure why.

Frozen: This is when the shoulder is just “stuck” and will not move very much. There is typically still pain in this phase but not as intense.

Thawing: This is when people start to notice the pain subside and the shoulder starts to move a bit more. People also notice some cracking and popping during this phase (this is the capsule loosening and adhesions breaking up).

Each phase can last anywhere from weeks to months and is different for each person.

    Rotator Cuff Tendonitis

    Rotator cuff tendonitis is when one of the muscles of the rotator cuff becomes irritated, inflamed, or torn due to overuse or injury. The rotator cuff is made up of 4 muscles; subscapularis, infraspinatus, supraspinatus, and teres minor. The rotator cuff is extremely important for shoulder movement and stability.

    Rotator cuff injuries are very common. Partly because the shoulder is in use almost constantly, shoulder movements require a lot of combined movement and use of multiple muscles, and the shoulder isn’t the most stable joint compared to others in our body.

    Levels of rotator cuff tendonitis/ tears:

    There are 3 levels of injury that a physiotherapist will grade your rotator cuff injury.

    Grade 1 is pretty mild and will typically feel like some mild to moderate pain with certain movements at the end range or almost feel like you overstretched a muscle. Grade 1 typically takes weeks to heal.

    Grade 2 is a bit more serious and you may have pain at rest. Grade 2 tears/tendonitis can take weeks to months to heal.

    Grade 3 is typically classified as a tear of one of the muscles in the rotator cuff and may require surgery. A grade 3 will take several months to heal.

    Still wondering what the difference between frozen shoulder and tendonitis is??
    • Frozen shoulder has 3 phases (freezing, frozen, thawing)
    • Frozen shoulder will be pain and progress loss of range of motion
    • Tendonitis presents as pain with certain movements, weakness, and the arm may even “give way” due to weakness.
    • Tendonitis is typically after an injury or prolonged use, so usually people know the event that caused it, but not always.

    As you can see telling the difference can be tricky and the treatment for these two things is very different. If you think you may have frozen shoulder or rotator cuff tendonitis/ tear, it is important to get a thorough assessment done by a physiotherapist. Our team at Altea Physiotherapy and Wellness is here to help!

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