I asked this in one of the previous 2 posts about this but I don't believe I got a definitive answer.

To those of you with a positive dx of RC tendinosis/tendinitis: Where is/was your pain located? Was it actually IN the shoulder, or further down the arm? Could you sleep on your affected arm?

I ask because my pain is on the lateral aspect of my arm midway between my shoulder and elbow. With the exception of a very seldom twinge at the top of the shoulder, I have NO pain in the shoulder itself.

When I mention this to the doctor and PT, they explain that's where the tendon attaches to the bone. I assume they mean that when I raise my arm, the rotator cuff is being used but the pain is referred to where the tendon attaches to the bone. But, if there is a tear in the RC muscle itself (which the PT seems certain there is), wouldn't there be pain where the tear is located?

AND -- If I press on the sore spot, it hurts even if my arm hangs at my side (i.e. even when the RC muscle is not in use).

Also... when I read about classic symptoms, one of them is pain while sleeping on the arm -- but that is not true in my case.

Where the pain is located or referred will depend on which muscle or tendon is injured. I get the same pain you do, about halfway down the arm on the outside, but also get it when I place my arm behind my back or out in front and to the side. My recent tear was in the shoulder capsule itself but the pain was both local and referred. I have no issues sleeping though I sleep on my right side not on the injured left. Mostly though, it is much better. My problem now is some C-spine stenosis which can complicate finding the source of shoulder pain as they can present in a similar fashion.

Thank you... very interesting.

So, this is what I've learned so far:

• Tendinitis and tendinosis are NOT the same; what's more, many cases diagnosed as the former are actually the latter.
• Pain might be at the source, or not; it varies person to person.
• MRIs aren't always conclusive
• Surgery should be a last resort (except, probably, cases involving full-thickness tears)
• PT works... with lots of time, and patience.
• If one stops the exercises, the pain returns.

The pain in both shoulders over the years has been mainly when trying to lift weights, specifically shoulder exercises. I am assuming that is arthritis. After the cycling fall on my left shoulder the pain was in the outside midway down the arm as you have described. However, there was some pain in lkifting and I have had a lot of weakness in that arm. In addition I do sleep on my side with my arm extended under my pillow. (both sides, I just alternate). I did feel pain in the shoulder when I would awaken in the middle of the night. Again the surgery I am having tuesday is described as a total rupture of the rc. The right shoulder pain I have now I think is more tendinitis. Although the pain is in a similar spot as the left, it just feels different. There is no popping when I move the arm (something the doc said is a tell tale sign of a tear). Hopefully it will settle down over time or he can give me a cortisone shot to accelerate the process.