Red Flags & When to Go In Person for Rotator Cuff Tendinopathy (Mild) in Children

Audience: pediatric

Rotator cuff tendinopathy is a common cause of shoulder pain in children and adolescents. It involves irritation or mild injury to the tendons around the shoulder joint, often from repetitive use or minor injury. Symptoms usually include mild pain, especially when moving the arm, and some stiffness. Many cases improve with rest, gentle exercises, and avoiding activities that cause pain. Telemedicine can help guide care, provide advice on exercises, and monitor symptoms. However, some signs mean your child should see a healthcare provider in person. These include severe pain, sudden loss of shoulder movement or strength, swelling, fever, or if symptoms worsen or do not improve over time. Early in-person evaluation can help rule out more serious problems and ensure proper treatment. This guide helps parents and caregivers understand when telemedicine is appropriate and when to seek in-person care for mild rotator cuff tendinopathy in children.

Red flags — go in person / ER

• Severe shoulder pain that limits movement or sleep — seek urgent in-person care.
• Sudden inability to move or weakness in the shoulder or arm — get immediate medical evaluation.
• Signs of infection such as swelling, redness, warmth, or fever — see a healthcare provider promptly.

What telemedicine can do

• Initial assessment of mild shoulder pain and stiffness.
• Guidance on rest, activity modification, and exercises.
• Monitoring symptom progress over time.
• Answering questions about rotator cuff tendinopathy.

What telemedicine cannot do

• Severe or worsening pain requiring physical examination.
• Sudden loss of shoulder movement or strength.
• Signs of infection or systemic illness.
• Need for imaging tests or procedures requiring in-person visit.

What is Rotator Cuff Tendinopathy?

Rotator cuff tendinopathy happens when the tendons around the shoulder become irritated or mildly injured. In children, this often results from repeated overhead activities or minor injuries. It can cause mild shoulder pain and stiffness but usually does not involve severe damage.

Common Symptoms in Children

Children with mild rotator cuff tendinopathy often experience:

Symptoms usually develop gradually.

When to Use Telemedicine for Care

Telemedicine can help by:

It is a convenient way to get advice without leaving home.

Red Flags: When to Seek In-Person Care

Seek in-person care if your child has:

These signs may indicate a more serious problem needing urgent evaluation.

Preparing for a Telemedicine Visit

Before the visit, prepare by:

This helps the provider give the best advice.

Aftercare and Follow-Up

After the telemedicine visit, follow the care plan which may include:

If symptoms worsen, seek in-person care promptly.

How to prepare for your tele-visit

• Note when symptoms began and how they have changed.
• Identify activities that cause or worsen pain.
• Have your child perform gentle shoulder movements to demonstrate.
• Prepare a list of questions or concerns for the provider.
• Ensure a quiet space with good internet connection for the tele-visit.

After your tele-visit

• Follow the provider’s advice on rest and activity.
• Perform recommended exercises as instructed.
• Monitor symptoms daily for improvement or worsening.
• Contact healthcare provider if red flags appear.
• Schedule follow-up visits as advised.

FAQs

Can mild rotator cuff tendinopathy heal on its own?

Yes, many cases improve with rest, avoiding painful activities, and gentle exercises over time. However, monitoring symptoms is important to ensure proper healing.

Is it safe to do exercises at home?

Gentle stretching and strengthening exercises are often safe and helpful. Your healthcare provider can guide you on the right exercises during a telemedicine visit.

When should I worry about my child's shoulder pain?

Seek in-person care if your child has severe pain, sudden loss of movement or strength, swelling, redness, fever, or if symptoms do not improve after a few weeks.

Can telemedicine replace all shoulder care?

Telemedicine is useful for mild cases and follow-up but cannot replace in-person exams when severe symptoms or complications occur.

Sources

1. Rotator Cuff Injuries — MedlinePlus, U.S. National Library of Medicine.
2. Shoulder Pain in Children — American Academy of Pediatrics.
3. Telemedicine: What You Need to Know — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms, worsening pain, or signs of infection, seek immediate in-person evaluation by a healthcare professional.