Rotator Cuff – Injury, Symptoms and Treatment
The rotator cuff is a group of four muscles and their tendons that stabilise and move the shoulder. Problems with it are a common cause of shoulder pain, and many people respond well to conservative treatment.
What the rotator cuff is
The rotator cuff includes the supraspinatus, infraspinatus, teres minor and subscapularis muscles. They hold the head of the upper arm bone in its socket and allow the arm to lift and rotate. Their tendons can become irritated, wear down, or tear partially or completely.
Symptoms often start gradually with pain during overhead movements and at night. After an acute injury, such as a fall onto the arm, sudden pain and weakness can appear. Imaging shows rotator cuff changes in people without pain too, so assessing symptoms and function is essential.
Many partial tears and tendinopathies improve with targeted exercise and therapy. For large or acute tears, especially in young active people, a specialist may discuss surgery.
Common causes
- repetitive overhead movements
- age-related wear of the tendons
- a fall onto an outstretched arm or a direct blow
- sudden lifting of a heavy load
- poor shoulder blade control and posture
- sports such as swimming, tennis and weightlifting
How it feels
- a dull ache deep in the shoulder
- pain when lifting the arm sideways or overhead
- night pain, especially when lying on the affected side
- weakness when lifting or rotating the arm
- difficulty reaching behind the back
- clicking with movement
How we can help
We start with a thorough assessment of strength, mobility and shoulder blade control. We build an individual programme of therapeutic exercise, manual therapy and therapeutic massage, adding shockwave, laser, ultrasound or TECAR where useful to ease pain. If the assessment shows a need for further investigation or an orthopaedic opinion, we will refer you in good time.
When to see a doctor
See a doctor promptly if you cannot lift the arm after a fall or injury, if the shoulder looks deformed, or if you suddenly lose strength. Also consult a specialist if night pain and weakness do not improve after a few weeks, as imaging may be needed.
This page is for information only and does not replace an assessment by a specialist.