The rotator cuff is a group of four muscles that work together to hold the ball of the shoulder joint in place in its socket in the shoulder blade, providing strength and stability to the shoulder. The co-contraction of these tendons lead to the shoulder being held in place, much like a golf ball on a tee. However, due to the high level of mobility the shoulder has, the tendons of the rotator cuff muscles can sometimes become overworked, leading to tendinopathy (inflammation or degeneration of the tendon). It is also possible to tear one or multiple rotator cuff tendons, either after a traumatic injury like falling or lifting something heavy, or just through wear and tear. You do not have to be an elite athlete to suffer with rotator cuff related shoulder pain.
Typically, patients with a rotator cuff tendinopathy present with pain at the shoulder while sleeping, at rest or most commonly, while moving shoulder. The pain usually starts off as slight but tends to become gradually worse over a period of weeks or months and you can sometimes find your shoulder becoming harder to move due to stiffness. Unlike a tendinopathy, a rotator cuff tear following a traumatic injury usually causes immediate pain and weakness in certain movements of the shoulder.
A rotator cuff injury can usually be diagnosed following a thorough physical examination by one of our therapists. However, if your problem is more complex, we may refer you in-clinic for diagnostic ultrasound scan to provide a specific diagnosis or to determine the severity of the injury. This can often help to determine whether you are suffering from tendinopathy or a tear within the tendon, as they can present quite similarly.
Rotator cuff related shoulder pain can, depending on the severity of the injury, take some time to recover from. However, physiotherapy can help to alleviate your pain and allow you to return to full function much quicker. As well as advice on how to manage your symptoms, treatment you can expect following a rotator cuff injury diagnosis are:
- Structured exercise programs that are progressed as and when each individual patient is ready, aiming to restore normal function and strength within the shoulder
- Radial shockwave therapy – more commonly used for tendinopathies as opposed to rotator cuff tears
- Acupuncture
- Manual therapy
- Ultrasound-guided steroid injection. Rotator cuff related shoulder pain is one of the most commonly injected conditions, as it can sometimes be quite difficult to treat. Steroid injections contain a strong anti-inflammatory and are used always alongside physiotherapy and not as a standalone alternative. Read more about our injection service here.
