Shoulder pain and rotator cuff injuries

 A common cause of shoulder pain is rotator cuff injury. This can include impingement, tendinopathy, strains and tears, all of which can be acute or chronic in nature. The rotator cuff is more at risk of injury due to the large amount of movement required in the shoulder joint. Most rotator cuff injuries occur from repetitive overuse due to overload.

What are the symptoms of a rotator cuff injury?

  • pain from the top of the shoulder down towards the elbow.
  • pain lying directly on the shoulder.
  • shoulder pain at rest (with more severe injury).
  • pain or weakness when reaching up above or out to the side
  • pain reaching behind the back or the head.
  • pain with overhead activities e.g. reaching up to a cupboard, swimming, overhead shots in tennis

How is a shoulder pain diagnosed?

  • If you are experiencing pain in your shoulder a thorough assessment of the shoulder and surrounding structures is important for accurately diagnosis..
  • A physiotherapist will suspect a rotator cuff injury based on the clinical history and findings from a series of clinical tests on the shoulder.
  • A MRI or ultrasound of the shoulder may be required to identify a partial or full thickness tear. This may be recommended if this is suspected or if there is no improvement with conservative treatment. X-rays are of little help when a rotator cuff injury is suspected.

What is the treatment for a rotator cuff injury?

Depending on the diagnosis physiotherapy treatment may include:

  • limiting activities which aggravate the shoulder
  • applying ice to the shoulder
  • joint mobilisation
  • soft tissue release
  • dry needling/ acupuncture
  • posture advice
  • thoracic stretches
  • exercises focusing on improving scapular/ shoulder control
  • exercises to strengthen the shoulder

A graduated physiotherapy rehabilitation program will improve the movement, control and strength of the shoulder to enable full recovery.

Janette O’Toole

Janette O’Toole

Principle Physiotherapist
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