Rotator Cuff Injury

An important point about scans: rotator cuff tears are found in a substantial proportion of people over 50 who have no shoulder pain at all, and the proportion rises with age. A tear on your scan is not automatically the cause of your symptoms.

What it feels like

Pain on the outer shoulder, often referring down the upper arm. Worse reaching overhead, out to the side, or behind you. Frequently painful at night, especially lying on that side. Weakness on specific movements.

Unlike Frozen Shoulder, passive movement, someone else moving your arm, is usually much better preserved.

Why it happens

Either gradual overload, common in overhead sports and overhead work, or an acute injury such as a fall onto an outstretched arm. Age-related tendon change contributes and is very common.

Surgery or not

Many rotator cuff problems, including a good number of partial and even some full-thickness tears, respond well to structured rehabilitation. Surgery is considered for larger acute tears, particularly in younger people, and where rehabilitation has not helped.

That decision belongs to a surgeon. We will give you an honest assessment and refer you when we think it is warranted.

How we treat it

Settling symptoms enough to load, then progressive strengthening of the cuff and the muscles controlling the shoulder blade, which are almost always involved.

What to expect

Assessment includes the neck and shoulder blade as well as the shoulder itself. Neck problems refer to the shoulder often enough that it is always checked.

How long it takes

Tendon problems are slow. Meaningful improvement usually takes months of consistent loading rather than weeks.