What is the Rotator Cuff?

Your shoulder joint is a relatively unstable and non-weight bearing, ball and socket joint that is moved and controlled by a small group of four muscles known as the rotator cuff.

The muscles are;




and Teres Minor

These small rotator cuff muscles stabilise and control your shoulder movement on your shoulder blade (scapula).

As the name suggests, the rotator cuff muscles are responsible for shoulder rotation and form a cuff around the head of the Humerus.

What is Rotator Cuff Syndrome?

Rotator cuff syndrome is very common shoulder injury.

The rotator cuff muscles and tendons are very susceptible to rotator cuff tears, rotator cuff tendonitis and rotator cuff impingement and other related rotator cuff injuries due to the shoulder joint relinquishing stability for mobility.

Rotator cuff injuries vary from mild tendon inflammation (tendonitis), shoulder bursitis (inflamed bursa), calcified tendonitis (calcium deposits within the Supraspinatus tendon) through to partial and full thickness rotator cuff tears, which may require surgical intervention.

The rotator cuff muscles hold your arm (Humerus) onto your shoulder blade (Scapula). Most of the rotator cuff tendons are hidden under the bony point of your shoulder (Acromion), which as well as protecting the tendons, can also impinge upon them.

What Causes a Rotator Cuff Injury?

The rotator cuff tendons are protected by bones (mainly the Acromion) and ligaments that form a protective arch over the top of your shoulder.

In between the rotator cuff tendons and the underside of the Acromion is the Subacromial Bursa (a protective cushion like structure), which helps to protect the tendons from touching the bone and provide a smooth surface for the tendons to glide over.

Rotator cuff impingement syndrome is a condition where your rotator cuff tendons are intermittently trapped and compressed during shoulder movements This causes injury to the shoulder tendons and bursa resulting in painful shoulder movements.

What are the Symptoms of Rotator Cuff Injury?

The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles. If tendons are injured for a long period of time, the tendon can tear, resulting in a rotator cuff tear. 

How is a Rotator Cuff Injury Diagnosed?

Our physiotherapist will suspect a rotator cuff injury based on your clinical history and the findings from a series of clinical tests.

A diagnostic ultrasound scan is the most accurate method to diagnose the specific rotator cuff injury pathology. MRI’s may show a rotator cuff injury but have also been known to miss them. X-rays are of little diagnostic value when a rotator cuff injury is suspected.

How to Treat a Rotator Cuff Injury?

Once you suspect a rotator cuff injury, it is important to confirm the exact type of your rotator cuff injury since treatment does vary depending on the specific or combination of rotator cuff injuries.

Treatment consists of;

Initial Pain control and inflammation reduction. This can be accomplished with a combination of relative rest, ice, and NSAID. 

Rehabilitation phase to restore full pain-free range of movements of the shoulder, increase strength and stability of the muscles acting over the shoulder joint.

Return to full functional activity/sport.

 Our physiotherapist will use acupuncture, IFC (interferential current), TENS (transcutaneous electrical nerve stimulation), moist heat, and/or ice to help manage pain. Muscle balance and patterning will be addressed through work with stabilizing muscles, and the physiotherapist will work on improving both the active and passive range of motion through exercise and manual therapy. In some cases, therapeutic ultrasound and laser will be used to stimulate healing and break down scar tissue. However, as every client is different treatment will always be tailor-made to your specific requirements.

If you have shoulder pain call AAP Physiotherapy now on 01495 370288 for an immediate appointment with expert, experience physiotherapists. Alternatively e mail us here and we will call you back within 2 hours.