Why does my shoulder hurt?

Selena O’Dwyer – Physiotherapy

The rotator cuff is a group of muscles and tendons that stabilize the shoulder, allowing it to move smoothly and with a wide range of motion. Because of its important role in shoulder mobility and strength, injuries to the rotator cuff are common, especially among athletes, manual laborers, and older adults. If left untreated, these injuries can significantly affect daily activities and quality of life.

In this blog, we will explore what a rotator cuff injury is, the differential diagnoses, and the treatment options available, including both non-surgical and surgical approaches.

What is a Rotator Cuff Injury?

The rotator cuff consists of four muscles—supraspinatus, infraspinatus, teres minor, and subscapularis—along with their tendons, which form a “cuff” around the shoulder joint. These muscles provide stability and allow the shoulder to move in multiple directions.

A rotator cuff injury can occur due to:

  • Repetitive motion: frequently overhead activities, like throwing or lifting, can lead to wear and tear on the tendons
  • Acute trauma: such as falling on an outstretched arm or lifting something heavy.
  • Degeneration: age-related wear, which is common in people over 40, can weaken the tendons, making them more prone to injury.

These disruptions can manifest as irregular periods, fertility challenges, menopausal symptoms, thyroid disorders, and even contribute to conditions like endometriosis and PCOS.

The most common reasons for pain:

The most common reasons for pain in the shoulder due to the rotator cuff are:

  • Tendonitis: inflammation of the tendons.
  • Tears: partial or complete tears of one or more tendons.
  • Bursitis: inflammation of the bursa (a fluid-filled sac that cushions the tendons).

Other Conditions Associated with Shoulder Pain

When diagnosing a rotator cuff injury, it’s important to rule out other causes of shoulder pain:

  • Shoulder Impingement Syndrome: Repetitive overhead movements compress tendons between the humeral head and acromion, causing pain and weakness.

  • Frozen Shoulder (Adhesive Capsulitis): Stiffness and limited motion, often after injury, immobility, or perimenopause.

  • Labral Tear: A cartilage tear (often SLAP) in the shoulder socket, leading to pain and instability.

  • AC Joint Injury: Pain at the clavicle-acromion joint, common in contact sports or falls.

  • Cervical Radiculopathy: Neck nerve compression causing shoulder pain, tingling, numbness, or weakness.

  • Thoracic Outlet Syndrome: Nerve and blood vessel compression between the collarbone and first rib, leading to pain, numbness, or weakness.

Physiotherapy Management of Rotator Cuff Injuries

Physiotherapy is key in managing rotator cuff injuries, especially minor tears or tendonitis. Treatment focuses on pain relief, restoring function, and strengthening the shoulder.

Physiotherapy Exercises

Range of Motion: Maintains or restores mobility.

Strengthening: Builds rotator cuff endurance and stability.

Scapular Control: Enhances shoulder blade function for better mechanics.

Recovery can take 3-6 months—patience is essential!

For severe cases requiring surgery, physiotherapy aids in recovery:

0-6 weeks: Passive motion exercises to prevent stiffness.

6-12 weeks: Gradual active movement and strengthening.

3-6 months: Functional training to restore daily or sports activities.

Full recovery may take 6-12 months, depending on the severity of the injury and adherence to rehab.

Rotator cuff injuries can significantly impact shoulder function and quality of life, but with early diagnosis and appropriate treatment, most people can return to their normal activities. Conservative treatments like physiotherapy and anti-inflammatory medications are effective for many, but some cases may require surgical intervention. Our physiotherapist can help you decide the appropriate treatment path for you.

If you are experiencing shoulder pain, stiffness, or weakness, you should consult our physiotherapist to rule out a rotator cuff injury and determine the best course of treatment tailored to your needs.

Do you have shoulder pain?

Hey there! I’m Selena O’Dwyer and as a Physiotherapist, I’m deeply passionate about getting your body out of pain and back into balance.

You’ll find me inside our Green Point clinic located next to the Green Point Village Shops!

Book your appointment today, and let’s get you back to feeling fantastic.