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HealthInfo Waitaha Canterbury

Rotator cuff problems

Ngā pokohiwi ngoikore

Your rotator cuff is a group of muscles and their tendons that surround your shoulder joint, keeping the head of your upper arm bone firmly in your shoulder socket.

A common rotator cuff problem is rotator cuff tendinopathy, where your rotator cuff tendons become weak and painful. Another is torn tendons, giving you a rotator cuff tear.

Most rotator cuff tears happen gradually because of long-term wear and degeneration of your shoulder tendons. Often, they do not cause any symptoms. They generally happen to people who have done lots of overhead activities or used their arms a lot in their work. Sometimes these tears can become painful for no apparent reason, but the pain will often get better with time and treatment.

Some medical conditions, such as heart disease and some metabolic disorders as well as poor nutrition and smoking can weaken your tendons making it more likely you'll get a rotator cuff tear.

Symptoms of a rotator cuff problem

Symptoms of rotator cuff problems include:

But sometimes the pain comes on suddenly or after a traumatic event like falling on your shoulder, lifting a heavy object or falling onto your outstretched hand. A forceful overhead movement can also be to blame.

When this happens, it's called an acute tear (acute means something that comes on quickly). You may have pain that goes down into the top of your arm. Your arm may also feel heavy, and you will not be able to move it much.

Diagnosing a rotator cuff problem

If you suspect you have a torn rotator cuff, it's important to see your general practice team or a physiotherapist. After listening to what happened and what your symptoms are and examining you, they will decide if you need an ultrasound scan to see where the injury is. If you have a significant rotator cuff tear, your doctor or physiotherapist may refer you to see an orthopaedic specialist, who will decide how to manage your injury.

Self-care for a rotator cuff problem

If your pain is bad, take regular pain relief. The best pain relief is paracetamol (Panadol). Take two tablets every four hours but no more than eight tablets a day.

Anti-inflammatory pain relief medicines can help you manage rotator cuff pain in the short-term. Examples include ibuprofen, diclofenac and naproxen. Never take more than the recommended dose.

Some people shouldn't take anti-inflammatories. For example, people with asthma, stomach problems, high blood pressure, kidney failure or heart failure. If you aren't sure, ask your general practice team or pharmacist.

You should avoid any heavy lifting, but do not rest totally, as you may have more pain if you're totally inactive.

The best treatment for rotator cuff tendinopathy is to do exercises that help to strengthen your tendons and the muscles around your shoulder. These include the shoulder blade squeeze exercise and resisting rotation inwards and outwards exercise (as long as it doesn't make your pain worse). The sooner you start doing these exercises the better as they can stop your muscles from becoming weak.

The way you stand and sit (your posture) affects your shoulder tendons, as does physical activity, leg strength and what you eat. See a physiotherapist to learn about how you can manage your pain and better use your arm. Exercises to improve your posture and strengthen your shoulder may help.

Treating rotator cuff problems

Most rotator cuff conditions will get better with time, but it can take months.

Physiotherapists can help you to heal by advising on exercises and other treatments for your muscles and tendons.

If your rotator cuff problem doesn't get better as expected, your general practice team may suggest a steroid injection.

If you have a large tear in your rotator cuff or the condition isn't healing as expected, you may need to see an orthopaedic surgeon for more investigation. You may need an MRI scan and you may need surgery to help repair the tendon.

Written by a Canterbury physiotherapist. Adapted by HealthInfo clinical advisers. Last reviewed July 2022.


Page reference: 298129

Review key: HISHI-13267