Rotator Cuff (Shoulder) Muscle Injuries

Rotator Cuff Shoulder Muscle Injuries 300x232 Rotator Cuff (Shoulder) Muscle Injuries

Rotator Cuff Muscular Injuries

What is the Rotator Cuff?

The rotator cuff is a group of muscles located at the shoulder joint, they originate on the scapula (shoulder blade) and attach on to the humerus (upper arm bone). Like most muscles the rotator cuff has a tendon at each end which serves to attached the muscle to the bone. Unlike other joints, our shoulders are very mobile and able to move in multiple of directions. Such movement has a trade-off – stability. The rotator cuff helps to position and secure the ball into the socket as it moves through range into different positions. The muscles of the rotator cuff are not very big so cannot generate large amounts of power however they constantly work – as such have great endurance.

How Does The Rotator Cuff Get Injured?

As the rotator cuff is made up of muscles, any injury that can happen to a muscle can affect the rotator cuff. Any injury to the cuff which affects function will have an impact on the shoulder; pain, instability, reduced range or power etc.


It can become weak, normally through disuse or a reduction in activities levels, just like another muscle “use it or lose it”. If the muscles are weak its ability to perform its job is impaired and it cannot control the shoulder joint effectively. As such the muscle needs to be strengthened to the appropriate level and demands of the individual, whether that’s general every day activities or playing golf or tennis.


The muscle can be inhibited by pain – which would give the appearance of weakness. Pain inhibition decreases the body’s ability to switch on and activate the muscle. The muscle is healthy and not injured but just not working efficiently or effectively. In this case the muscle “weakness” is a symptom and not the cause. Identification and treatment of the cause are key but equally the rotator cuff muscles need to be re-activated to reduce symptoms.


And finally, the muscle can be damaged or strained (muscle tear). The muscle fibers themselves are damaged – either from repetitive over load or a specific injury such as a sudden forceful movement. Again, this will present as weakness of the rotator cuff and affect shoulder movements and stability. We would expect to see pain on or near the site of the injury – as you would expect with muscle injuries anywhere else in the body.

Muscle strains are graded by clinicians from 1 to 3 depending on severity.

Grade 1 strains are mild and only affects a few muscle fibers and has minimal power or function loss.

Grade 2 strains covers a bigger range, but more fibers are affected with more weakness and pain

Grade 3 strains are complete rupture of the muscle – sometimes there will be no pain but would have a significant weakness

Muscle injuries are generally considered to take 6 weeks to heal but this depends on the severity of the injury. Naturally the body will attempt to heal the damage but often needs assistance or input to aid and speed up recovery. This section only covers muscle injuries to the rotator cuff, the tendons

associated with each muscle can be damaged or injured – please see Tendon Injuries in the condition section for more detail.

Signs and Symptoms

  • Pain on movement of your shoulder – particularly with overhead activities or repetitive movements. It may present as a deep ache at rest or give sharp pain on movement
  • Weakness or reduced power with certain movements, often with rotation movements. This is often accompanied by pain. Common complaints include changing gear, brushing hair or reduced sporting ability.
  • Reduced range of movement – hand behind your head or behind your back – it may feel tight or be limited by pain.

Risk Factors for Rotator Cuff Injuries

  • Age – as we age our muscles slowly deteriorate, become less robust and more susceptible to injury
  • Occupation – physical or demanding jobs will place increased stress onto muscles
  • Sport or hobbies – repetitive, overhead, throwing or contact sports can all cause injury to the rotator cuff
  • Decreased muscle strength – the stronger the muscle the better it can protect its self from damage

How Can Physiotherapy Help?

Physiotherapy can be effective in treating rotator cuff injuries. A detailed assessment of the shoulder and surrounding structures will help to correctly identify the source of the symptoms.

Treatment Goals

  • Restore normal movement and function of the shoulder joint / complex
  • Manage pain levels
  • Educate patients to the cause of the initial problem
  • Prevent re-occurrence of injury
  • Achieve specific patient goals

Treatment may include

  • Advice regarding activity and exercise modification, positional or posture changes
  • Individual exercise programme to strengthen, activate or promote healing
  • Acupuncture to address pain levels or specific areas of muscle spasm
  • Soft tissue treatment of muscles – often addressing neighbouring muscles which are compensating for the injury
  • Taping – where appropriate to help offload or provide postural feedback

What Can I Do To Help This Condition Myself?

If you are yet to attend physiotherapy, patients can somewhat help speed up the healing process or manage the symptoms.

  • Appropriate analgesia (pain medication) can help manage the pain levels and often facilitates normal movement of the joint – and normal movement promotes normal healing. For further advice, it is recommended to see your G.P. or pharmacist, especially if you are already taking other medication.
  • Relative rest and avoidance of the aggravating factors can help normal healing of the affected tissues. Relative rest does not mean complete rest and it is important to still move and use the shoulder as able in a pain free range; otherwise it could become weaker through inactivity.

Still concerned about a possible rotator cuff injury, & self treatment is not helping? One of our highly qualified physiotherapists can help, with immediate appointments often available across one of our many clinic locations – Royal Crescent, Newton Mearns, Clarkston, Mosspark, & Kirkintilloch.

Please call 0141 353 0906 to appoint.