Rotator cuff related pain

Sep 25, 2019

Rotator Cuff Related Shoulder Pain is the most common shoulder problem we see in clinic.  You may have heard of rotator cuff related shoulder pain referred to as many other different names including sub acromial impingement,sub acromial bursitis, supraspinatus tendinopathy and rotator cuff tears. The rotator cuff is a common name for a group of four muscles and their tendons that attach to the top of your arm bone from your shoulder blade. These muscles work to provide strength and stability to the shoulder joint whilst you move your arm.

In most cases rotator cuff related shoulder pain occurs when a shoulder tendon is overloaded. This can happen slowly over time, or quite quickly if the tendon has been exposed to a sudden increase in load. For example, it can occur quite quickly if you have used your arm for an activity that is much more demanding than you are used to. We also know that rotator cuff related shoulder pain can occur slowly over time. This happens when the tendon becomes irritated and overloaded and is then less able to tolerate normal day to day activities. Rotator cuff related shoulder pain can also occur after a trauma or fall, in this case it is important to rule out a significant tear to the rotator cuff which your osteopath can help you do.

Risk factors

    1. Being over 50 years old
    2. Being diabetic (due to reduced blood flow affecting the healing process)
    3. Repeated overhead activities


Usually Rotator cuff related shoulder pain is diagnosed by listening to the history of your problem and by a physical examination. Your osteopath will examine your neck and shoulder movements, the strength of your shoulder muscles and perform some tests of your shoulder.

Patients with rotator cuff related shoulder pain commonly report pain in the upper part of the arm that occasionaly moves into the neck or further down the arm. Pain is usuallyaggravated when raising the arm above 90 degrees, reaching behind the back or when sleeping on the affected side.

Do I need an MRI?

In most cases no. A good history and physical examination of your shoulder alone provides enough information to diagnose your problem. Scans are not always useful for diagnosing shoulder pain. While a scan may provide lots of information it does not necessarily alter the treatment or management options for your shoulder pain. We also know that the information the scan may or may not pick up might not necessarily be causing your problem. We know that scan findings are very poorly linked with pain and often people with no pain have very similar findings on their scans to those that do.

Treatment options

  1. Activity modification. It is possible to change the load on your shoulder and help your symptoms by making slight alterations in the way you do things such as stepping towards something as opposed to reaching for it. You may also be able to break activities or tasks into more manageable smaller chunks and gradually increase the time your do the task over time. It is important to keep moving and exercising your shoulder so avoid not using it all together.
  2. Manual therapy. Hands on manipulation can provide pain relief and improve the function and movement of the shoulder and surrounding areas.
  3. Strengthening exercises. Exercise will provide pain relief and also allow the tendon to adapt to increased load. Research suggests that a well constructed exercise plan gives the same benefits as surgery!

How long will it take to get better?

Typically patients will see a good improvement in pain and movement within 6 to 12 weeks.

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