What Is the Rotator Cuff?
The rotator cuff is a group of four muscles and their tendons (supraspinatus, infraspinatus, teres minor and subscapularis) that wrap around the shoulder joint, stabilising the ball in the socket and enabling the full range of arm movement. These tendons are vulnerable to both acute injury and gradual wear — particularly in people over 40.
Types of Rotator Cuff Injury
- Tendinopathy: Degeneration of the tendon without a structural tear. Causes pain with overhead movements, particularly between 60–120 degrees of elevation.
- Partial tear: A tear through part of the tendon thickness. Can be treated conservatively in most cases.
- Full-thickness tear: The tendon is completely torn. Smaller tears can often be managed with physiotherapy; larger tears may require surgical discussion.
- Calcific tendinopathy: Calcium deposits within the tendon cause intense pain. Physiotherapy is first-line management.
How Physiotherapy Treats Rotator Cuff Injuries
Load Management
Understanding which activities load the rotator cuff tendons and modifying them appropriately — particularly in the painful arc of movement — is a key early step in reducing irritation and allowing healing to progress.
Progressive Strengthening
Isometric (static) exercises are introduced early to maintain tendon load without provoking pain. As tolerance improves, isotonic and then resistance-based exercises progressively reload the tendon and rebuild strength.
Scapular Control
The scapula (shoulder blade) forms the foundation for all shoulder movement. Poor scapular control is a major contributor to rotator cuff irritation — and a key physiotherapy target.
Postural Correction
Forward head posture and rounded upper back are strongly associated with rotator cuff impingement. Physiotherapy addresses these through specific exercises and movement re-education.
Typical Recovery Timeline
- Tendinopathy: 6–12 weeks with a structured loading programme
- Partial tear: 3–6 months of progressive rehabilitation
- Post-surgical repair: 4–6 months for return to full function (see post-op rehab page)
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