Rotator Cuff Related Shoulder Pain

The rotator cuff is a group of four muscles that surround the shoulder joint, providing stability and enabling a wide range of motion. These muscles are the supraspinatus, infraspinatus, teres minor, and subscapularis.  

One of the most common causes of shoulder pain is rotator cuff-related shoulder pain (RCRSP), accounting for up to 70% of shoulder pain cases.

What Causes Rotator Cuff Pain? 

Overuse: Repetitive overhead motions, such as throwing, painting, or lifting heavy objects, can strain the rotator cuff tendons. 

Age: As we age, the rotator cuff tendons naturally weaken and become more susceptible to injury.

Trauma: A sudden injury, such as a fall or direct blow to the shoulder, can cause a rotator cuff tear. 

Recognising the Symptoms 

Rotator cuff pain can manifest in several ways. Common symptoms include: 

Pain at rest and at night, often interfering with sleep. 

Pain when lifting and lowering your arm. 

Weakness in the shoulder. 

Pain when reaching behind your back. 

Treatment Options for Rotator Cuff Pain 

The appropriate treatment for rotator cuff pain depends on the severity and cause of the condition. Physiotherapy has a strong evidence base in treating rotator cuff related shoulder pain and should be

your first port of call. Treatment options include: 

Physiotherapy: A physiotherapist can assess your condition and create a tailored treatment plan to reduce pain and restore function. This regularly involves advice, education around the condition and tactics that can be employed to reduce pain and dysfunction, and exercises to strengthen the rotator cuff muscles, improve range of motion, and correct posture.

Pain Relief Medication: Over-the-counter pain relievers, such as ibuprofen or naproxen, can help reduce pain and inflammation, however we always recommend talking to your GP.

Injections: In some cases, a corticosteroid injection may be recommended to reduce inflammation and pain. However, injections are often used in adjunct with physiotherapy, not as an alternative. 

Surgery: If conservative treatments are not effective, surgery may be necessary to repair a torn rotator cuff tendon. 

Tips for Prevention and Recovery 

Preventing rotator cuff problems is often better than needing a cure. Here are some tips: 

Warm-Up: Before any activity that involves overhead motions, warm up your shoulder muscles with gentle stretches and exercises. The best warm-up is often the exact movement you're preparing for simply performed lighter and slower. e.g. Before shoulder pressing a barbell, trial the movement with lighter dumbbells first, focusing on moving through the movement slowly in full range.

Strengthen Your Shoulders: Incorporate exercises that strengthen the rotator cuff muscles into your regular fitness routine. Focusing on movements with variability, different angles and stimulus. e.g. dumbbell work, using resistance bands and bodyweight.

Graded exposure: When starting a new activity, or progressing one you have been doing for some time, try to build tolerance gradually. 

Follow your Physiotherapist's advice: If you are recovering from a rotator cuff injury, make sure to follow the advice provided by your physio. 

Summary 

Rotator cuff related shoulder pain is a common problem that can significantly impact your quality of life. By understanding the causes, recognising the symptoms, and seeking appropriate treatment, you can effectively manage your pain and restore function to your shoulder. Remember, prevention is key, so take steps to protect your rotator cuff muscles and maintain good shoulder health.