Rotator Cuff Related Shoulder Pain

What is Rotator Cuff Related Shoulder Pain?

Rotator cuff related shoulder pain involves dysfunction or injury to the group of four muscles and tendons that surround the shoulder joint - the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles work together to stabilise the shoulder joint and control arm movement, particularly overhead activities.

This condition can range from minor irritation and inflammation (tendinopathy) to partial or complete tears of the rotator cuff tendons. It's one of the most common causes of shoulder pain, particularly affecting people over 40 and those involved in overhead activities or sports.

What Causes Rotator Cuff Related Shoulder Pain?

Rotator cuff problems typically develop through various mechanisms and contributing factors:

Overuse mechanisms:

  • Repetitive overhead activities (swimming, tennis, throwing sports)

  • Occupational tasks requiring frequent overhead reaching

  • Poor shoulder mechanics during lifting or carrying

  • Gradual wear and tear from repetitive use

  • Inadequate recovery between training sessions

Acute injury mechanisms:

  • Falls onto an outstretched arm

  • Sudden forceful lifting or pulling movements

  • Direct impact to the shoulder during sport

  • Throwing with excessive force or poor technique

Age-related factors:

  • Natural degeneration of tendon tissue over time

  • Reduced blood supply to tendons with aging

  • Bone spurs that can impinge on rotator cuff tendons

  • Changes in shoulder joint mechanics

Contributing factors:

  • Postural stress leading to altered shoulder blade position

  • Muscle imbalances between rotator cuff and larger shoulder muscles

  • Weakness in scapular stabilising muscles

  • Tight chest muscles and posterior shoulder capsule

  • Previous shoulder injuries or surgery

  • Sleeping consistently on the affected shoulder

What Are the Symptoms?

Rotator cuff related shoulder pain presents with characteristic patterns:

Primary symptoms:

  • Deep, aching pain in the shoulder, often felt on the outer arm

  • Pain that worsens with overhead activities

  • Weakness when lifting or rotating the arm

  • Night pain that frequently disturbs sleep

Activity-related symptoms:

  • Pain when reaching overhead or behind your back

  • Difficulty with personal care activities (washing hair, dressing)

  • Weakness when lifting objects away from your body

  • Pain when lying on the affected shoulder

  • Discomfort during throwing or racquet sports

Progressive symptoms:

  • Gradual onset of symptoms over weeks or months

  • Initially pain only with activity, progressing to constant discomfort

  • Increasing weakness in the affected arm

  • Compensatory movement patterns using other muscles

  • Stiffness developing if movement is avoided

Functional limitations:

  • Reduced ability to perform work tasks requiring overhead reach

  • Difficulty with sporting activities involving throwing or overhead motion

  • Impact on sleep quality due to night pain

  • Reduced confidence in using the affected arm

  • Compensatory neck and upper back tension

Severity indicators:

  • Complete inability to lift the arm (may indicate full-thickness tear)

  • Sudden onset of severe weakness following injury

  • Persistent night pain despite rest and medication

  • Progressive loss of motion over time

Struggling with shoulder pain affecting your daily activities or sport? Our specialist team has extensive experience treating rotator cuff injuries across all levels, from recreational athletes to professional rugby players, racquet sports athletes and World Champion MMA fighters. We provide comprehensive assessment, targeted manual therapy including joint mobilisation, and bespoke rehabilitation programmes designed to restore function and prevent re-injury.