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Rotator Cuff Tendinopathy

The rotator cuff is a group of four muscles that hold the shoulder joint together and control it through range. Tendinopathy is what happens when those tendons are loaded more than they are currently conditioned for. It is one of the most common shoulder condition we see, and it responds to progressive loading better than to rest — which surprises people, because resting is the instinct.

Related reading: pinching pain on reaching up.

What causes it

  • A rapid increase in overhead activity — painting, swimming, a new gym program
  • Repetitive work at or above shoulder height
  • Age-related tendon change, which begins earlier than most people expect
  • Weakness through the shoulder blade muscles
  • A single heavy lift or catch that overloaded the tendon

What you might notice

  • Pain on the outer upper arm or sometimes the point of the shoulder
  • Difficulty reaching overhead, behind the back, or into a back seat
  • Pain lying on that side at night
  • A painful arc partway through lifting the arm out to the side
  • Weakness that is more about pain inhibition than true loss of strength

How we treat it

  • Progressive loading of the cuff — the core of the treatment, and well evidenced
  • Shoulder blade strengthening, so the cuff is not working alone
  • Manual therapy and dry needling for symptom relief alongside the loading
  • Reducing the aggravating load temporarily rather than stopping altogether
  • Sleep position advice, since night pain is often the worst part
  • Realistic timeframes — tendons respond in months, not days

This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment. If your pain followed a significant injury, is getting worse, or comes with numbness, weakness or unexplained weight loss, please see your GP.

Resting a sore cuff usually makes it worse

Tendons need load to recover, but the right load at the right time. Getting that wrong is why shoulders drag on for a year. An assessment sets the starting point.

Book a shoulder assessment Ask a question first

Or call us on (08) 7008 7566 — we see patients across Seaton, Modbury and Stepney.

Other shoulder conditions we treat

Shoulder Impingement

Back to all shoulder conditions