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Guide to Rotator cuff strain

What is a Rotator cuff strain?

What is a Rotator Cuff Strain?

The term rotator cuff is used to describe the muscles in the shoulder that are responsible for moving your arm. These muscles include the supraspinatus, infraspinatus, subscapularis, teres major and teres minor. Rotator cuff injury is the most common problem that affects the shoulder. Injuries can range from a mild strain of a single tendon to a complete rupture of multiple tendons. A rotator cuff tendinopathy is when a tendon in the shoulder has tiny tears in it or is inflamed causing pain.

The symptoms of a rotator cuff injury vary between acute and chronic. Acute injuries that often occur as a result of a fall or powerful movements usually begin as a “tearing” or “popping” sensation followed by intense pain and weakness especially when trying to lift your arm by your side.
A Chronic rotator cuff injury usually presents itself slowly with variable symptoms which become more evident as the injury progresses. Patients often report pain in the outer part of the upper arm and in the top of the shoulders occasionally. You might also notice some of the following:

  • Swelling and tenderness in the front of the shoulder
  • Reduction in the strength and mobility of the shoulder
  • Stiffness in the joint
  • Shoulder pain that increases with more shoulder movements especially overhead movements

If you present with some of these symptoms a rotator cuff tendinopathy is suspected.

What causes a Rotator cuff strain?

Rotator cuff injuries can happen suddenly from an insult such as falling, pushing, pulling lifting or throwing, but more commonly develop as a result of multiple factors including repetitive injury and age-related wear and tear. A rotator cuff tendinopathy is more likely to happen in the following situations:

  • A slumped posture
  • Repetitive overuse of your arms above your head
  • Prolonged or repetitive overuse of muscle-tendon over a short period of time

How is a Rotator cuff strain diagnosed?

The diagnosis of a rotator cuff injury will be based on the presenting symptoms and the completion of a complete physical examination which will include, orthopaedic, neurological and range of motion assessments which will determine severity of the rotator cuff injury and any problems it may be causing to the rest of the body.

Our practitioners will try and eliminate other possible diagnosis that may have similar presentations so that a correct diagnosis can be reached. They may suggest ultrasound scans which would identify any tendinopathies that may have developed and will better help you in your treatments.

How is a Rotator cuff strain treated?

There is no consensus on the most appropriate management for rotator cuff injuries, current research suggests that conservative care should be the first choice for most non-traumatic injuries. Physical therapy of rotator cuff injuries will aim to reduce pain and swelling of the tendons to achieve a normal range of motion and eventually strengthen the shoulder.

Another option that is considered is Injections that are carried out by our Sports Doctor. The most common injection that is performed for a rotator cuff tendinopathy is an ultrasound-guided injection. They are extremely effective in reducing pain that has not been improving with physical therapy and pain that wakes you up at night.

Most patients only require 1 course of injection with the aim to provide a window of opportunity to enable you to undergo physical therapy to restore and strengthen the rotator cuffs pain-free.


Aly, A. R., Rajasekaran, S., & Ashworth, N. (2015). Ultrasound-guided shoulder girdle injections are more accurate and more effective than landmark-guided injections: a systematic review and meta-analysis. Br J Sports Med, 49(16), 1042-1049.

Kibler WB, Chandler TJ, Pace BK. Principles of rehabilitation after chronic tendon injuries. Clinics in sports medicine. 1992 Jul;11(3):661-71.

Oh LS, Wolf BR, Hall MP, Levy BA, Marx RG. Indications for rotator cuff repair: a systematic review. Clinical Orthopaedics and Related Research®. 2007 Feb 1;455:52-63.

Kibler WB. Rehabilitation of rotator cuff tendinopathy. Clinics in sports medicine. 2003 Oct 1;22(4):837-47.

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