Most rotator cuff pain improves with progressive loading, including many tears. We work out what your shoulder can tolerate and build from there.
The rotator cuff is four muscles that hold the shoulder joint centred while the arm moves. Pain here is usually described as rotator cuff related shoulder pain, an umbrella covering tendon overload, impingement-type symptoms and partial tears, because those overlap heavily and respond to similar treatment.
Cuff tears are far more common than most people expect, and a large share of people over 60 have one with no symptoms at all. A tear on a scan does not automatically explain the pain, which is why examination matters more than imaging here.
Common symptoms:
Progressive loading is the primary treatment and the evidence is strong. Trials comparing structured exercise with surgical decompression for cuff related pain have repeatedly found no meaningful difference in outcome, which is why a genuine course of rehab comes first in almost every case.
We load the cuff and the surrounding shoulder in positions you can tolerate, then expand the range as capacity grows. Where a large traumatic tear in a younger arm is suspected, we say so and support the referral rather than delaying it.
Shoulders respond to patient, progressive loading. Here is how the course usually runs.
We test the cuff, the joint and the neck, and establish what your shoulder can currently do, so the starting load is measured rather than guessed.
Sleeping positions, overhead activity and isometric loading are addressed first, because night pain is usually what people most want gone.
Graded strengthening through increasing range is the core of treatment, typically over three months or more, since tendon and muscle adapt slowly.
We rebuild towards lifting, throwing, racket sport or work at height, and leave you with the maintenance work to keep it there.
Not sure whether your shoulder needs rehab or an opinion on surgery? Book a free discovery call and we will talk through where you are.
Book a Free Discovery CallA torn tendon does not usually knit back together, but shoulders with tears frequently become pain-free and strong with loading, because the remaining cuff and the surrounding muscles take up the work. Many people function well for years with a known tear.
Usually not to start. Scans find cuff changes in a high proportion of people with no symptoms, so an unexpected finding can mislead. We image where a large traumatic tear or another specific diagnosis is suspected.
Meaningful change usually takes three months or more of consistent loading. Improvements in night pain often come sooner, within a few weeks.
Lying on the shoulder compresses the cuff and reduces blood flow to an already irritable tendon. Position changes and early loading usually improve this before daytime pain settles.
Frozen shoulder restricts movement in every direction, including when someone else moves your arm for you. Cuff problems are usually painful in specific directions with range largely preserved.
Rarely completely. Load is usually modified rather than removed, since the shoulder needs strength work to recover.
Book a thorough assessment in Uckfield and we will establish what your shoulder can tolerate and build from there.
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