Shoulder pain is one of the most common issues we treat in the clinic—and one of the first questions patients tend to ask is, “Is it my rotator cuff?” It’s a fair question, especially given how often the rotator cuff is involved in both acute and chronic shoulder conditions. Whether you’re dealing with a recent injury or unexplained discomfort, understanding what the rotator cuff is and how it works can help you make informed decisions about your care.
What Is the Rotator Cuff?
The rotator cuff is a group of four muscles and their tendons that surround the shoulder joint. These muscles originate on the shoulder blade and attach to the top of the upper arm bone (humerus), helping stabilize the shoulder and support movements like lifting, reaching, and rotating your arm.
Think of the rotator cuff as your shoulder’s support team. It keeps the ball of your upper arm bone securely in the socket while you move your arm. When the rotator cuff is working properly, you don’t notice it. But when something goes wrong—whether from a traumatic injury, repetitive stress, or age-related wear and tear—you’ll likely feel it every time you reach overhead, roll over in bed, or put on a jacket.
Common Causes of Rotator Cuff Tears
Rotator cuff injuries can happen for a number of reasons, including:
- Trauma: A fall on your outstretched arm or a sudden jerking motion during lifting can result in a tear.
- Overuse: Repetitive arm movements—especially in sports like tennis, baseball, or swimming, or in jobs that involve frequent overhead work—can wear down the tendons over time.
- Degeneration: As we age, tendons naturally become weaker and more prone to injury. Rotator cuff degeneration is especially common in adults over 40.
Signs You Might Have a Rotator Cuff Tear
If you’re wondering whether your shoulder pain could be due to a rotator cuff tear, here are some symptoms to watch for:
- Pain at rest or at night, particularly when lying on the affected shoulder
- Discomfort when lifting your arm, especially overhead
- Pain that radiates from the shoulder into the upper arm
- Difficulty reaching behind your back or brushing your hair
- A clicking, grinding, or catching sensation when moving your shoulder
- Weakness or inability to lift or rotate your arm fully
Some people experience sudden symptoms after an obvious injury, while others notice a gradual buildup of discomfort over time. Either way, it’s important not to ignore signs that are getting in the way of daily movement or sleep.
Do All Tears Require Surgery?
Not necessarily. In fact, research shows that about 80% of people with partial rotator cuff tears do well with conservative, nonsurgical treatment. The best approach often depends on the size and location of the tear, your age, activity level, and how long the symptoms have been present.
Small or partial tears can often heal with rest and focused rehabilitation, especially when caught early.
Non-Surgical Treatment Options
For most mild to moderate rotator cuff injuries, a non-operative plan is a great first step. Treatment may include:
- Activity modification to reduce stress on the injured tendon
- Anti-inflammatory medications (NSAIDs) to reduce pain and swelling
- Steroid injections for short-term relief in more inflamed cases
- Physical therapy, which is the cornerstone of long-term recovery
At PhysioPoint, our physical therapists will evaluate your shoulder function and tailor a rehab program to your specific needs. That might include exercises to improve shoulder stability, posture correction, manual therapy to reduce stiffness, and gradual return-to-activity protocols. We’ll also help you avoid positions or movements that worsen your pain, giving your shoulder the best chance to heal.
When Is Surgery Needed?
Surgical intervention may be considered if:
- Conservative care doesn’t relieve symptoms after several months
- You have a full-thickness tear that severely limits function
- Your pain is constant and affecting sleep or daily life
- The tear is worsening or affecting adjacent structures in the shoulder
Surgery usually involves repairing the torn tendon with sutures or anchors. Recovery includes a period of rest followed by guided rehab to rebuild strength and motion.
When to See a Physical Therapist
If you’re experiencing persistent shoulder pain or suspect a rotator cuff injury, don’t wait to seek help. Early intervention makes a big difference in preventing further damage and speeding up recovery. A physical therapist can help determine whether the pain is related to the rotator cuff or something else entirely—like the joint capsule, biceps tendon, or even your neck.
We’re here to assess your shoulder, create a custom treatment plan, and help you return to the activities you enjoy—whether that’s sports, work, or simply reaching for a coffee cup without discomfort.
