Firstly what is a rotator cuff?

The rotator cuff is a group of four muscles that help move your upper arm, relative to your shoulderblade.  These muscles play an important part in rotation of the arm (obviously) and also help with the finer movements of the shoulder (less obviously).  These muscles turn in to tendon(s) which cover the top of the arm bone. These tendons are more commonly injured than the muscles

How do I know if I have a rotator cuff tendon injury?

There are numerous structures around the shoulder that can cause pain and reduce movement. The rotator cuff is one of the most common. Physiotherapists and doctors have a number of tests that can help narrow down the cause of your pain. Reduced movement and strength as well as pain on movement can be signs of a rotator cuff tendon. However these symptoms can be caused by a number of things.

What about an MRI?

MRI’s are very useful but normally its wise to seek a physiotherapists opinion first.  It can be a waste of money and a delay in time to get one before being assessed.  Frequently after getting an MRI, the advice is to go to your physiotherapist

So will I need surgery?

Physiotherapy can help all but the most severe of tears and should always be the first option.  Studies show up to 75% of tears in the rotator cuff get as good an outcome with physio compared to surgery and exercises vastly reduces the need for surgery. If surgery is needed, it is a quick procedure but a long recovery so best to avoid it if possible. Injections are possible should physiotherapy not be helping quickly enough.

 So what will the physio entail?

Key to your recovery will be exercises. The rotator cuff tendons, just like any other tendon respond well to strengthening at the right level.  If your shoulder has reduced movement, manual work on the shoulder may be needed to free it up. There may also be underlying cause for this injury, muscle imbalance, poor posture, etc and this should be addressed too.  Your physio should be able to prescribe appropriate exercises. With varying degrees of injury,  APPROPRIATE exercises are needed as some may aggravate the shoulder and others may be of no benefit.