Understanding It
What Is Going On
The rotator cuff is a group of four muscles and their tendons that hold the ball of the shoulder joint centred in its shallow socket and control movement of the arm.
Most shoulder pain involves these tendons: irritated, overloaded, degenerative, or partially torn. Related problems include bursitis, where the fluid-filled sac that cushions the tendons becomes inflamed, and impingement, where structures are compressed as the arm lifts.
Tendon changes on a scan are extremely common in people over 50 who have no pain at all, so imaging findings need to be interpreted alongside symptoms rather than on their own.
How does it usually present?
- Pain on the outside or front of the shoulder, sometimes referring down the upper arm
- Pain reaching overhead, behind the back, or out to the side
- Difficulty sleeping on the affected side: often the most disruptive symptom
- Weakness lifting or carrying
- A painful arc partway through raising the arm
- Clicking or catching sensations
- Gradual onset, or onset after a specific lift or fall
When to Act
When to Seek Help
See a physiotherapist if pain persists beyond two to three weeks, is disturbing sleep, or is limiting work or activity.See your GP or a physiotherapist promptly if you cannot lift your arm at all after a fall or injury, or you have significant sudden weakness: this may indicate a substantial tear.
Seek emergency care immediately if you have:
- Shoulder or arm pain with chest tightness, shortness of breath, sweating or nausea — this can indicate a cardiac event and needs urgent assessment
- An obvious deformity of the shoulder after injury — which may indicate dislocation or fracture
- A red, hot, swollen shoulder with fever — which may indicate joint infection
Causes & Risk
What Causes It and Who Is at Risk
Common contributors include repetitive overhead activity at work or in sport, a sudden increase in load or training, a fall onto an outstretched arm, and age-related tendon change. Risk rises with age, diabetes, smoking, and previous shoulder injury.
Frozen shoulder is a distinct condition with a different course: see our frozen shoulder page if your main problem is stiffness rather than pain on movement.
How We Help
How Our Team Can Help
Our physiotherapists assess which structures are involved, how the shoulder blade and neck are contributing, and what load the tendon is currently tolerating. Rotator cuff problems generally respond to progressive loading, and the skill is in pitching that load correctly and progressing it at the right rate.
Physiotherapy
Hands-on treatment to reduce pain, a structured exercise program targeting the cuff and shoulder blade muscles, activity and sleep position advice, and guidance on returning to work or sport.
Osteopathy
Also treats shoulder complaints with manual therapy and graded loading, alongside physiotherapy.
Remedial Massage
May be used alongside where muscular tension is a significant contributor.
Where the presentation suggests a significant tear or another problem requiring imaging or specialist review, we refer back to your GP.
Starting Out
What to Expect at Your First Appointment
Your clinician will ask how it started, what movements hurt, and how it is affecting sleep and daily activity. They will examine shoulder and neck movement, test the rotator cuff muscles, and screen for the warning features above.
You will receive an explanation, initial treatment, and a home program. Rotator cuff rehabilitation usually takes months rather than weeks, and your clinician will be upfront about that timeframe.
Ready to book?
Ready to get started?
Contact inOne Healthcare on 1300 765 456 or submit a referral online. Shoulder pain is most commonly managed by our Physiotherapy and Osteopathy teams.
info@inonehealthcare.com.au
Flexible Options
Funding we accept.
Medicare
A GP Chronic Condition Management Plan may allow up to five rebated services per calendar year, with a gap payment.
TAC
For shoulder injuries following a Victorian transport accident.
NDIS
Where shoulder problems relate to a funded disability.
Support at Home
For older Australians, within the fully funded clinical care category.
Private
No referral required.
Free 20min Consultation
Unsure what support you need, or have funding enquiries? Book a free 20-minute telehealth consultation with our team.