Rotator Cuff Physio – Shoulder Pain Treatment & Rehab Guide

Rotator Cuff Related Pain is Common

Shoulder pain is one of the most frequent issues we treat as physiotherapists. It can make everyday activities like sleeping, driving, or even putting on a t-shirt painful and frustrating.

The most common cause of shoulder pain is rotator cuff–related pain. If you’re considering physiotherapy for a rotator cuff injury, this guide will explain the anatomy, causes, symptoms, treatment, and rehabilitation you can expect from a structured physio program.

Anatomy of the Rotator Cuff

Your shoulder is made up of three joints – the scapulohumeral (shoulder), acromioclavicular (collar bone), and scapulothoracic (shoulder blade). For your rotator cuff to function properly, all three must move well together.

The rotator cuff itself is a group of four muscles:

• Infraspinatus

• Supraspinatus

• Subscapularis

• Teres Minor

he long head of the biceps tendon is also closely related to the rotator cuff. The supraspinatus muscle is the most commonly affected, accounting for up to 70% of shoulder-related pain.

A fluid-filled sac called the subacromial bursa helps lubricate shoulder movement. When irritated, this can lead to bursitis, often linked to rotator cuff problems.

Symptoms of Rotator Cuff Injury

Rotator cuff pain is usually described as: – A dull ache in the shoulder and upper arm. – Sharp pain during sudden or overhead movements. – Stiffness or muscle spasm limiting shoulder motion. – Difficulty with reaching movements (e.g., lifting a handbag from the back seat, moving luggage).

If these symptoms sound familiar, rotator cuff physio can help reduce pain and restore strength.

Causes and Common Pathologies

Rotator cuff pain can stem from various conditions, the most common form of a rotator cuff tear is a suprapinsatus tear.

Other possible issues include:

• Subscapularis, infraspinatus, or teres minor tears

• SLAP tear (Superior Labrum Anterior Posterior)

• Frozen shoulder (adhesive capsulitis)

• Osteoarthritis of the ACJ or shoulder joint

• Shoulder dislocations or subluxations

• Calcific tendinopathy

A thorough shoulder physio assessment can help identify the root cause of your pain.

Examination and Diagnosis

Most rotator cuff injuries can be diagnosed clinically without scans. However, your physiotherapist may refer you for an ultrasound or X-ray if they suspect a larger tear that may need surgical opinion or they want to rule out less common shoulder conditions.

It’s important to remember: we treat the person, not just the scan. Your physio will correlate symptoms, clinical tests, and imaging to guide the best treatment approach.

Rotator Cuff Physio – Treatment & Rehabilitation

Most rotator cuff physiotherapy programs take 8–12 weeks, but the duration depends on your injury severity, goals, and lifestyle. A structured program usually includes four key elements:

1. Education

• Setting clear expectations around recovery timelines.

• Teaching safe vs risky shoulder movements.

• Learning strategies to adapt movements and reduce pain.

2. Hands-On Manual Therapy

• Massage, dry needling, joint mobilisations, or acupuncture.

• Helps reduce pain and improve shoulder mobility in early rehab.

3. Taping & Bracing

• Used when pain levels are too high for exercise.

• Supports the shoulder and reduces strain on damaged tissues.

4. Exercise Rehabilitation

• Progressive strengthening and mobility training.

• Focuses on restoring full range, endurance, and stability.

• Exercises are tailored to keep pain minimal and manageable.

Outcome Measures in Rotator Cuff Physio

Limb Symmetry Index (LSI)

Measures shoulder strength using a dynamometer, comparing the injured side to the healthy side. A score close to 100% shows good recovery.

BABER Test

Assesses strength, endurance, and motor control by balancing a 2kg ball during shoulder movement.

Patient-Specific Goals

Your satisfaction matters most. The Patient Specific Functional Scale (PSFSQ) measures how well you’ve returned to activities that matter to you.

Discharge and Risk of Re-Injury

Once rehabilitation is complete, your physio will advise on reducing re-injury risk. Generally, if your shoulder is strong, mobile, and conditioned to your activities or sport, your re-injury risk remains low.

Why You Should Choose Link Health and Fitness

We have experienced senior clinicians with one of the best equipped facilities on Auckland’s North Shore. We are part of several ACC programs, and you may be eligible to receive fully subsidised healthcare for your injury. To find out more don’t hesitate to book online or contact us on 09 5536565.