Update date: 10 March 2026
Publish date: 6 March 2026
Read in: 13 min
Rotator cuff injury is one of the potential causes of shoulder pain. Depending on the severity of the condition, treatment takes the form of rehabilitation under the supervision of a physical therapist or surgery. Find out what can cause damage to the rotator cuff of the shoulder, what the symptoms of the injury are, how it is diagnosed, and all the methods of treatment.
Contents
The rotator cuff (commonly known as the shoulder rotators) is the name given to a group of four muscles: supraspinatus, infraspinatus, teres minor, and subscapularis, and their tendons, which connect the scapula to the head of the humerus and surround the glenohumeral joint, forming a cone around it – hence the name “rotator cuff.”
The main task of these structures is to stabilize the head of the humerus in the glenoid cavity of the scapula and enable arm movements.
The causes of rotator cuff damage can be divided into chronic and acute.
Chronic (degenerative) causes include any chronic overloading of the shoulder structures. This group includes many years of working with the arms raised above the head, which reduces blood flow in the tendon areas most susceptible to degeneration and causes osteophytes (pathological bone growths) to appear in the subacromial space.
Acute causes include:
The various mechanisms of damage to the shoulder rotator cuff are often interrelated. A tendon that is damaged may already be in the process of degeneration, and mechanical injury will exacerbate the problems.
There are many factors that increase the risk of rotator cuff damage, including:
The injury mainly manifests itself as pain in the shoulder area – most often dull and felt deep in the shoulder joint. The symptoms appear or intensify when raising the arm, working with the arms above the head, reaching behind the back, or sleeping on the injured side.
There may also be limited mobility. The patient may have difficulty raising their arm to the side or front and reaching behind them.
Another characteristic symptom is muscle weakness, especially in the shoulder girdle muscles and those responsible for abduction or rotation of the arm.
Symptoms vary, and their severity depends on the patient’s subjective pain perception and previous history of injuries. It is also worth remembering that the degree of damage or structural changes to the rotator cuff tendons does not directly translate into noticeable symptoms. This is why some people, despite existing rotator cuff damage, may not experience any significant symptoms at all.
Choose reliable diagnostics and comprehensive physiotherapy.
In order to diagnose the cause of shoulder pain, the patient visits a physiotherapist or orthopedic surgeon. During the consultation, the physiotherapist/orthopedist conducts an interview and physical examination, which consists of:
Based on the results of the physical examination, further diagnostics are ordered, such as an ultrasound, X-ray, or MRI.
Ultrasound is indicated when physical examination and specialized tests show damage to the rotator cuff. The test has good sensitivity for complete injuries, but is less accurate for partial injuries.
X-rays can help rule out other causes of shoulder pain: fractures, bone changes, degeneration, osteophytes, or changes in the acromion.
MRI (magnetic resonance imaging) is recommended when:
Based on the diagnostic measures and test results, the doctor will present possible forms of treatment for the injury. When choosing a course of treatment, it is important to remember that the extent of the damage is not always proportional to the degree of pain felt. Sometimes patients live with untreated rotator cuff damage because they feel no pain or only negligible pain.
In the case of non-acute tendon damage (tendinopathy and enthesopathy), conservative treatment with a physical therapist is used.
Physical therapy plays a key role in the treatment of shoulder pain. If the damage does not qualify for surgical treatment, the physical therapist develops a therapy plan to restore the patient’s fitness. Its main goals are:
In patients with diagnosed rotator cuff tendinopathy, it usually takes 6 to 12 weeks to get rid of the pain and restore shoulder joint function. However, the length of treatment depends on the extent of the damage, the patient’s overall health and activity level, and the nature of the changes (chronic or acute).
If there has been an acute injury or damage to the rotator cuff tendons, and the symptoms experienced by the patient are reflected in the test results, the doctor will probably recommend surgical treatment. Rehabilitation is necessary after the operation.
At NAMI Medical Resort and Clinic, we work with patients after surgery, helping them regain their former fitness. We also focus on prehabilitation, i.e., working with a physical therapist even before the planned surgery. A proper diet, stress reduction, exercise, and appropriate treatments can comprehensively strengthen the patient’s overall health, thereby supporting the body’s natural ability to regenerate, better tolerate the procedure, and undergo rehabilitation more efficiently.
Conservative treatment should be carried out under the supervision of a specialist. An experienced physiotherapist will properly guide the rehabilitation of rotator cuff injury and manage the load on the shoulder in a controlled manner. They will also analyze the individual characteristics and situation of the patient and select an appropriate exercise program for rotator cuff injury that will strengthen the shoulder girdle.
Ask your doctor about what medications you can take for rotator cuff injury. Pharmacotherapy recommended by a specialist (not used on your own) can help relieve pain and thus speed up rehabilitation, as you will be able to use more weight during exercises.
An important part of prevention and treatment of the condition is also modifying daily activities. Avoid repetitive overhead movements and heavy lifting, and do not forget to warm up the entire shoulder girdle before sports activities.
At NAMI, we will take care of not only your shoulder, but your entire body. We believe in the power of holistic medicine and take a comprehensive approach to patient health. We have all the necessary facilities for the rehabilitation of rotator cuff injuries. We work with athletes and people who are not very physically active on a daily basis. Our physical therapists focus on finding the cause of the problem and select a therapy that not only relieves pain but also prevents recurrence of the condition.
If necessary, treatment may also include dedicated procedures. During the orthopedic medical program, you will also take care of your diet and soothe your nervous system. Comprehensive health support during rehabilitation gives the best results. In this way, we will also prepare you for the best possible outcome of the surgery. Start working with a specialist even before the planned procedure.
NAMI Medical Resort and Clinic exclusively offers medical programs.
Physiotherapy, treatments, preparation for surgery, and comprehensive support for the body.
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