Shoulder Pain? Understanding Your Rotator Cuff

If you’ve ever felt a sharp "tweak" in your shoulder while reaching for a seatbelt, or a dull ache that keeps you awake at night, you’re likely dealing with your Rotator Cuff.

At Dr Zo The Physio, we see shoulder injuries daily. Because the shoulder is the most mobile joint in the body, it relies heavily on a specific group of muscles to stay stable. When these muscles aren't happy, even simple tasks like brushing your hair can feel like a marathon.

What is the Rotator Cuff?

Many people think of the rotator cuff as a single muscle, but it’s actually a team of four muscles that surround the shoulder joint like a "cuff" on a sleeve. Their job is to pull the head of your arm bone (humerus) firmly into the shallow socket of your shoulder blade.

The four key players are:

1. Supraspinatus: Helps lift your arm out to the side (the most commonly injured).

2. Infraspinatus: Rotates your arm outward.

3. Teres Minor: Also assists with outward rotation.

4. Subscapularis: Rotates your arm inward.

How Do These Injuries Happen?

Rotator cuff issues generally fall into two categories:

• Acute Tears: Usually caused by a sudden fall on an outstretched hand or lifting something too heavy, too quickly.

• Overuse/Tendinopathy: These develop over time due to repetitive overhead reaching, heavy lifting, or age-related changes. This is often what people mean when they say they have "shoulder impingement."

  
  

The Warning Signs

How do you know if your rotator cuff is the culprit? Look for these "Red Flags":

• The "Arc" of Pain: Pain that is worst when your arm is halfway up (between 60 and 120 degrees).

• Night Pain: Inability to sleep on the affected side.

• Weakness: Feeling like you can’t hold a cup of coffee out in front of you.

• Referred Pain: A dull ache that travels down the outside of your arm, sometimes as far as the elbow.

Why "Rest" Isn't Always the Answer

A common mistake is to stop moving the shoulder entirely. While we want to avoid "poking the bear" (aggravating the pain), complete rest can lead to a reduction in range of movement

In physiotherapy, we use a "Load Management" approach. We find the "Sweet Spot"—the amount of movement that keeps the tendon healthy without making the inflammation worse.

Phase of Recovery	Goal	Common Exercise
Phase 1: Protection	Calm the inflammation.	Pendulum swings & Isometric holds.
Phase 2: Strength	Build the "Cuff" capacity.	External rotation with resistance bands.
Phase 3: Function	Return to sport/work.	Overhead pressing & Plyometrics.

3 Tips for a Healthier Shoulder

1. Check Your Mid-Back: If your upper back (thoracic spine) is stiff and hunched, your shoulder blade can’t move properly, which pinches the rotator cuff. Stand tall!

2. The "Scapular Set": Before lifting anything, gently draw your shoulder blades back and down "into your back pockets."

3. Sleep Support: If you have shoulder pain at night, try sleeping on your back with a pillow tucked under your arm to support the joint.

Let's Get You Moving Again

At Dr Zo The Physio, we don't just treat the pain; we look at the whole kinetic chain—from your posture to your grip strength—to ensure your shoulder stays strong for the long haul. Why not book an appointment or get a free 15 minute phone call to discuss your problem?