Rotator cuff tendinopathy
Rotator cuff tendinopathy is one of the most common causes of shoulder pain. It describes pain and reduced tolerance to load in the rotator cuff tendons (often the supraspinatus), sometimes with associated subacromial bursitis. The good news: most people improve with the right physiotherapy programme and a clear plan for gradually re‑loading the shoulder.
Typical symptoms
- Pain when lifting the arm, reaching overhead, or reaching behind your back
- Night pain (often worse lying on the affected side)
- Weakness or fatigue with repeated lifting
- Pain with gym movements like pressing, lateral raises or pull‑ups
Why it happens
Rotator cuff pain is usually a load‑tolerance issue. The tendon becomes sensitive when load spikes too quickly (new job, DIY, sport, heavier weights) or when the shoulder has been under‑loaded for a period and then suddenly asked to do more.
Assessment and diagnosis
We assess your movement, strength, neck contribution, and shoulder mechanics. Diagnostic ultrasound can evaluate the rotator cuff tendons and the subacromial bursa, identify calcific tendinopathy or tears, and guide injection treatment accurately where clinically appropriate.
Physiotherapy treatment (first‑line)
- Progressive strengthening: rotator cuff and scapular stabilisers
- Load management: modify painful activities while maintaining movement
- Technique coaching: pressing/pulling mechanics, posture and pacing
- Return‑to‑sport/work plan: staged increases in volume and intensity
When an injection might help
In selected cases (often with significant bursitis/inflammatory pain), an ultrasound‑guided cortisone injection may reduce pain enough to help you progress rehab. Injections are most effective when combined with physiotherapy, and we provide full consent and aftercare guidance.
When to seek urgent help
- Sudden inability to lift the arm after a traumatic injury
- Severe swelling, redness, fever or feeling unwell
- Progressive neurological symptoms (numbness/weakness) down the arm
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