Rotator cuff injury: causes, symptoms and treatment
A clinically reviewed guide to rotator cuff problems — from tendinopathy to tears, and how they are treated.
Medically reviewed by D.C Matt · Lead Director
Last reviewed 1 July 2026
- The rotator cuff is four muscles that stabilise and move the shoulder.
- Problems range from tendon irritation to tears.
- Most cases, including many tears, respond to exercise-based care.
What is a rotator cuff injury?
A rotator cuff injury is damage or irritation to the tendons that stabilise the shoulder, ranging from tendinopathy to partial or complete tears.
The rotator cuff keeps the ball of the shoulder centred in its socket during movement. Overload, age-related change or injury can irritate or tear these tendons.
What are the symptoms of a rotator cuff injury?
Typical symptoms are pain when lifting or reaching, weakness, and pain at night, especially lying on the shoulder.
- Pain raising or reaching overhead
- Weakness lifting or rotating the arm
- Night pain, especially lying on the shoulder
- Difficulty with tasks like reaching behind the back
How is a rotator cuff injury treated?
Most rotator cuff problems are treated with a progressive strengthening programme and manual therapy, which is effective even for many tears.
Exercise is first-line for tendinopathy and many tears. Shockwave therapy may help certain calcific tendon problems. Surgery is considered for selected significant tears, particularly after injury in younger people.
The Postura approach
At Postura Wellness, care for rotator cuff injuries is built around OrthoRestore™ — our signature method that combines chiropractic and physiotherapy into one coordinated plan. Depending on your assessment, it can bring together chiropractic adjustments, dry needling, muscle manipulation, Active Release Technique, and targeted exercises, supported where helpful by technology such as shockwave therapy and bioelectric therapy. The aim is to relieve symptoms while addressing the underlying causes, with a plan tailored to you.
When to seek assessment
Sudden weakness or inability to lift the arm after an injury may indicate a significant tear and should be assessed promptly.
Sciatica FAQs
Do all rotator cuff tears need surgery?
No. Many tears, especially age-related ones, respond well to a structured exercise programme. Surgery is considered for selected cases.
How long does a rotator cuff injury take to heal?
Tendon irritation often improves over several weeks to months with exercise. Recovery depends on the severity and type of injury.
Why is my rotator cuff pain worse at night?
Lying on the shoulder loads the tendons and removes daytime distraction, which is why night pain is common.
Can physiotherapy help a rotator cuff injury?
Yes. A progressive strengthening programme is the first-line treatment for most rotator cuff problems.
This guide is informed by patient information from accredited medical institutions:
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