Rotator Cuff Injury: What’s Going On In Your Shoulder and What To Do About It

Your shoulder is the most mobile joint in your body. That freedom of movement is great until something goes wrong, and when it does, the rotator cuff is usually involved. Rotator cuff injuries are some of the most common shoulder problems we see at Basham Chiropractic, affecting athletes, tradies, office workers, and everyone in between.

What is the rotator cuff?

The rotator cuff is a group of four muscles that wrap around the ball of your upper arm bone (humerus) and hold it into the shallow socket of your shoulder blade (scapula). Unlike your hip, which is a deep ball-and-socket joint, your shoulder relies heavily on these four muscles to stay stable while allowing a huge range of movement.

Rotator cuff injury symptoms

The symptoms depend on the type and severity of the injury, but the most common signs include:

Pain when your arm is at or above shoulder height. This is the classic sign. Reaching up to a shelf, throwing a ball, or even washing your hair can become painful.

Weakness when lifting or reaching. You might notice your arm feels heavy, or you can’t hold things at arm’s length the way you used to.

Pain lying on the affected side. Many people with rotator cuff injuries struggle to sleep comfortably, especially if they’re a side sleeper.

A catching or clicking sensation in the shoulder during certain movements.

The most common rotator cuff injuries

Impingement syndromes. The tendons of the rotator cuff get pinched between the bones of the shoulder during overhead movements. This causes pain and inflammation, and over time can lead to more serious damage.

Rotator cuff tendinopathy. The tendons become irritated and weakened, usually from repetitive overuse. This is common in swimmers, throwing athletes, and people whose work involves a lot of overhead activity.

Rotator cuff tears. These can be partial or full thickness, and they can happen suddenly from a fall or heavy lift (acute), or develop gradually over time (chronic). Smaller tears can often be managed conservatively. Larger tears sometimes require surgical evaluation.

What causes rotator cuff injuries?

The causes vary, but the most common factors include lifting heavy objects (especially overhead), direct trauma or falls, poor scapular control, a slouched or forward posture that narrows the space in the shoulder, muscular imbalances between the chest and back, repetitive overhead movements, and general wear and tear over time.

How we assess and treat rotator cuff injuries

Getting the right diagnosis is the first step. We use a combination of orthopaedic tests, movement assessment, and clinical reasoning to identify which structure is involved and how severe the injury is. In some cases, we may refer for imaging (ultrasound or MRI) to confirm the diagnosis.

Once we know what we’re dealing with, treatment focuses on four things: restoring full range of motion to the shoulder, developing proper scapular function, strengthening the rotator cuff muscles, and correcting any postural issues that are contributing to the problem.

Treatment typically includes manual therapy, dry needling, soft tissue work, and a progressive rehabilitation program. The rehab component is where the long-term results come from.

For more severe tears or cases that aren’t responding to conservative care, we’ll refer you for a surgical opinion. But many rotator cuff injuries, even some tears, can be successfully managed without surgery when the rehab is done properly.

Don’t wait on shoulder pain

Shoulder injuries have a habit of getting worse when you ignore them. The compensations your body creates to avoid pain often lead to new problems in the neck, upper back, or the other shoulder. If your shoulder is limiting what you can do, come in and let us have a look.