The shoulder is the most mobile joint in the human body—but with that mobility comes a higher risk of injury. At the core of shoulder stability is the rotator cuff, a group of muscles and tendons essential for lifting, reaching, and rotating the arm.
Rotator cuff injuries are one of the leading causes of shoulder pain, particularly in
people over 40, athletes, tradies, and anyone performing frequent overhead activities. With early diagnosis and the right treatment plan, many patients return to full function—whether through non-operative care or surgical repair.
What Is the Rotator Cuff?
The rotator cuff consists of four key muscles and their associated tendons:
- Supraspinatus
- Infraspinatus
- Subscapularis
- Teres minor
These muscles stabilise the shoulder joint and enable controlled arm movement. Injuries to the rotator cuff can range from inflammation and degeneration (tendinopathy) to partial or full-thickness tears.
📊 Clinical Insight: Studies estimate that rotator cuff tears affect 20–30% of adults over age 60, and that rate increases with age [1].
Causes of Rotator Cuff Injury
- Degenerative wear and tear (age-related tendon breakdown)
- Acute trauma, such as a fall or lifting a heavy load
- Repetitive strain, especially in athletes or manual workers
- Subacromial impingement, where tendons are compressed under the acromion (part of the shoulder blade)
Symptoms of Rotator Cuff Injury
- Dull or aching pain in the shoulder
- Pain that worsens at night or when lying on the affected side
- Difficulty lifting the arm or reaching overhead
- Weakness when rotating or lifting objects
- Clicking or catching sensations with movement
Symptoms may develop gradually or follow a specific injury. Left untreated, rotator cuff tears can worsen, affecting shoulder stability and long-term function.
Diagnosing a Rotator Cuff Injury
The first step is a clinical assessment by an orthopaedic surgeon. Dr Ryan du Sart evaluates:
- Shoulder range of motion
- Strength and function
- Pain with specific movements
Imaging May Include:
- Ultrasound – to assess tendon integrity
- X-ray – to detect bone spurs or joint narrowing
- MRI – for detailed evaluation of tendon tears or degeneration
📈 Best Practice: Imaging helps differentiate between tendinopathy, partial tears, and complete tendon ruptures, guiding the most appropriate treatment plan [2].
Treatment Options
Non-Surgical Management
Many rotator cuff injuries—particularly tendinopathy or partial tears—can be managed successfully without surgery.
Conservative treatment may include:
- Activity modification to avoid aggravating movements
- Physiotherapy to restore strength and shoulder mechanics
- Anti-inflammatory medication or pain relief
- Corticosteroid injections for short-term inflammation and pain control
These measures are often effective in improving function and reducing pain in less severe injuries.
Surgical Treatment
Surgery may be recommended when:
- There is a
full-thickness tear or significant tendon damage
- Symptoms do not improve with conservative care
- There is functional weakness or loss of motion affecting daily life
- The tear is acute and linked to trauma in younger, active patients
Surgical options include arthroscopic rotator cuff repair, where small incisions and a camera are used to visualise the shoulder and reattach the torn tendon to the bone. This minimally invasive technique reduces soft tissue disruption and promotes faster healing compared to traditional open surgery.
Dr du Sart will guide you through the surgical decision-making process and ensure the approach is tailored to your specific goals and lifestyle.
Recovery After Surgery
Recovery from rotator cuff surgery is a gradual process and involves several phases:
Weeks 0–6:
- Immobilisation with a sling
- Early
passive movement under physiotherapy supervision
- Pain relief and wound care
Weeks 6–12:
- Begin
active range of motion exercises
- Restore flexibility and shoulder mechanics
- Start gentle strengthening work
Months 3–6:
- Return to light work or daily activities
- Continued strengthening and functional retraining
- Return to sport or overhead work by
6 months, depending on healing and activity level
📊 Evidence-Based Insight: A 2022 meta-analysis reported over 85% success rates for arthroscopic rotator cuff repairs, especially when physiotherapy is properly followed [3].
Shoulder Care Close to Home
Dr Ryan du Sart offers comprehensive care for shoulder injuries, from diagnosis through to post-operative rehabilitation. Whether you’re dealing with new shoulder pain or have been managing ongoing symptoms, expert assessment can help clarify your options and restore your shoulder health.
📞 (08) 9779 9767
🌐
www.ryandusart.com.au
📍 South Bunbury & Busselton, WA
References
- Yamamoto A, Takagishi K, et al.
Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010;19(1):116–120.
- Seitz AL, et al.
Clinical practice guidelines for the management of rotator cuff disorders. Br J Sports Med. 2019;53(6):305–310.
- Saccomanno MF, et al.
Clinical outcomes and retear rates after rotator cuff repair using a single-row vs double-row technique: a meta-analysis. J Shoulder Elbow Surg. 2022;31(2):351–362.
