Rotator cuff syndrome

Table of contents

Rotator cuff syndrome: causes, symptoms & treatment of the shoulder

What is the rotator cuff?

The rotator cuff is a group of four muscles and their tendons that stabilise and move your shoulder joint. They are:

Supraspinatus
Infraspinatus
Teres minor
Subscapularis

Together they make sure that the head of your humerus stays securely in the socket and that you can move your arm with control.

The shoulder is the most mobile joint in the body, but that is exactly what makes it prone to problems. The rotator cuff therefore plays a central role in the balance between stability and mobility.

What is rotator cuff syndrome?

Rotator cuff syndrome describes various problems in the area of this muscle-tendon structure, for example:

Irritation or inflammation (tendinitis)
Wear (tendinosis)
Partial tears or complete tendon tears

These changes often arise in the so-called subacromial space, a narrow area under the shoulder roof where the tendons run. The supraspinatus is often especially affected.

Causes & risk factors

In most cases the problem does not arise suddenly, but over time through several factors:

Overload & repeated movements

Overhead work (e.g. trades, nursing)
Sports such as tennis, swimming or volleyball

Repeated movements can lead to small micro-injuries that add up over time.

Ageing

From about the age of 40, the load capacity of the tendons decreases
Poorer blood flow → less regeneration

Important: changes are common, even without pain.

Anatomical factors

Narrow space under the shoulder roof
Bone spurs or shape variants of the acromion
Instability in the shoulder joint

Acute injuries

Falling onto the arm
Sudden pulling load
→ can lead to partial or complete tears

Muscular imbalances

"Movement muscles" that are too strong (e.g. chest, shoulder)
Stabilising muscles that are too weak

This leads to unfavourable loading in the shoulder joint.

Typical symptoms of rotator cuff syndrome

The symptoms often develop gradually:

Pain when raising the arm (typically at 60–120°)
Radiating into the upper arm
Night pain (especially when lying on the shoulder)
Loss of strength in the arm
Restricted mobility

In everyday life, things like:

Getting dressed
Combing your hair
Reaching overhead

become increasingly difficult.

The course: why early treatment is important

Without treatment, the symptoms can get worse:

increasing pain
restricted function
possible tendon tears

Early therapy can influence the course clearly for the better and often avoid surgery.

What can you do yourself?

Acute: reduce pain

Take the load off the shoulder (no overhead movements)
Still: light movement in the pain-free range
Cool for acute pain (15–20 minutes)
Heat for chronic tension

Gentle mobilisation

Pendulum exercises:

Let your arm hang loosely and move it gently back and forth or in circles.

→ promotes blood flow & reduces stiffness

Adjust sleep & everyday life

Don't sleep on the affected shoulder
Support your arm when lying down
Reduce overhead work

Exercises for rotator cuff syndrome

Targeted training is one of the most important building blocks of therapy.

Early phase (isometric)

External rotation against a wall
Internal rotation against a wall
Press your arm lightly against resistance
→ hold for 5–10 seconds each, 10 repetitions

Build-up phase (with resistance)

External rotation with a resistance band
Internal rotation with a resistance band
Lateral raise (light weight)

→ 2–3 sets of 10–15 repetitions

Whole-shoulder exercises (Y-T-W)

They train overall shoulder stability:

Y position
T position
W position

→ especially effective for the rotator cuff and shoulder blade control

Mobility & stretching

Good mobility is crucial:

Chest stretch (against a rounded back)
Stretch for the back of the shoulder
Shoulder circles
Thoracic spine mobilisation

Goal: better biomechanics and less pressure on the tendons

Ergonomics & everyday tips

Small adjustments often make a big difference:

Screen at eye level
Elbows close to the body
Regular breaks
Avoiding overhead loading
Carrying loads close to the body

Good posture takes an enormous load off your shoulder in the long term.

How can physiotherapy help?

Targeted physiotherapy is one of the most important building blocks for shoulder problems.

Goals of treatment

Reduce pain
Improve mobility
Build strength and stability
Avoid recurrences

Therapy at KINEO: individual & evidence-based

1. Precise analysis

Mobility & strength
specific shoulder tests
Posture & movement patterns

2. Manual therapy

Joint mobilisation
Releasing tension
Improving tissue function

3. Active therapy (crucial!)

Individual training programme
targeted muscle building
Improving coordination

4. Complementary methods

Dry needling
Trigger point treatment
if needed, shockwave therapy

If you have pain in your shoulder or can no longer move your arm freely, it is worth acting early. Book your appointment at KINEO Physiotherapie now and start your way back to a strong, pain-free shoulder.

Our goal is not only to make you pain-free, but to let you fully load your shoulder again in everyday life and sport.