Conditions we treat
Rotator Cuff Injury
Reviewed by Andrew Macdonald, Senior Physiotherapist — AHPRA registered, APA member
What is a Rotator Cuff Injury?
The rotator cuff is a group of four muscles and tendons that stabilise the shoulder joint and control its movement. Injuries range from irritation and inflammation (tendinopathy) through to partial or full-thickness tears, and can result from a single traumatic event (like a fall) or from repetitive overhead activity that gradually wears the tendon down.
Symptoms
Common signs include pain when lifting the arm overhead or reaching behind your back, weakness with certain movements, a dull ache deep in the shoulder, and pain that disturbs sleep, particularly when lying on the affected side.
Treatment
Most rotator cuff injuries, including many partial tears, respond well to conservative physiotherapy without needing surgery. Andrew’s assessment identifies which structures are involved and how severe the injury is, then builds a treatment plan combining manual therapy, dry needling and soft tissue work to manage pain, with a graded strengthening programme to restore the rotator cuff’s capacity to stabilise the shoulder. Shockwave therapy is often useful for chronic tendinopathy that hasn’t responded to rest alone.
If imaging shows a significant full-thickness tear or symptoms aren’t improving with conservative treatment, Andrew will discuss whether a specialist referral is appropriate.
How we treat it
Treatments used for rotator cuff injury
Manual TherapyManual therapy uses hands-on techniques — soft tissue work, trigger point therapy, joint mobilisation and fascia distortion release — to ease pain, restore movement and speed recovery.
Dry NeedlingDry needling uses thin, sterile needles to release tight, overactive trigger points in muscle — a Western, evidence-based technique distinct from traditional acupuncture.
Shockwave TherapyShockwave therapy uses focused acoustic pulses to stimulate healing in chronic tendon conditions that haven't responded to other treatment, such as Achilles tendinopathy, tennis elbow and plantar fasciitis.Frequently asked questions
How do you know if you've torn your rotator cuff?
Common signs include pain when lifting your arm overhead or reaching behind your back, weakness with certain movements, a deep ache in the shoulder, and pain that disturbs sleep — particularly lying on the affected side. A physiotherapy assessment can determine which structures are involved and how severe the injury is.
Does a rotator cuff tear need surgery?
Not always — most rotator cuff injuries, including many partial tears, respond well to conservative physiotherapy. Surgery tends to be considered for significant full-thickness tears or when symptoms aren't improving with appropriate conservative treatment, and that decision is best made with a proper assessment first.
Can physiotherapy fix a rotator cuff tear?
For many rotator cuff injuries, yes — physiotherapy combining manual therapy, dry needling and a graded strengthening programme can restore the shoulder's stability and function without surgery. Shockwave therapy is also useful for chronic tendinopathy that hasn't responded to rest alone.
How long does it take to recover from a rotator cuff injury?
Recovery timeframes vary widely depending on the severity of the injury and whether surgery is involved, ranging from several weeks for milder tendinopathy to months for a significant tear. Andrew builds a staged plan with clear milestones so progress is tracked properly rather than guessed at.
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