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Rotator Cuff Injuries

The rotator cuff is a group of muscles and tendons that surround the shoulder joint, keeping the head of your upper arm bone (humerus) firmly within the shallow socket of the shoulder. 30% of people will experience shoulder pain in their lives. A rotator cuff injury can cause a dull ache in the shoulder which can radiate down to the arm. The pain can be sharp on certain movements and is often worsens when you try to sleep on the involved side. A rotator cuff injury can make it difficult and painful to do everyday tasks, such as brushing your hair and getting dressed.

Injuries that can occur in the Rotator cuff:

1. Tendinopathy

The tendons connect muscle to bone and often connect near a joint. When a tendon is subjected to a sudden increase or change in load, this can result in changes to the tendon’s structure such as swelling or thickening. When this happens the tendons are no longer able to repair themselves properly and over time, the tendon can become very painful and less able to tolerate normal activities and can make it difficult to move the arm. It’s usually due to wear and tear of your rotator cuff over time.

2. Rotator cuff Tear

Rotator cuff tears occur most often in people who repeatedly perform overhead motions in their jobs or sports (e.g. painters, carpenters, or people who play baseball or tennis). They can also occur by falling on an outstretched arm or sudden lifting movements particularly when carrying load. The risk of a rotator cuff tear increases with age and degenerative tears can occur as a result of wear and tear as a normal part of the aging process.


• Many people recover from rotator cuff tendinopathy and small tears with physiotherapy exercises that improve flexibility and strength of the muscles surrounding the shoulder joint. In the early stage of tendonitis, anti-inflammatory medication and simple painkillers may help, in addition to modifying daily activities to avoid excessive or repetitive lifting of the arm.
• Aqua therapy is a great adjunct to your rehabilitation here as you can work the muscles to strengthen them while keeping load off the tendon allowing it to recover. In the initial stages of rehabilitation it can be painful moving your arm, but the heat and hydrostatic pressure from the pool can make this movement much easier and help you progress quicker.


With an acute tear you may require surgical repair. Depending on the severity of your tear, your surgeon may recommend one of the following procedures:

1. Open Repair: If your tear is particularly complex or large, your surgeon will likely choose this option to fully detach the shoulder muscle and better see the torn tendon. Bone spurs are usually removed and additional reconstruction may be performed.
2. Arthroscopic Repair: Using a small camera in your shoulder through a small incision, instruments are used to repair the tear. This method is less invasive and usually means quicker recovery.
3. Mini-Open Repair: With a 3 to 5 centimetre incision, an arthroscope is used to remove bone spurs and treat damage. After this portion of the procedure, the rotator cuff is repaired via the incision while viewing sutures directly (without a camera).

After Surgery

Making a full recovery and being able to resume your usual activities can take between four to six months. You should follow the guidelines set out by your surgeon.

Hydrotherapy following Shoulder surgery

There are many benefits for the early use of aquatic Physiotherapy following shoulder surgery. The buoyancy effect allows normal active shoulder movements with reduced muscular activity and reduced load on the repaired tissues, so active motion can be done earlier and more safely compared with exercise on land. The heat of the water also allows for increased circulation and can be very effective for very painful and guarded shoulders allowing an effective introduction to shoulder rehabilitation. Aquatic Physiotherapy is safe and can be commenced within days of surgery once your wounds have healed. You will need to check with your surgeon before booking. 

Whether you have an acute problem or have been struggling for a long time, aquatic therapy can be tailored to your needs. Please contact us on 020 8330 6777 for more information on how Aqua-physio can help you with a rotator cuff problem.