Rotator Cuff Tendinopathy

What is Rotator Cuff Tendinopathy?

The rotator cuff is a group of four tendons that hold the ball of the shoulder in its socket and let you lift and rotate the arm. Rotator cuff tendinopathy is degeneration, wear, and inflammation in these tendons, most often the supraspinatus.

It develops from a mix of factors: repetitive overhead activity, poor posture, muscle imbalance, and the natural changes that age brings to tendon tissue. Because the core problem is degeneration rather than simple inflammation, it tends to persist and often does not respond to anti-inflammatories alone.

The pain is usually a dull ache felt in the outer shoulder and upper arm. It is provoked by overhead reaching and is frequently worse at night. Ultrasound confirms the diagnosis by showing the degenerative changes and any associated tears in the tendon.

Symptoms

• A dull, aching pain in the outer shoulder and upper arm
• Pain with lifting the arm overhead or out to the side
• Night pain, particularly when lying on the affected shoulder
• Weakness when lifting or carrying
• Clicking or catching with overhead movement
• Difficulty reaching behind the back

How We Treat It

Where the tendon shows degeneration rather than acute inflammation, we favour treatments that drive genuine repair. PRP therapy concentrates your own platelets and growth factors and is delivered under ultrasound guidance to the degenerative zone, stimulating the tendon to remodel. Shockwave therapy is a non-injection alternative that uses focused acoustic energy to trigger the same healing response without needles, which suits patients who prefer to avoid injection.

When pain is severe and limiting engagement with rehabilitation, a single ultrasound-guided steroid injection can settle the acute pain and create room to start exercising, though it does not repair the tendon itself. Throughout, our physiotherapy team leads a programme of progressive rotator cuff and scapular strengthening. That loading work is the element that consistently determines long-term outcome.