Rotator cuff injury: symptoms, test and treatment

Based on NHS guidance and NHS physiotherapy leaflets.

Reviewed by Harvir Ubhi, HCPC-registered physiotherapist. Last reviewed 28 September 2026.

What the rotator cuff is

Your rotator cuff is a group of four muscles and their tendons that wrap around the top of your arm bone and keep it steady in the shoulder socket. When the problem is coming from them, doctors and physios often call it rotator cuff related shoulder pain. It's an umbrella term for several problems in and around those tendons, and it affects men and women of all ages equally.

Rotator cuff injury symptoms

• pain in the upper arm, on the outside
• a catching pain
• pain reaching forwards, above head height or out to the side
• pain putting your hand behind your back, like tucking in a shirt or fastening a bra
• pain when you sleep or lie on that shoulder

If your shoulder is stiff as well as painful, and won't move far whichever way you try, read about frozen shoulder. If the pain starts in your neck and runs down your arm with tingling, it may be a trapped nerve in your neck.

Is there a rotator cuff injury test?

Not a single one. A GP or physio examines you, moves your arm in different directions and notes what brings the pain on. Scans are less helpful than people expect. Changes around the shoulder that show up on a scan are also found in people with no pain at all, so a scan result doesn't always explain your symptoms. That's why the examination matters more.

Rotator cuff injury treatment, in the order it usually happens

1. 1

   Keep moving

   Stay active and gently move your shoulder. The NHS advises against keeping it still.

2. 2

   Painkillers, ice or heat

   Paracetamol or ibuprofen. A bag of frozen peas in a tea towel for up to 20 minutes, 3 times a day, or a heat pack. A pharmacist can tell you what's safe for you.

3. 3

   Exercises

   The NHS suggests shoulder exercises for 6 to 8 weeks to stop the pain coming back. A graded programme builds strength a step at a time.

4. 4

   Physiotherapy

   A physio works out which movements your shoulder is struggling with and sets exercises at the right level, so you push enough to get stronger without flaring it up. Many areas also let you refer yourself to NHS physio.

5. 5

   Stronger medicine or an injection

   A GP may offer these if painkillers aren't enough.

6. 6

   Specialist referral

   If the pain doesn't settle.

Rotator cuff exercises from an NHS programme

These are the starting level of the four exercises in the Royal United Hospitals Bath physio programme. Start with 5 repetitions, build to 3 sets of 15, and do them 3 to 5 days a week with rest days in between. Once 3 sets of 15 feels manageable, you move to a harder version, which is the part a physio helps you judge.

1. Weight shifts on all fours. Start on your hands and knees. Shift your weight slowly side to side, then forwards and backwards.
2. Supported arm lift. Sit with your forearm resting on a table, holding a small weight. Lift your arm away from the table as far as is comfortable.
3. Doorway press. Stand in a doorway with your arms by your sides. Press your hands outwards into the door frame and hold.
4. Bent-over row. Lean forward with one hand on a table and a weight in the other. Lift the weight towards you by bending your elbow, then lower it slowly.

How much pain is OK? Keep it at 4 out of 10 or below. It should calm down within a few hours and not keep you awake. If it's still up the next day, you did too much: do a bit less next time rather than stopping altogether. Pain here doesn't mean you're damaging your shoulder.

When to see a GP

The NHS says see a GP if:

• shoulder pain is getting worse, or hasn't improved after 2 weeks
• it's very difficult to move your arm or shoulder

Rotator cuff questions

Related: shoulder pain: causes and where it hurts · frozen shoulder · private physio costs