Rotator cuff tendinopathy exercises

The rotator cuff is a group of four small muscles that wrap around the top of the arm bone and blend into the shoulder blade. While the bigger muscles do the lifting, the cuff quietly keeps the ball of the joint centred in its shallow socket. Rotator cuff tendinopathy means one or more of those tendons has become irritated and temporarily less able to cope with load. The tendon is sensitive, not falling apart.

It usually follows a change rather than an accident: a weekend painting a ceiling, a new gym programme, a return to racket sport after months off, or weeks of decorating. Age plays a part too, because tendons become a little less tolerant of sudden spikes in load from the forties onwards, so the same amount of overhead work bites harder than it once did.

The typical picture is a nagging ache over the outer shoulder and upper arm rather than one sharp spot. Reaching to a high shelf, putting on a coat, fastening a seatbelt or getting the arm behind your back tends to catch it, and lying on that side at night is often what people mind most. It settles with the arm supported and grumbles after a busy day.

It is sore rather than dangerous, and the outlook is good. Most people feel the edge come off within a few weeks of sensible loading, with fuller strength and comfort over three to six months. Tendons change slowly, so steady work across weeks matters far more than any single hard session. This programme calms the shoulder and keeps it moving, rebuilds the strength and control of the cuff and shoulder-blade muscles, then rebuilds your tolerance for overhead and carrying work.

Who this programme is for

Adults with a gradual onset of outer-shoulder pain that is worse with reaching, lifting or lying on it, and no history of a significant injury or trauma. If your shoulder suddenly became weak after a fall or a heavy pull, get it assessed first.