You may have been told you have rotator cuff tendinitis, or perhaps a tear. Either can sound worrying, especially when your shoulder aches as you reach, lift or try to sleep. The reassuring news is that most rotator cuff problems respond well to the right kind of exercise, and your shoulder can stay strong and useful.

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, a bit like a cuff. They keep the ball of your shoulder centred in its socket while your bigger muscles move your arm. Every time you reach, lift or turn your arm, they are working.

Tendinitis means the tendons have become sensitive and sore, often after doing more than they were used to. A tear means part of a tendon has frayed or split. Many tears are partial, and they often develop gradually over time rather than from a single injury.

Tears are more common than you might think

The word tear can sound alarming, but rotator cuff tears are very common, especially as we get older. Research has found that many people have tears on scans without any pain at all. That means a tear does not always explain the pain, and it does not mean your shoulder cannot work well.

For many people with tears that came on gradually, exercise works as well as surgery. In one trial of people with this kind of tear, those who followed a physiotherapy exercise programme did as well after a year as those who had an operation.

Why exercise helps

Exercise is one of the most effective approaches for rotator cuff problems. It helps the tendons get stronger and better able to cope with load, and it builds the surrounding muscles so they can share the work. Over time, this can ease pain and help you use your arm more comfortably.

If you have been given an exercise plan by a physiotherapist or your GP, keep following it. If you have had surgery, or have been advised to, follow the plan from your surgical team. The ideas below can sit alongside that advice.

Keeping your shoulder moving

Gentle movement helps your shoulder stay supple. Something to try once or twice a day:

• Pendulum swings. Lean forward, supporting yourself on a table, and let your sore arm hang down. Gently swing it in small circles.
• Table slides. Sit at a table with your hand on a cloth and slowly slide it forward as far as feels comfortable.
• Wall walks. Walk your fingers up a wall in front of you, then back down.

A mild ache that settles quickly is fine. If a movement feels sharp, make it smaller. If you would like a guided stretch, VIDA has short videos you can follow at your own pace.

Building strength gradually

Strength work is at the heart of looking after a rotator cuff. Something to try two or three times a week:

• Shoulder squeezes. Sit tall, draw your shoulder blades back and down, hold for five seconds, then relax.
• Outward turns. With your elbow tucked into your side and bent, hold a light weight and slowly turn your forearm outwards, then back.
• Side lifts. Slowly lift your arm out to the side, below shoulder height to start with, holding a light tin or bottle, then lower.

If you would like to follow along, VIDA has short videos of shoulder squeezes you can use at your own pace. Start light and build up gradually over weeks.

A mild ache during exercise that settles by the next day is usually fine. If your shoulder is sorer the following morning, ease back a little rather than stopping.

Everyday tasks

Small changes can make daily life easier on your shoulder:

• Keep things you use often between waist and shoulder height.
• Hold heavier items close to your body.
• Rest your forearms on your desk when typing.
• Put your sore arm into sleeves first when dressing.

Sleeping more comfortably

Rotator cuff pain often feels worse at night. Lying on your back with a pillow under your sore arm, or on your other side hugging a pillow, can help.

When to get your shoulder checked

If you have had a fall or sudden injury and now cannot lift your arm, it is worth getting your shoulder checked by your GP or a physiotherapist promptly.

Your VIDA pain check-in can help you notice how your shoulder responds as you build strength.

What to take away

• Rotator cuff problems are common and usually respond well to exercise.
• Many people have tears without pain, and a tear does not mean your shoulder cannot work well.
• Keep your shoulder moving gently within a comfortable range.
• Build strength gradually, two or three times a week.
• Keep following any plan you have been given by your physiotherapist.

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