ROTATOR CUFF RELATED SHOULDER PAIN: New Guidelines

50% of all shoulder pain is Rotator Cuff Related Pain.

What is it?

Rotator Cuff (RC) related pain simply means pain that is associated with your RC muscles in the shoulder. This group of 4 muscles (supraspinatus, infraspinatus, subscapularis and teres minor) have an important role rotating your upper arm bone (the humerus bone) to stabilise the shoulder joint.

How do I know I have Rotator Cuff Related Pain?

Pain usually occurs over the upper outer arm, and is worse with overhead or rotating movements.

Diagnosis

Mint physio’s are trained to diagnose your RC related pain. By asking you specific questions, assessing your shoulder and measuring the strength of specific muscles using a dynamometer, we are able to determine if you have RC related pain. This group of disorders includes most commonly RC tendinopathies (with or without calcifications) and partial-thickness RC tears.

Terms such as

• subacromial pain syndrome,
• subacromial impingement syndrome,
• subacromial bursopathy (or bursitis), and l
• ong head of biceps tendinopathy

are all considered in the RC tendinopathy diagnosis and guidelines.

How do I treat it?

In 2025, brand new international guidelines indicate 12wks of Physiotherapy as the gold standard in treating Rotator Cuff related pain:

Rehab (12wks)

• Exercise therapy - evidence shows rehab is the most effective treatment - we will prescribe a progressive motor control & resistance exercise program.
• Education - helps you understand your condition, modify activities, improve ergonomics and teaches you self-management techniques.
• Pain Management
  • Manual therapy, like soft tissue massage and joint mobilisations, reduce pain
  • Taping and acupuncture may be offered, alongside rehab
  • Paracetamol and NSAIDs can help - speak with your pharmacist
  • For severe pain, we’ll refer you to a sports doctor who may offer an injection to help get you back to rehab

What not to use

• Scans (like X-rays, ultrasounds or MRI’s) are not needed during the first 12wks
• Ultrasound Therapy is an old technique, which has been shown to be ineffective
• Shockwave and Laser may ONLY be offered for Calcific Tendinopathy

Mint physio's allows follow the most up to date guidelines - which means you'll never waste your time and money on therapies not proven to work. If you have shoulder pain, book in for an assessment now, so we can diagnose your condition and get you started on the right rehab pathway.

https://www.jospt.org/doi/10.2519/jospt.2025.13182 - A Clinical Practice Guideline for RC Related pain (including tendinopathy with and without calcification, and partial thickness tears). NB: this guideline does not relate to full-thickness RC tears.