Rotator Cuff Physiotherapy in Bundoora: Tears, Tendinopathy & Repair Rehab

Rotator cuff injuries are among the most common shoulder conditions in Australia — affecting people across all age groups, from young athletes to older adults with degenerative changes. Whether you have a tendinopathy, partial tear, full tear, or are recovering from rotator cuff surgery, physiotherapy is the cornerstone of treatment and recovery.

Understanding the Rotator Cuff

The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, teres minor, subscapularis) and their tendons that surround the shoulder joint. They stabilise the humeral head within the glenoid and power the rotational movements of the arm. The supraspinatus is the most commonly injured — it passes under the acromion and is vulnerable to both impingement and degenerative tears.

Types of Rotator Cuff Injury

• Rotator cuff tendinopathy: Degenerative changes within the tendon without a structural tear. Causes pain with overhead activities, pain at night, and weakness. Most common in adults over 40. Responds very well to progressive loading exercises.
• Partial thickness tear: A structural tear affecting only some fibres of the tendon. Can be intratendinous, bursal-side, or articular-side. Many partial tears are managed successfully with physiotherapy.
• Full thickness tear: Complete disruption through the tendon. Small tears in older adults often managed conservatively. Larger tears in younger, active individuals may require surgical repair.
• Massive rotator cuff tear: Involvement of two or more tendons. Surgical management often required, followed by lengthy rehabilitation.

Conservative Management (Without Surgery)

Physiotherapy for non-surgical rotator cuff management includes:

• Progressive rotator cuff loading: Isometric exercises initially, progressing to isotonic and then functional loading — stimulating tendon repair and muscle strengthening
• Scapular strengthening: The shoulder blade muscles control the position of the glenoid and are critical for optimal rotator cuff function
• Joint mobilisation: Restoring glenohumeral mobility and thoracic extension to allow full shoulder function
• Dry needling: For associated muscle trigger points and pain modulation
• Activity modification: Avoiding positions that load the compromised tissue while maintaining as much function as possible

Post-Surgical Rotator Cuff Rehabilitation

Rehabilitation after rotator cuff repair surgery follows a strict staged protocol to protect the surgical repair while the tendon heals to bone:

• Phase 1 (0–6 weeks): Protection. Arm in a sling. Passive range of motion only. No active muscle contraction through the repaired tendon. Pendulum exercises, elbow and wrist exercises.
• Phase 2 (6–12 weeks): Active movement. Begin active-assisted and then active shoulder movement. Gentle rotator cuff activation exercises. Postural work.
• Phase 3 (12–20 weeks): Strengthening. Progressive resistance exercises for rotator cuff and scapular muscles. Functional movement patterns.
• Phase 4 (20–24 weeks): Functional return. Return to overhead activities, sports-specific movements, and full function.