Rotator Cuff Pain: When to See a Physical Therapist

Rotator Cuff Pain: When to See a Physical Therapist

By Daria Klein, PT, DPT, CMPT at Axes in Fenton, MO

If you’re asking yourself, “Why does my shoulder hurt when I lift my arm?” or “How do I know if I’ve injured my rotator cuff?” — you’re not alone. Shoulder pain, especially related to the rotator cuff, is one of the most common reasons people seek physical therapy.

As a physical therapist, I see it all the time: people come in worried they’ve torn something or assume surgery is inevitable. The good news? Many rotator cuff issues can be managed — and even resolved — with the right physical therapy program. In this post, we’ll walk you through what the rotator cuff is, what causes it to hurt, and when it’s the right time to come see us at Axes Physical Therapy.

What Is the Rotator Cuff?

The rotator cuff is a group of four small but mighty muscles that surround the shoulder joint. They originate on the shoulder blade and insert on the top of the humerus (your upper arm bone). Their job is to keep the ball of the shoulder securely in the socket while you move your arm — up, out, behind, or overhead.

Think of your shoulder as a golf ball sitting on a tee. The rotator cuff keeps that ball from rolling off every time you move your arm. It’s essential for everything from reaching up into a cabinet to washing your hair.

Common Causes of Rotator Cuff Pain

Rotator cuff pain can show up at any age, and the cause is often related to how we use our shoulder — or overuse it.

In Younger Adults:

• Overhead sports (like baseball, swimming, volleyball)
• Labor-intensive jobs (carpentry, painting, warehouse work)
• Repetitive lifting or poor posture

Pain in this age group is often due to rotator cuff tendonitis — inflammation from overuse. It can feel like a dull ache, soreness in the front or side of your shoulder, or weakness when lifting your arm.

In Middle Age and Beyond:

• Years of wear and tear
• Chronic poor posture
• Shoulder impingement (pinching of the tendons)
• Degenerative changes in the tendons

As we get older, we’re more prone to rotator cuff tears, tendinosis (chronic tendon breakdown), and impingement. This pain often presents with sharp discomfort, weakness, or difficulty lifting or lowering your arm — particularly through a painful arc of motion.

Symptoms of a Rotator Cuff Injury

If your pain is coming from the rotator cuff, you might notice:

• Pain on the outside of your shoulder or upper arm
• Pain that radiates into the biceps or outer arm
• A dull, aching, or throbbing sensation at rest
• Sharp pain when lifting overhead, reaching behind your back, or sleeping on the affected side
• Weakness or loss of control when lowering your arm

One classic sign of a rotator cuff tear is the “painful arc” — pain when lifting your arm between 60 and 120 degrees and again when lowering it.

So… When Should You See a Physical Therapist?

Here’s the answer: as soon as shoulder pain affects your daily life — sleeping, lifting, dressing, reaching, or working. Don’t wait for it to get worse or for imaging to tell you what’s wrong. In fact, many people with rotator cuff tears on MRI don’t have any symptoms at all, while others with “clean” imaging have significant pain.

This is why movement matters. And this is where physical therapy shines.

In Missouri, you don’t need a referral to see a physical therapist. At Axes, we can evaluate your shoulder, determine what’s contributing to your pain, and create a custom plan to:

• Reduce inflammation and pain
• Restore shoulder strength and control
• Correct movement imbalances
• Improve posture and flexibility
• Prevent future injury or surgery

Can Physical Therapy Help Me Avoid Surgery?

In many cases — yes. Research shows that structured, progressive physical therapy can be just as effective as surgery for partial rotator cuff tears or chronic impingement. Even when surgery is necessary, pre- and post-op PT leads to faster recovery and better outcomes.

If you’ve been told you have a rotator cuff tear, or you’re worried about one, physical therapy is a safe first step that puts you in control of your recovery.

What to Expect at Axes Physical Therapy

During your first visit, we’ll:

• Conduct a detailed assessment of your movement, strength, and pain patterns
• Discuss your lifestyle and physical demands
• Identify contributing factors (like posture, core weakness, or repetitive habits)
• Begin a tailored plan including manual therapy, therapeutic exercise, and education

Our goal? Help you move better, hurt less, and get back to doing what you love — without fear.

Ready to Get Started?

Shoulder pain doesn’t have to define your day. Whether you’re an athlete, a busy parent, or someone trying to stay active without discomfort, you deserve relief and clarity.

Let’s figure it out together. Visit one of our 21 Axes Physical Therapy locations across the Greater St. Louis Missouri and Illinois area. 

Schedule an appointment or visit AxesPT.com to find your nearest clinic and get expert help today!

To schedule an appointment with Daria, or any of our expert therapists, request an appointment online today!