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Weight on your shoulders - What is to Blame

Feeling Shoulder Pain?

Your Rotator Cuff is probably to blame...


Shoulder pain comes in many varieties, but the most common is subacromial pain, also known as shoulder impingement syndrome.

Shoulder impingement presents itself as pain on the front and side of the shoulder which increases with movement, especially when reaching, lifting or carrying.

When people complain about shoulder pain, it’s usually shoulder impingement they’re describing. And if they have shoulder impingement, a weak or injured rotator cuff is the source.

What is the rotator cuff?

The rotator cuff is a group of four muscles wrapped around your shoulder joint which provide stability for the shoulder during movement.

Weakness of the rotator cuff muscles causes shoulder impingement. Even worse, the rotator cuff could tear, resulting in intense pain and loss of mobility in the shoulder.

While the rotator cuff can be injured through trauma, most of the cases of shoulder impingement that we treat at Physiotherapy London result from overloading weak rotator cuff muscles.

If you don’t use it, you lose it

If the majority of your day is spent at a desk, your shoulders are rarely being utilised the way they’re supposed to, especially not with the rotational and overhead movements which activate the rotator cuff.

Over time, if it’s not used, the rotator cuff becomes de-conditioned. At this point, all it takes is a slight bit of overload for the tissue to be damaged. Something as simple as lifting a saucepan onto a high shelf or taking luggage out of an overhead locker can result in rotator cuff injury.

And if you’re something of a weekend warrior, those weekly tennis games or trips to the gym will suddenly put a lot of force through your rotator cuff which has otherwise been inactive all week.

When your shoulder becomes painful, your instinct might be to stop moving it, as movement results in pain. But not moving your shoulder only results in further de-conditioning of the rotator cuff, further weakness and further risk of injury.

On the other hand, you might treat the pain as a wake up call that it’s time to improve your shoulder strength. But if you throw yourself into the gym without knowing how to specifically train your rotator cuff muscles, you’re more likely to further injure them than make any progress.

Your rotator cuffs can be weak, even if you’re strong

It’s not just sedentary people and weekend warriors who are at risk of shoulder impingement. Highly active people, even athletes, are just as likely to overload their rotator cuffs.

Like many other muscles which provide stability rather than power, the rotator cuff won’t activate if you put them under heavy load. You need to do slow, controlled movements with light weights to isolate the rotator cuff and specifically strengthen these muscles.

Unfortunately, many people neglect lightweight exercises during their workouts, instead focusing on the larger, more powerful global muscles elsewhere in the shoulder which are capable of taking on heavy loads.

Athletes and gym-goers often don’t realise their rotator cuffs are the source of their shoulder weakness, and will continue to overload them the more that they try to strengthen their shoulders – quite the vicious cycle.

We encourage people to decrease their level of activity and slowly build back up from square one with a more balanced routine which increases the strength of the rotator cuff muscles in tandem with their larger muscles.

By balancing the strength of your shoulder muscles, you’ll be able perform the high power movements they need to do without overloading your rotator cuffs.

Physiotherapy is the best way to treat shoulder impingement

Strengthening your rotator cuff is slow, delicate work. Attempting to do it yourself is incredibly difficult, even if you think you know what you’re doing.


Thank you to our partners at Vita Health Group for the fantastic details around our shoulders!!

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