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If you are experiencing rotator cuff symptoms or looking for rotator surgery recovery, Apex Manual Therapy can help. Our advanced physical therapists are Fellows of the American Academy of Orthopedic Manual Physical Therapy (FAAOMPT). As fellows, they have obtained the highest level of orthopedic physical therapy training. This educational achievement exceeds the doctorate level and guarantees you’ll receive gold standard care for your musculoskeletal conditions.


At Apex Manual Therapy you will work one-on-one with a fellow to ensure the very best rotator cuff treatment and rotator cuff surgery recovery. 


If you live in the greater Austin or Pflugerville, Texas area schedule a free consultation with our advanced therapists. We guarantee you’ll see the difference in our approach and your results.


What is the Rotator Cuff?

The rotator cuff is a group of four muscles in the shoulder: 

  • Supraspinatus

  • Infraspinatus

  • Teres minor

  • Subscapularis















The shoulder complex is also comprised of four joints, which provide a large range of motion. The more mobile a joint is, the less stability it has.  

The rotator cuff plays an important role in increasing shoulder stability. The group of muscles originate on the scapula (shoulder blade) and insert onto the humerus (upper arm bone). For the rotator cuff to function correctly, the scapular muscles must be balanced, providing the appropriate amount of force and timing sequence. When this system begins to malfunction, one may experience shoulder pain in the rotator cuff or a torn rotator cuff. 


How Does the Rotator Cuff Tear (RTC Tear)?

Major trauma such as a fall or collision is one-way rotator cuff tears occur.  A true major trauma would include a single insult to a healthy rotator cuff which causes a rotator cuff to tear. If trauma happens after a simple task or minor incident then the rotator cuff was likely already degenerative and weakened.  The rotator cuff degenerates as a result of movement dysfunctions. 

Movement dysfunctions are the most common cause of rotator cuff pain and rotator cuff tears. Muscles must function with the right amount of tension and sequencing to prevent rotator cuff pain. Take a look at the movement dysfunctions below. Can you appreciate the complexity of movement to simply raise your arm up? Most people do not think twice about how complex the movement is until they can no longer do it.  

Scapular Movement Dysfunctions

  1. Scapular internal rotation

  2. Scapular internal rotation with anterior tilt

  3. Scapular internal rotation with insufficient upward rotation

  4. Scapular internal rotation with abduction

  5. Scapular depression with insufficient upward rotation 

  6. Scapular external rotation / Adduction with insufficient upward rotation 

  7. Scapular winging

  8. Scapular elevation


Humeral Movement Dysfunctions


  1. Humeral anterior glide

  2. Humeral superior glide

  3. Glenohumeral medial rotation

  4. Glenohumeral hypomobility

  5. Glenohumeral multidirectional accessory hypermobility


Rotator Cuff Symptoms 

The most common rotator cuff symptoms include:

  • Lateral arm pain

  • Night pain

  • Pain with reaching up or rotating the arm

  • Pain often described as aching, sharp or stabbing


Rotator Cuff Tear Classifications

Rotator cuff tears (RTC tears) are defined as partial or full thickness rotator cuff tears. Classifications are also defined based on which rotator cuff muscles were injured. The rotator cuff muscle can become strained without tearing which can also cause shoulder pain in the rotator cuff. 


Rotator Cuff Pain Treatment

Many rotator cuff tears can be treated non-surgically with physical therapy. The goal of physical therapy treatment is to restore proper shoulder movement to provide rotator cuff pain relief. 

Treatment and rotator cuff exercises must be tailored to each individual’s findings. To treat a torn rotator cuff the physical therapist must perform a thorough evaluation to identify any movement dysfunctions placing further strain on the rotator cuff.  

Rotator Cuff Exercises

Below is a rotator cuff exercise often used to provide rotator cuff pain relief. If this rotator cuff exercise increases your rotator cuff symptoms, please stop. This could be a sign you’re not performing the exercises correctly or this treatment is not for your specific injury.  


  • Lay on your back with elbow abducted out to your side (as shown in photo).

  • Place towels under the elbow.

  • Rotate your arm forward into internal rotation without the humerus gliding forward. Use your other hand to feel if you are moving off-axis. 

  • Repeat 10-20 times.

Schedule a free consultation at Apex Manual Therapy to customize YOUR rotator cuff treatment plan.


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