Book Appointment

Shoulder Pain and the Rotator Cuff

As a physiotherapist working with Powerhouse Rugby Union FC, one of the most commonly injured areas of the body I see is the shoulder. However, research and clinical experience tells us that it is not just athletes that suffer from shoulder pain, with up to two thirds of the general population experiencing shoulder pain in their lifetime (Luime et al 2004).

Exercise 1: External Rotation – Tension band by rotating arm outward from midline, keeping elbow tucked in.

On the rugby field, a common mechanism of injury will be when the arm is forced out to the side and overhead, such as when reaching out for a tackle. This causes the humeral head to shift forward in the socket and either sublux (go out and back in) or dislocate. This results in stretching of the ligaments of the shoulder joint and usually leads to anterior instability. Initial management of any acute injury should always consist of RICER (Rest, Ice, Compression, Elevation, Referral – in this case for X-ray or MRI). Once the initial pain has settled and range of movement has been restored, the rehabilitation process can begin.

When rehabilitating players from these traumatic injuries, there are many principles that can be applied to other types of shoulder pain, such as that from heavy lifting, overhead activities or poor posture at work.

The shoulder joint is often likened to a golf-ball on a tee, with a large range of movement, but relatively little bony stability. This makes it the most commonly dislocated joint in the body, accounting for 45% of all dislocations (Smith, 2013). The ‘rotator cuff’ are a group of four muscles that surround the shoulder to provide dynamic stability, without compromising range of motion. Whether you are an athlete or office worker, strengthening this group of muscles can often provide stability, reduce pain and improve performance. Below are examples of two exercises (Exercise 1 and Exercise 2) that can be used to strengthen the rotator cuff muscles using a ‘thera-band’.

Exercise 2: Sword-Pulls - From opposite waist, tension band by pulling arm and shoulder blade upward and back like drawing a sword. "Hoorah!"
Exercise 2: Sword-Pulls – From opposite waist, tension band by pulling arm and shoulder blade upward and back like drawing a sword. “Hoorah!”

The other important goal of rehabilitation is to increase joint position sense and control (proprioception). This allows the shoulder to adjust appropriately to different movements and positions, ie. throwing, lifting, etc. A great exercise for this is shown below (Exercise 3). Starting against a wall, this exercise can be progressed by stepping feet further back, or by performing a push-up (one hand or two) on the ball.

The final stage of the rehabilitation program is to then make it specific to the client’s needs, whether this be return to sport, work or leisure. This usually involves taking the strength and control worked on so far and applying it to relevant positions and environments. This is arguably one of the most important phases of rehabilitation, and one that is often neglected as pain subsides. The goal of this final stage of rehabilitation is to prevent re-injury and return the client to their full potential.

Exercise 3: Fit-ball circles – Leaning on Fit-ball, make small circles whilst maintaining a steady shoulder-blade.

If you, or someone you know, has shoulder pain, feel free to contact on of our physiotherapists for a consultation to learn how we can help.

Brodie Doyle Jones
South Melbourne Physio


Smith G, Chesser T, Packham I and Crowther M. (2013) First time traumatic anterior shoulder dislocation: A review of current management. Injury, Int. J. Care Injured 44: 406–408
Luime J, Koes B, Hendriksen I, Burdorf A, Verhagen A, Miedema H and Verhaar J. (2004) Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 33(2):73-81.
Helgeson K and Stoneman P. (2014) Shoulder injuries in rugby players: Mechanisms, examination, and rehabilitation. Physical Therapy in Sport 15: 218-227
Wilk, K and Macrina L. (2013) Nonoperative and Postoperative Rehabilitation for Glenohumeral Instability. Clin Sports Med 32: 865–914

DISCLAIMER: The exercises in this article are for reference purposes only, and should not replace a thorough assessment and tailored program from your physiotherapist.


South Melbourne Physiotherapy


We pride ourselves on accurate and prompt diagnosis We pride ourselves on accurate and prompt diagnosis. Our physios will identify factors in your everyday life and posture that may contribute […]


Online Physiotherapy

Introducing one-on-one physiotherapist appointments in the comfort of your own home via the video meeting program Zoom.


clinical pilates hip rotations

Clinical Pilates

Improve Posture and strength with Clinical Pilates South Melbourne Clinical Pilates has evolved from traditional Pilates, with the input of physiotherapists and evidence-based research, in to a rehabilitation tool for […]


Pre-pointe Assessment

A pre-pointe assessment aims to ensure a smooth transition from demi pointe to en pointe. What is a pre-pointe assessment? Starting pointe work is an exciting time for dancers. There […]


rehabilitation exercises

Rehabilitation Physiotherapy Classes

Our Rehab classes can help you get your groove back Do you have an injury? Or have special needs/goals that would benefit from having an experienced physio guiding you through […]


Sports Massage

Deep tissue Sports and Remedial Massage undertaken by one of our physiotherapists. Massage consultations will begin with an assessment of tight soft tissue and other injuries of concern. During your […]


bike fit setup seat height

Bike Fit

Because every cyclist is different and has different needs. Whether commuting, mountain biking, bunch riding, climbing hills, road racing or racing triathlon your position on the bike will affect not only your ability (speed, power and endurance) but also influence injury.


dry needling

Dry Needling

Dry Needling is excellent to help reduce muscular pain. Most people have heard of acupuncture but may not have heard of Dry Needling. So what is the difference? Dry needling […]


GLA:D – Good Life with Arthritis

Best first treatment for hip and knee arthritis GLA:D®, or Good Life with Arthritis: Denmark, is an education and exercise program developed by researchers in Denmark for people with hip […]


Running Assessment

Whatever your level, running is a great form of exercise for long-term physical and mental health. Why get a running assessment? Whatever your level, running is a great form of […]


Nutrition & Dietetics

We provide our patients with scientifically proven dietary strategies We are specialist dietitians for the management of gastrointestinal disorders, food intolerances, Type I and II Diabetes Mellitus, cardiovascular risk reduction […]


Occupational Health

Injury prevention within workplaces with OH&S compliance Injury Prevention and Health Promotion Pre-employment Assessments Ergonomic Assessments Risk Assessment Analysis Manual Handling Training Early Intervention Physiotherapy Onsite Physiotherapy


Women’s Health

Pelvic Floor Physiotherapy South MelbournePre / Post Natal Physio & Pilates The pelvic floor muscles play a significant role in offering support to the bladder, uterus and bowel. If weakened, […]