Rotator cuff problems
A very common cause of shoulder pain and weakness, where ultrasound is especially useful for an accurate diagnosis
The rotator cuff is the group of muscles and tendons that surround and move the shoulder. Problems with it, from irritation and inflammation through to tears, are among the most common causes of shoulder pain and weakness. The shoulder is one of the areas where ultrasound is particularly valuable, as it shows these tendons clearly.
Written for patients and reviewed by Dr Liubov Borukhson, Consultant Rheumatologist (GMC 7021928). Last clinically reviewed: June 2026.
Common symptoms
Rotator cuff problems tend to share a recognisable pattern. Features may include:
- Pain in the shoulder and upper arm, often worse when reaching up or out
- Pain at night, particularly when lying on the affected side
- Weakness, or difficulty lifting or rotating the arm
- A catching sensation with certain movements
How it is diagnosed
Rotator cuff problems can often be recognised from the history and examination of the shoulder. Confirming what is happening to the tendons, and how severe it is, guides the right treatment and distinguishes it from other causes of shoulder pain.
Ultrasound is particularly well suited to the rotator cuff. It shows the tendons in detail, can confirm inflammation or a tear and its extent, and helps direct treatment accurately. Dr Borukhson uses point-of-care ultrasound during the consultation, so the shoulder can often be examined in the same visit. Where she judges another type of imaging, such as an MRI, to be more appropriate, she will refer for it. You can read more on the ultrasound clinic page.
How it is treated
Many rotator cuff problems improve with a structured programme of exercise and physiotherapy to restore strength and movement, alongside activity modification and pain relief. Where pain is limiting progress, an ultrasound-guided injection into the shoulder can help. Larger or persistent tears may be referred for a surgical opinion. The plan is agreed with you.
Why assessment helps
Shoulder pain that is not settling is worth assessing to confirm the cause and put in place an effective plan. If you have ongoing shoulder pain or weakness, a specialist review, with ultrasound where helpful, can clarify it and guide treatment.
Ongoing shoulder pain or weakness?
A specialist assessment, with ultrasound where helpful, can confirm the cause and agree a plan to settle the pain and restore movement
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