Understanding Shoulder Pain: A Guide to Rotator Cuff Injuries and Recovery

January 14, 2025

Shoulder pain is something many people face at some point, and rotator cuff-related pain is one of the most common causes.
Whether you’re struggling to lift your arm or finding it difficult to sleep on your side, shoulder pain can interfere with daily life.

The good news? For most people, this pain improves with a combination of the right advice, treatment, and exercises.

Let’s explore what causes rotator cuff pain, its symptoms, and how you can take steps to recover and regain your shoulder strength.

The Shoulder: A Joint Built for Movement

Your shoulder is one of the most mobile joints in your body, but that mobility comes with a trade-off: it’s prone to injury.

The shoulder has two key joints:

  • The Glenohumeral Joint
    This ball-and-socket joint is where your arm bone (
    humerus) meets your shoulder blade (scapula), allowing a wide range of motion for activities like lifting and throwing.

  • The Acromioclavicular (AC) Joint
    This joint connects the top of your shoulder blade (
    acromion) to your collarbone (clavicle) and plays a stabilising role.

What Is the Rotator Cuff?


The
rotator cuff is a group of four muscles that surround the shoulder joint.
These muscles:


  • Help lift and rotate your arm.
  • Keep the ball of the shoulder joint centred in the socket.

Above the rotator cuff is a bursa, a fluid-filled sac that reduces friction and ensures smooth movement between tendons and bone.

Why Does Rotator Cuff Pain Happen?


Rotator cuff pain often develops gradually, especially from repetitive movements or lifestyle changes.
Common causes include:

  • Overhead movements, such as painting or lifting.

  • Starting a new sport or workout involving shoulder activity.

  • Returning to activity too quickly after a break.


Symptoms of Rotator Cuff Pain


Typical symptoms include:


  • Pain at the front or side of the shoulder, especially noticeable at night or when lying on the affected side.

  • Discomfort when lifting your arm above shoulder height.

  • Clicking or grinding sounds during movement.

  • Painful movement, though stiffness may not restrict your range of motion.



The Importance of Staying Active


One common mistake people make with shoulder pain is avoiding using the shoulder entirely.
If you stop using your shoulder because of pain, it’s likely your shoulder will become worse over time.

It’s crucial to keep your shoulder moving in daily activities as much as pain allows. This prevents stiffness, maintains strength, and promotes healing.

Why Stretching, Mobility, and Strength Exercises Are Key


A single treatment session—like those we offer at Good Health Group Clinic—is only
60 minutes per week. That leaves you with 167 hours to look after your shoulder at home.

To see real improvement, it’s essential to commit to a routine that includes:

  • Stretching to release tight muscles and maintain flexibility.

  • Mobility exercises to improve your range of motion.

  • Strength exercises to stabilise the shoulder and protect the rotator cuff from further strain.


A Real Example: Shoulder Pain in Action


A 33-year-old scaffolder and footy player came to us with:

  • Limited shoulder movement, especially internal rotation (he couldn’t touch his back with either hand).

  • Clicking and grinding in both shoulders.

  • Pain during push-ups and other upper-body exercises.

  • A history of left shoulder dislocation and right shoulder injury.

What We Found


Our assessment showed:

  • Tight muscles in his rhomboids, glutes, and piriformis.

  • Restricted internal rotation and horizontal flexion in his shoulders.

  • Discomfort in his lower back and left ankle due to a previous injury.

What We Did


We treated him with:

  • Remedial Massage: Released muscle tension to improve flexibility and movement.

  • Trigger Point Therapy and Dry Needling: Targeted deep areas of tightness to reduce pain.

  • Personalised Exercises: Focused on improving shoulder mobility and strength.

The result? He felt immediate progress after the first session and continued to improve with regular exercises.

Take Control of Your Recovery


If you’re experiencing shoulder pain, here are some steps to get started:

  • Keep using your shoulder as much as pain allows: Avoid complete rest, as it can lead to stiffness and weakness.

  • Stay consistent with your exercises: Stretching, mobility, and strengthening are your best allies.

  • Seek professional advice: A therapist can assess your condition and guide you with the right treatment plan.


Conclusion


Rotator cuff pain can be frustrating, but with the right approach, you can take control and see real improvement. Remember, it’s not just about what happens during a treatment session, it’s about how you care for your shoulder in the hours and days between.

With patience, consistency, and the right support, you’ll be back to moving freely and doing what you love.
Don’t let shoulder pain hold you back, start your recovery journey today!

Meet the Experts Behind Your Recovery


At
Good Health Group Clinic, we’re dedicated to helping you manage shoulder pain and get back to doing what you love.

Our expert practitioners include:

Together, we provide a holistic approach to shoulder pain, combining hands-on treatments with practical advice to support your recovery.


Ready to Take the Next Step?


Shoulder pain doesn’t have to hold you back.
With the right support, you can take control of your recovery and start feeling better.
Our team at Good Health Group Clinic is here to help you every step of the way.

Take the first step towards pain-free movement by booking an appointment today.

Click the button below to secure your session with one of our experts.

Book Now

References

  1. American Academy of Orthopaedic Surgeons (AAOS) – Rotator Cuff Injuries
  2. Physiotherapy Evidence Database (PEDro) – Evidence for Exercise in Rotator Cuff Pain
  3. Shoulder and Elbow Society of Australia (SESA) – Shoulder Pain Guidelines


Blogs

By Ian Selvarajoo September 4, 2026
The Real Mechanism Stiffness on waking isn't damage, and it isn't really "just getting older" in the vague sense people mean it. It's a fluid and movement-frequency problem. Every hour spent still in one position lets your discs, joints, and fascia settle into a compressed or dehydrated state. Intervertebral discs in particular rely on nocturnal rehydration through osmosis while unloaded — around a quarter of a disc's fluid is expressed and re-absorbed with each daily loading cycle (1), and that process becomes less efficient with age as disc water content and hydration capacity decline (2). On top of that, deep sleep (slow-wave sleep) — when growth hormone release peaks and tissue repair happens — declines significantly with age. Research tracking healthy men found the amount of deep slow-wave sleep dropped from around 19% of total sleep in early adulthood to roughly 3-4% by midlife, alongside a corresponding decline in growth hormone secretion (3). By around age 45, most people have lost the majority of their capacity to generate deep sleep, and growth hormone secretion during sleep falls by a similar magnitude (4). Since tissue repair is concentrated in this stage, overnight recovery of muscle and connective tissue is naturally reduced as you age. There's also a movement piece: younger people shift position far more during sleep, which redistributes joint loading and fluid through the night. Position shifts and body movements during sleep decrease progressively with age (11, 12), and older adults spend more time in a single position — particularly side-lying — with fewer overall shifts per hour than younger adults. That means the same posture, and the same load on the lumbar spine and hips, gets held for longer periods. Add in the joints themselves: synovial fluid depends on hyaluronic acid for its lubricating viscosity, and both the concentration and molecular size of hyaluronic acid in joint fluid decline with age — one study found hyaluronan concentration dropping by roughly 10% per decade, more strongly linked to age than to visible joint degeneration (5, 6). Fascia undergoes its own aging process too: collagen cross-linking increases, elastin content drops, and tissue hydration declines, all of which reduce fascial pliability and increase stiffness and adhesion formation (9, 10). Layered on top of all this is "inflammaging" — the low-grade, chronic inflammatory state that becomes more pervasive with age, contributing to stiffness and tissue degeneration even without any specific injury (7, 8). Why Stillness Is the Real Culprit None of this is really about sleep quality in isolation — it's about how much time tissue spends static without fluid exchange. That reframes the problem: instead of "sleep is the cause and there's not much to do about it," the actual lever is controllable. You can reduce how much stiffness builds up overnight, and you can clear it much faster once you're awake, by deliberately bracketing sleep with movement. Before Bed: Reducing How Much Stiffness Accumulates Spending 5-10 minutes on slow mobility work before sleep — targeting the areas that hold tension longest overnight, typically the hips, lumbar spine, and thoracic spine — primes fluid distribution and synovial lubrication before hours of stillness set in, rather than trying to undo the damage after the fact. Movements like cat-cow, hip flexor stretches, and gentle spinal rotations are enough; this isn't about building flexibility, it's about starting from a better baseline. As a secondary benefit, this kind of slow mobility work activates the parasympathetic nervous system, which can also improve how easily you fall asleep in the first place. On Waking: Clearing Stiffness Fast Instead of Waiting It Out Most people's instinct is to just get up and move through the day, letting stiffness fade naturally — but that process can take 30-60+ minutes or longer as you age. A short, structured sequence immediately on waking can clear it in a fraction of that time. The logic is to start with gentle, low-effort movement (light stretching or distal movement like ankle pumps), progress into the areas that were under the most sustained load overnight (usually the lower back and hips), and finish with a compound movement that reintroduces full-body loading — something like a slow sit-to-stand or a few controlled squats. The order matters here. Mobilizing the spine and hips before standing and loading them prevents the "guarded," stiff-walking pattern many people default to when they get up too stiff too fast — which can itself create secondary tension as the body compensates. The Bottom Line Age-related morning stiffness is driven by reduced disc and joint hydration, less deep sleep, reduced overnight movement, and slower fascial recovery — all of which compound over time. But the single most practical, controllable lever isn't just "sleep better," it's minimizing prolonged stillness and treating both bedtime and waking as deliberate windows to manage fluid exchange and joint lubrication through movement. References Sivan SS, Neidlinger-Wilke C, Würtz K, Maroudas A, Urban JPG. Diurnal fluid expression and activity of intervertebral disc cells. Biorheology, 2006;43(3-4):283-291. https://pubmed.ncbi.nlm.nih.gov/16912401/ Iatridis JC, et al. Effect of Hydration on Healthy Intervertebral Disk Mechanical Stiffness. PubMed, 2015. https://pubmed.ncbi.nlm.nih.gov/26300418/ Van Cauter E, Leproult R, Plat L. Age-Related Changes in Slow Wave Sleep and REM Sleep and Relationship With Growth Hormone and Cortisol Levels in Healthy Men. JAMA, 2000;284(7):861-868. https://pubmed.ncbi.nlm.nih.gov/10938176/ UChicago Medicine. Aging alters sleep and hormone levels sooner than expected. 2000. https://www.uchicagomedicine.org/forefront/news/2000/august/aging-alters-sleep-and-hormone-levels-sooner-than-expected Temple J, et al. Hyaluronan concentration and size distribution in human knee synovial fluid: variations with age and cartilage degeneration. Arthritis Research & Therapy, 2016. https://arthritis-research.biomedcentral.com/articles/10.1186/s13075-016-0922-4 An update on the study of synovial fluid in the geriatric patient. ScienceDirect, 2024. https://www.sciencedirect.com/science/article/abs/pii/S1699258X23002899 Franceschi C, Campisi J. Chronic inflammation and the hallmarks of aging. ScienceDirect (review), 2023. https://www.sciencedirect.com/science/article/pii/S2212877823000893 Source of Chronic Inflammation in Aging. PMC, 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC5850851/ Wilke J, et al. Structural and Functional Changes in the Coupling of Fascial Tissue, Skeletal Muscle, and Nerves During Aging. Frontiers, 2020. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327116/ Pavan PG, et al. (as cited in fascia/aging review) — fascial densification and fibrosis with age. https://d-nb.info/1232323802/34 Bruyneel M, et al. Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms. Nature and Science of Sleep, 2017. https://pubmed.ncbi.nlm.nih.gov/29138608/ Gyllensten IC, et al. Body movements during night sleep and their relationship with sleep stages are further modified in very old subjects. ScienceDirect, 2007. https://www.sciencedirect.com/science/article/abs/pii/S0361923007002304
March 3, 2025
If you’re someone who spends hours in the gym, lifting heavier weights every week, but still deals with nagging aches, tightness, or even injuries, you’re not alone. I see this all the time. People come in complaining about shoulder pain, lower back tightness, or feeling stiff, even though they train hard and look strong. When I check their movement, though, there’s one thing that stands out, they’re strong, but not stable . This is a common issue, especially for those who focus only on building muscle and strength while ignoring stability and mobility . Strength alone isn’t enough. If your body can’t control that strength, you’re setting yourself up for problems.
February 27, 2025
I recently watched a lecture video called "Is Pain Science Really a Pain for Massage Therapists?" by Aran Bright. This was part of my ongoing professional development, something I dedicate a lot of time to every day to improve my skills and knowledge so I can provide better care for my clients. And it really changed the way I think about pain! So, I wanted to share some of the key things I learned with you, because understanding pain better can actually help you feel better, too.
February 11, 2025
Let me tell you about something weird I saw the other night while scrolling through YouTube. Lately, I’ve been really into watching other therapists work, checking out different approaches on Instagram and YouTube. Last night, I stumbled across a video on a fitness celebrity’s channel in the U.K. He was getting an IASTM (Instrument-Assisted Soft Tissue Mobilisation, also known as Graston technique) treatment from a sports therapist, and everything seemed normal, until the therapist made a pretty bold claim. As soon as redness started appearing on the guy’s skin, the therapist confidently said it was because “toxins were coming out.” No explanation, no scientific backing, just a statement that made it sound like IASTM was some kind of detox miracle. And of course, in the comments section, people ate it up, believing it just because the practitioner is a health expert and the channel owner is a well-known fitness personality.  But let’s set the record straight: IASTM is NOT a detox therapy, and there’s no such thing as a manual “detox” treatment.
February 4, 2025
At Good Health Group Clinic Brighton , we often hear clients say, "I've been stretching my tight muscles, but they just won’t loosen up!" Recently, a viral social media post caught my attention, claiming that stretching makes muscle knots worse and that stretching fascia doesn’t work. The video compared stretching a muscle with trigger points to pulling on a knotted rubber band, it supposedly makes the knot even tighter. The post gained a lot of traction, with many people commenting, "No more stretching for me!" But is this really true? As a clinic that specialises in myotherapy, chiropractic care, and remedial therapy , our practitioners, myotherapist Ian Selvarajoo , chiropractor Dr. Tanja Nishibata , and remedial and dry needling therapist Sam Noh , understand that while stretching alone isn’t always the solution, dismissing it entirely is misleading. So, let’s explore what the science actually says about stretching, trigger points, and flexibility. What Are Trigger Points? Trigger points, commonly known as muscle knots , are hyperirritable spots in the muscle that can cause local and referred pain. They develop due to: Chronic overuse Repetitive strain Poor posture Stress and nervous system tension Inadequate recovery after workouts A muscle with trigger points is often tight but weak , contracted and stiff, yet lacking strength. This explains why simply stretching the muscle may not provide relief. Does Stretching Really Make Trigger Points Worse? The viral video suggested that stretching a tight muscle is counterproductive because it worsens the "knotting" effect. While this analogy may seem logical, the reality is more complex. In some cases, aggressive stretching can aggravate tight muscles, especially when: The muscle is in a highly contracted state (such as after prolonged stress or poor posture). The nervous system is hypersensitive , causing muscles to tighten further in response to a stretch. You hold static stretches for too long without first addressing the root cause of the tension. However, this does not mean stretching is inherently bad, it just needs to be done correctly . What Does the Science Say About Stretching and Trigger Points? Contrary to the claim that stretching is harmful, research shows that when performed properly, stretching can actually help alleviate muscle tightness and improve function . Stretching Increases Blood Flow and Oxygenation Studies have shown that stretching enhances circulation , reducing muscle ischemia (lack of oxygen), which is one of the primary causes of trigger points. Stretching Helps Regulate Muscle Tension When you stretch, you activate the Golgi tendon organs , which help relax overactive muscles and reduce excessive tension. Stretching Restores Functional Muscle Length Chronic muscle tightness can lead to adaptive shortening , making muscles more prone to pain and dysfunction. Stretching helps counteract this. How to Stretch the Right Way Without Making It Worse Instead of avoiding stretching altogether, here’s how to incorporate it safely and effectively : 1. Start With Soft Tissue Work First Before stretching, release the muscle tension using: Self-massage (hands or massage ball) Foam rolling (avoiding excessive pressure on painful spots) Trigger point therapy, dry needling, or myotherapy , which our practitioners at Good Health Group Clinic Brighton offer. 2. Use Active and Dynamic Stretching Instead of prolonged static stretching, opt for controlled, movement-based stretches to encourage blood flow and mobility. Example: Instead of a deep static hamstring stretch, try hamstring swings or single-leg Romanian deadlifts . 3. Avoid Overstretching Painful Muscles Pain is a signal from your body— forcing a stretch won’t fix the issue . If stretching worsens your symptoms, it’s time to adjust your approach. 4. Strengthen Weak Muscles Trigger points often form because a muscle is both tight and weak . That means stretching alone isn’t enough—you also need strength training . Example: Instead of constantly stretching tight hip flexors, incorporate glute and core strengthening exercises . How Good Health Group Clinic Brighton Can Help At Good Health Group Clinic Brighton , we take an evidence-based approach to muscle health and mobility. Our team of skilled practitioners can help with: Myotherapy : Our myotherapist Ian Selvarajoo specialises in releasing muscle knots using advanced soft tissue techniques. Chiropractic S ports and Spinal rehab : Dr. Tanja Nishibata can assess your posture and spinal health, ensuring your nervous system and musculoskeletal system function optimally. Remedial Massage & Dry Needling : Sam Noh provides expert remedial therapy and dry needling to address chronic muscle tension and improve flexibility. Stretching Is Not the Enemy The idea that "stretching makes knots worse" is an oversimplification . While improper stretching can sometimes aggravate muscle tightness, when done correctly , stretching is a powerful tool for reducing discomfort and improving mobility. The key is how you stretch. By combining stretching with soft tissue release, active movement, and strengthening exercises , you can effectively manage muscle tension and enhance performance. If you’re struggling with persistent muscle tightness, book an appointment at Good Health Group Clinic Brighton , where our expert team can help you find the best approach to mobility and recovery.
February 2, 2025
Baseball is not the most popular sport in Australia, but as someone who grew up in South Korea and in a KIA Tigers supporting family, I’ve been watching KBO (Korean Baseball Organization) games since I was born. This year, I noticed an interesting development from one of the team’s top young players, Do-young Kim, who has dramatically improved his hitting performance. In the 2023 season, Kim was already a talented batter, but he only hit 7 home runs with a slugging percentage (SLG) of 0.453. For those unfamiliar with baseball, a home run is when a batter hits the ball over the outfield fence, allowing them to score instantly. Slugging percentage (SLG) measures the total bases a player earns per at-bat, indicating their power-hitting ability. Fast forward to 2024, and Kim’s stats have skyrocketed, he has hit 38 home runs with an SLG of 0.647. That’s an incredible leap! So, what changed? After closely watching his batting stance and swing, I realised he had enhanced his hip internal rotation (HIR) , allowing him to generate more torque and power in his hitting mechanics. This got me thinking, the same principle applies to improving my clients’ daily movements and sports performance.
January 31, 2025
When clients walk into Good Health Group Clinic after a musculoskeletal injury, most have one goal in mind, getting stronger. Strengthening exercises have long been seen as the gold standard for recovery, but in reality, jumping into strength training too soon can often make things worse rather than better . Over the years, I’ve noticed a common pattern, more than half of my clients experience aggravation when they begin strengthening exercises early in rehab . Their pain flares up, movement feels unnatural, and their body starts compensating in ways that lead to more dysfunction. This got me thinking 'Is there a better way?' 
January 31, 2025
When I was a sports trainer for the Ferntree Gully Football Club, I worked with many young athletes pushing their limits to perform at their best. One of them, a talented midfielder, came to me with a problem, he felt "stuck" when kicking the footy. His range of motion was limited, and his leg didn’t extend fluidly in the follow-through. He had no pain, just the feeling that something was holding him back. After assessing him, I found that his adductors were excessively tight. When I released them, he immediately felt lighter, more mobile, and his kicking mechanics improved. The issue? Adductor overactivity, a common but often overlooked factor affecting footy players.
January 20, 2025
Have you ever experienced that annoying tingling or numbness in your hand, particularly in your ring and pinky fingers? It might feel like your arm fell asleep, but if it keeps happening, you could be dealing with ulnar nerve entrapment. Don’t worry, this is more common than you think, and your posture could be playing a bigger role than you realise. Let’s break it down in a way that’s easy to understand.
January 16, 2025
If you’re dealing with tendinopathy, you know how frustrating it can be. Tendinopathy causes pain and stiffness in the tendons, making it hard to move and do the things you love. Understanding how to manage it effectively can make a significant difference in your recovery and long-term function.