Rotator Cuff Tendonitis: Causes, Symptoms, and Exercises to Relieve Pain and Improve Mobility

Maybe you’ve been perfecting your golf swing, pushing yourself in the weight room, or diving into a new summer swim routine. But now, you’re feeling twinges of pain when you reach overhead — grabbing something from a cabinet, throwing a ball for your dog, or even just getting dressed. Your shoulder feels stiff, maybe even weaker than usual.

If this sounds familiar, you might be dealing with rotator cuff tendonitis (tendinitis) — a common condition that occurs when the tendons in your shoulder become irritated or inflamed, often due to repetitive movements or a sudden increase in activity. “It’s especially common if you’ve ramped up a new activity too quickly,” says Joey Loeb, PT, DPT, a physical therapist at Hinge Health.

As inconvenient as rotator cuff tendonitis is, recovery doesn’t have to mean sitting on the sidelines. Gentle movement and targeted exercises can help ease pain, restore flexibility, and get your shoulder back in top form.

Here’s what you need to know about rotator cuff tendonitis — what causes it, what it feels like, and expert-backed treatments, including exercises recommended by Hinge Health physical therapists.

What Is Rotator Cuff Tendonitis?

Your rotator cuff is made up of four muscles — the supraspinatus, infraspinatus, teres minor, and subscapularis — along with the tendons that connect them to the top of your upper arm bone (humerus). Together, they form a supportive “cuff” around your shoulder joint, helping you lift, push, and rotate your arm.

With rotator cuff tendonitis, these tendons become inflamed, leading to pain right where they attach to your upper arm bone. “It can affect one, several, or even all four tendons,” says Dr. Loeb. “But unlike some other causes of rotator cuff pain, tendonitis symptoms stay mostly in the shoulder joint itself, rather than radiating to your neck or down your arm.”

Rotator Cuff Tendonitis Symptoms

If you have rotator cuff tendonitis, you’ll mostly feel symptoms in the front of your shoulder, says Dr. Loeb. “The pain can be sharp and focused in one spot, or it may feel more like a dull ache or burning sensation,” he explains. 

Other common symptoms of rotator cuff tendonitis include:

• Pain that worsens when reaching overhead or behind your back

• Discomfort with lifting and reaching movements

• Pain at night, especially when sleeping on the affected shoulder

• Pain that sometimes spreads from the front of your shoulder down the side of your arm

• Reduced shoulder strength and flexibility

What Causes Rotator Cuff Tendonitis?

Rotator cuff tendonitis usually develops gradually over time, says Dr. Loeb. Here are some common causes. 

• Doing too much too soon. If you suddenly increase the intensity or frequency of activities like tennis, swimming, or weightlifting, your rotator cuff tendons may become overworked. “When the tendons experience more stress than they’re used to without enough time to adapt, they can become irritated and inflamed,” explains Dr. Loeb.

• Repetitive overhead movements. The rotator cuff is very well able to handle a variety of activities, including overhead movements. But sports like tennis, swimming, baseball, and volleyball that naturally involve very frequent overhead motions may put extra strain on the tendons, especially with a sudden increase in activity. Similarly, occupations like painting, construction, or hairstyling that involve regular overhead arm use can contribute to shoulder pain over time.

• Movement habits and muscle balance. Your shoulders are designed to move in many different ways, and variety in movement helps keep them strong and resilient. If certain muscles around your shoulder or upper back aren’t as active or coordinated as they could be, the rotator cuff tendons may have to work a little harder. Similarly, spending long periods in one position — like sitting at a desk or working overhead — can sometimes lead to extra shoulder fatigue. 

• Age-related changes. As we age, the rotator cuff tendons naturally become less flexible and more prone to irritation. This is why rotator cuff tendonitis is more common in people over 40, even without a sudden increase in activity.

• Underlying medical conditions. Certain health conditions, such as diabetes, high cholesterol, and thyroid disease can increase the likelihood of tendon inflammation. (Note that statin use for high cholesterol may provide some protection against tendonitis.) 

• An injury. While most cases of rotator cuff tendonitis develop gradually, an acute injury — such as falling on an outstretched arm, forcefully pulling or lifting something heavy, or a direct blow to the shoulder — can also trigger inflammation.

If you have rotator cuff tendonitis, it’s natural to want to limit movement when your shoulder feels sore. But movement is one of the best ways to support healing. Gentle exercises that focus on both range of motion and strength help keep your shoulder flexible, reduce stiffness, and build resilience in the surrounding muscles. These rotator cuff tendonitis exercises are recommended by Hinge Health physical therapists to help you move with more ease and confidence.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Rotator Cuff Tendonitis Treatments

When it comes to your rotator cuff, movement is medicine, says Dr. Loeb. “You want to keep it strong and flexible because it plays such a crucial role in everyday activities,” he explains. “Resting completely might make your shoulder feel better in the short term, but it can actually slow recovery. Movement helps increase blood flow and nutrients to the injured area, supporting healing.” Most of the time, rotator cuff tendonitis can be treated at home with simple, conservative care. Here’s what can help. 

• Do exercise therapy. You should start doing gentle stretching and strengthening exercises as soon as possible to maintain your shoulder’s range of motion and support the rotator cuff muscles and tendons. Research shows that a regular exercise program can improve pain, function, and overall quality of life in people with rotator cuff injuries. The exercises above are a great place to start, as long as they feel okay for you. 

• Work with a physical therapist. If your pain limits movement or persists despite home exercises, or the exercises mentioned above are too difficult, a physical therapist can help guide you through the right movements and modifications. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• Use ice or heat. If your shoulder feels swollen, ice can help reduce inflammation, says Dr. Loeb. Apply it to the upper and outer portion of your shoulder for 10 to 15 minutes several times a day. After a few days, switching to moist heat can improve blood flow and help relax tight muscles.

• Modify activity. You don’t need to completely avoid using your shoulder — just be mindful of movements that cause an unacceptable increase in your pain while inflammation in your rotator cuff settles down. Dr. Loeb suggests small adjustments to stay active while giving your shoulder time to recover:

  • If swimming is uncomfortable, try the sidestroke or breaststroke instead of freestyle.

  • In sports, switch to underhand throws instead of overhand for a while.

  • At the gym, focus on lighter weights and avoid pushing exercises like push-ups, bench presses, and chest flies.

  • When lifting, try to keep movements below shoulder level when possible and hold heavier objects close to your body to reduce strain.

• Over-the-counter medications. Nonsteroidal anti-inflammatory medications (NSAIDs) such as naproxen (Aleve), ibuprofen (Advil, Motrin) and aspirin can all be helpful for pain from rotator cuff tendonitis. It’s important to make sure that you’re safely able to take these medications, based on your medical history.

Most people feel significantly better after six to eight weeks of consistent exercise or physical therapy, says Dr. Loeb. If your pain doesn’t improve, it may be time to see a doctor. They can assess whether something more serious, like a rotator cuff tear, is causing your symptoms. In some cases, a steroid injection may be recommended to provide temporary pain relief, allowing you to stay active and continue rehabilitation.

PT Tip: Stay Ahead of Shoulder Pain 

“A consistent exercise routine for your shoulders is beneficial, even if you’re not experiencing pain or stiffness,” says Dr. Loeb. “Keeping them strong and mobile helps reduce the risk of overuse injuries like rotator cuff tendonitis — especially if you’re active in sports or do a lot of lifting.”

How Hinge Health Can Help You

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program. 

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. 

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References 

1. Leong, H., Fu, S., He, X., Oh, J., Yamamoto, N., & Yung, S. (2019). Risk factors for rotator cuff tendinopathy: A systematic review and meta-analysis. Journal of Rehabilitation Medicine, 51(9), 627–637. doi:10.2340/16501977-2598

2. Varacallo, M., & Mair, S. D. (2019, June 4). Rotator Cuff Tendonitis. Nih.gov; StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK532270/

3. Lin, T. T.-L., Lin, C.-H., Chang, C.-L., Chi, C.-H., Chang, S.-T., & Sheu, W. H.-H. (2015). The Effect of Diabetes, Hyperlipidemia, and Statins on the Development of Rotator Cuff Disease. The American Journal of Sports Medicine, 43(9), 2126–2132. doi:10.1177/0363546515588173

4. Christensen, B. H., Andersen, K. S., Rasmussen, S., Andreasen, E. L., Nielsen, L. M., & Jensen, S. L. (2016). Enhanced function and quality of life following 5 months of exercise therapy for patients with irreparable rotator cuff tears – an intervention study. BMC Musculoskeletal Disorders, 17(1). doi:10.1186/s12891-016-1116-6

5. Liaghat, B., Pedersen, J. R., Husted, R. S., Pedersen, L. L., Thorborg, K., & Juhl, C. B. (2022). Diagnosis, prevention and treatment of common shoulder injuries in sport: grading the evidence – a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). British Journal of Sports Medicine, 57(7), bjsports-2022-105674. doi:10.1136/bjsports-2022-105674

6. Simons, S. M., & Kruse, D. (2024, August 14). Rotator cuff tendinopathy. UpToDate. Retrieved from https://www.uptodate.com/contents/rotator-cuff-tendinopathy

7. Tangtiphaiboontana, J., Aibinder, W. R., & Armstrong, A. D. (2024, June). Shoulder Impingement/Rotator Cuff Tendinitis. OrthoInfo — American Academy of Orthopaedic Surgeons. Retrieved from https://orthoinfo.aaos.org/en/diseases--conditions/shoulder-impingementrotator-cuff-tendinitis/\