Rotator Cuff Soreness or Injury? 
An Expert Weighs In

January 23, 2026

Rotator cuff injuries can be painful, but not every rotator cuff injury requires surgery. Scott Lowe, PT, DPT, OCS, FAAOMPT, and assistant professor of physical therapy at PCOM Georgia provides insights on how this group of muscles and tendons function, and what treatment options to explore if it is a source of pain.

The rotator cuff refers to the group of four muscles and tendons that attach to the upper arm bone. As the name suggests, these muscles are some of the primary movers for rotational motion, however, their role in stabilizing and controlling other arm movements is also vital.

Lowe says that rotator cuff tears can feel different depending on whether the tear is traumatic or not. “The size of the tear influences how it feels; oftentimes small tears are quite painful, whereas full tears may present primarily with weakness, but not a lot of pain.”

While causes of a tear can vary, a lot of times these injuries occur as people get older and the tendons in the rotator cuff become too weak to handle repeated stress. According to Lowe, these gradual tears tend to be less painful than those that occur due to a fall or trauma.

To differentiate between muscle soreness and a rotator cuff injury, Lowe recommends visiting a physical therapist who can perform appropriate testing as it can be hard to diagnose on your own. Additionally, if someone is experiencing significant weakness or difficulty lifting the arm, there is risk of more structural damage and thus a need to seek medical attention.

“The simplest assessment would be to gauge how quickly the symptoms improve. Muscle soreness after physical activity typically improves in 1-3 days, whereas the symptoms from an actual structural injury are likely to last longer, and warrant further professional assessment,” shared Lowe.

There are several clinical tests that have fairly good diagnostic accuracy to help determine the cause of upper arm and shoulder pain. An MRI, especially one with contrast dye, is considered the "gold standard," though even this is not 100% accurate, says Lowe.

For cases that do not require immediate surgical attention, Lowe says a physician can prescribe strong anti-inflammatory medications or inject steroids into the affected area to ease pain. Additionally, physical therapy can provide exercises to strengthen the cuff itself and the surrounding muscles to improve stability and function.

“It's important to listen to your body because it will often tell you when to seek medical treatment," said Dr. Lowe. "Recognizing warning signs of rotator cuff injuries early and seeking proper treatment not only will relieve pain quicker, but also help preserve strength, motion and long-term shoulder function."

You May Also Like:

• PCOM Georgia Unveils New Mural by Renowned Atlanta Artist
• PCOM Georgia Celebrates White Coat Ceremonies for PharmD and DPT Students
• Willette Shines in Hollywood and PCOM Georgia's Simulation Center