Shoulder Pain in Older Adults: Understanding Rotator Cuff Tendinopathy
Shoulder pain is common in older adults and can make reaching, lifting, or even dressing difficult. One frequent cause is rotator cuff tendinopathy, where the tendons in the shoulder become irritated over time. With proper care, most older adults improve without surgery through physical therapy and safe exercises.
Common Symptoms
Pain at the top or side of the shoulder
Difficulty lifting the arm overhead
Night pain, especially when lying on the affected shoulder
Weakness or stiffness in daily tasks
Why It Happens
Rotator cuff tendons can become irritated due to:
Age-related changes in tendon tissue
Overuse or repetitive movements
Poor posture or movement patterns
Gentle movement is usually safe and helps recovery — pain does not always mean damage.
Safe Exercises for Older Adults
Physical therapy focuses on gentle, progressive exercises to restore strength, mobility, and function.
1. Pendulum Swings (Gentle Range of Motion)
Lean forward slightly, let the affected arm hang
Swing the arm gently in small circles or back and forth
1–2 minutes, 1–2 times per day
2. Wall Slides (Flexibility & Shoulder Mobility)
Stand facing a wall, forearm on the wall
Slowly slide the arm upward as far as comfortable, then back down
8–10 repetitions, 1–2 sets
3. Shoulder Blade Squeezes (Posture & Stability)
Sit or stand tall
Squeeze shoulder blades together gently, hold 3–5 seconds, relax
10 repetitions, 1–2 sets
4. Gentle Resistance Band Exercises (Strengthening)
Use a light resistance band to strengthen rotator cuff muscles
External rotation: elbow bent 90°, rotate forearm outward
8–10 repetitions, 1–2 sets
5. Daily Activity Integration
Gradually return to reaching, lifting, and overhead tasks
Break tasks into smaller steps to avoid overloading the tendon
Tip: Mild soreness is normal, but pain should not worsen the next day.
What to Expect in Physiotherapy
Assessment & Education: Understanding safe movement and activity limits
Exercise Guidance: Gentle stretching and strengthening tailored to your ability
Posture Training: Correcting shoulder and upper back position to reduce strain
Gradual Progression: Slowly increasing strength, range of motion, and activity
Activity Coaching: Advice on safely performing daily tasks
Recovery Tips
Be consistent with exercises
Avoid sudden increases in activity or heavy lifting
Use supportive seating and maintain good posture
Be patient — improvements often take several weeks
With the right approach, older adults can reduce pain, improve function, and safely return to daily activities.
Reference
Kirk‑Sanchez, N., McDonough, C., Avin, K. G., Blackwood, J., & Hanke, T. (2025). Rotator cuff tendinopathy: Diagnosis, non-surgical medical care, and rehabilitation – Clinical practice guideline (CPG+). Journal of Geriatric Physical Therapy, 48(2), 88–112. https://doi.org/10.1519/JPT.0000000000000455