If you’re here, you’re probably dealing with shoulder pain that just won’t quit. Maybe it started after lifting something, reaching up, or sleeping wrong.

Now it’s getting in the way of your workouts, sleep, and everyday life. In fact, shoulder pain is one of the most common reasons people visit their doctor for muscle and joint problems¹ .

One of the most common causes? A supraspinatus tear, part of your rotator cuff. It’s small but crucial for lifting your arm.

As a physiotherapist, I see this all the time—especially in people looking for shoulder pain relief in Sandton.

This guide will walk you through what’s going on, how it happened, and the best ways to treat it with supraspinatus tear physiotherapy and more.

What is a Supraspinatus Tear?

A supraspinatus tear is a common injury to one of the four muscles that make up your rotator cuff—a group of muscles and tendons that help lift and move your shoulder.

The supraspinatus sits at the top of your shoulder blade and helps you lift your arm away from your body. When this muscle or its tendon tears, even simple things like reaching for a shelf or lifting a bag can become painful and difficult.

There are two types of supraspinatus tears:

Partial tear: The tendon is damaged but not fully torn.
Full-thickness tear: The tendon is completely torn and may even pull away from the bone.

This kind of tear can happen suddenly, like from a fall or heavy lift, or it can build up slowly over time from overuse.

That’s why it’s common in people who do repetitive overhead movements—think gym-goers, swimmers, builders, and even people who work at desks with poor posture.

How Common is It?

Supraspinatus tears are more common than you might think. Research shows that about 20-30% of people over 60 have a rotator cuff tear, rising to ~50% over 80². However, younger, active people aren’t off the hook—sports, lifting weights, and even poor posture can lead to tears at any age.

The supraspinatus is the most commonly torn of all the rotator cuff muscles, especially in people who lift weights or play sports that involve throwing or overhead movement. It’s also more common in men over 40, and in people with jobs or hobbies that involve repetitive arm use above shoulder height³.

Common Signs and Symptoms of a Supraspinatus Tear

Pain on the top or side of the shoulder: You feel a dull, aching pain at the top of your shoulder or slightly to the side, especially when moving your arm.
Pain when lifting your arm overhead: Reaching up to grab something, doing shoulder presses, or hanging up clothes brings on a sharp or pinching pain.
Worse when lying on the injured side: Sleeping on the sore shoulder causes discomfort, often waking you up or making it hard to fall asleep.
Weakness when lifting objects: Lifting a bag, kettle, or even a light dumbbell feels harder than usual—your shoulder may feel weak or unstable.
Pain when reaching behind your back: Trying to tuck in a shirt or reach a back pocket is painful or feels restricted.
Clicking or popping in the shoulder: You might hear or feel a click or pop when rotating or lifting your arm, especially in wide or circular movements.
Pain after lifting weights or heavy objects: The shoulder aches during or after exercises like bench press, push-ups, or overhead lifts.
Stiffness and limited range of motion: Your shoulder feels tight, especially in the morning or after long periods of rest.
Pain during everyday tasks: Daily activities like brushing your hair, reaching into a cupboard, or opening heavy doors can trigger pain.
Symptoms mostly on one side: It usually affects only one shoulder—typically your dominant arm.

Why Does a Supraspinatus Tear Happen?

If you have a supraspinatus tear, it means the tendon at the top of your shoulder has been damaged—either partially or fully. This tendon helps lift your arm and keep your shoulder stable. Over time, or from one sudden movement, it can wear down or snap, leading to pain, weakness, and reduced movement.

The supraspinatus tendon sits in a tight space between the bones in your shoulder. That space is already small, so anything that adds more pressure—like poor posture, overuse, or aging—can irritate the tendon and lead to a tear.

What Causes the Tear?

Overuse or repetitive strain

Doing the same shoulder movements again and again—like lifting weights, swimming, or overhead work—can slowly wear down the tendon until it tears³.

Poor posture or weak muscles

Slouching, rounded shoulders, or weak upper back muscles can shift how the shoulder moves and add stress to the tendon¹.

Age-related wear and tear

As we get older, our tendons naturally weaken. Small tears can form over time—even without a major injury².

Sudden injury

A fall, heavy lift, or sudden force can tear the tendon instantly, especially in active people or athletes.

Poor blood flow

A small area of the supraspinatus tendon gets very little blood. That makes healing harder and raises the risk of long-term damage if the area is overloaded or injured.

How Bad Can a Supraspinatus Tear Be?

As your physio, it’s important you understand that not all supraspinatus tears are the same. Some are small and heal well with rehab. Others are more serious and may need surgery.

Grade 1: Partial-Thickness Tear (Mild)

This means only a small part of the tendon is damaged. You’ll feel pain with certain movements, but your shoulder still works. Most people get better with simple physiotherapy and exercises.

Grade 2: High-Grade Partial Tear (Moderate)

More than half the tendon is torn, but it’s still attached. You’ll likely feel more pain and weakness, especially when lifting. Rehab is essential, and surgery might be needed if things don’t improve⁴.

Grade 3: Full-Thickness Tear (Severe)

This is a complete tear where the tendon has fully pulled away from the bone. The shoulder will feel very weak, and you may struggle to lift your arm. Surgery is often needed, followed by proper rehab².

Chronic Tears

If a tear is left untreated, it can get worse over time. The muscle may shrink or turn to fat, making recovery longer and harder⁵.

What Other Conditions Could It Be?

Shoulder pain isn’t always caused by a supraspinatus tear. As a physiotherapist, I want to make sure we’re treating the right issue. Here are five common ones that are often mistaken for a supraspinatus tear—and how they’re different.

Shoulder Impingement Syndrome

This feels a lot like a tear, especially with pain during overhead movements. But instead of a torn tendon, the supraspinatus is getting pinched by nearby bones. It’s usually a sharp, catching pain and may improve with posture correction and movement changes¹.

Supraspinatus Tendinopathy

This is when the tendon is worn down but not actually torn. The pain usually builds slowly over time and can feel similar to a partial tear. It’s more about overuse and less about a single injury⁶.

Frozen Shoulder (Adhesive Capsulitis)

Unlike a tear, frozen shoulder causes a deep, aching pain and a big loss in movement. Even if someone tries to move your arm for you, it stays stiff. It usually develops slowly and can last months².

Biceps Tendonitis

Pain from the biceps tendon usually shows up in the front of the shoulder, not the top or side. It often gets worse during lifting or rotation, like during curls or reaching forward⁷.

Pinched Nerve in the Neck (Cervical Radiculopathy)

Sometimes what feels like shoulder pain actually comes from the neck. A pinched nerve can cause tingling, numbness, or sharp pain down your arm. If your symptoms change when you move your neck, this might be the cause⁸.

Common Mistakes When Treating a Supraspinatus Tear

Pushing Through Shoulder Pain

Trying to “tough it out” or push through the pain during workouts often leads to more damage. A small tear can grow into a full tear if you keep stressing it. This usually leads to more pain, weakness, and a longer recovery.

Only Resting and Avoiding Movement

Rest is important at first—but too much rest can backfire. Your shoulder might become stiff, and muscles can weaken.

Without the right physiotherapy for shoulder injury, healing takes longer and the joint may not move as well.

Skipping Strength Exercises

Some people avoid strengthening because they’re afraid it will hurt. But rebuilding shoulder and rotator cuff strength is essential for recovery. Without it, the tendon stays weak and your shoulder is more likely to get injured again.

Going Back Too Soon

Just because the pain eases doesn’t mean you’re fully healed. Jumping back into overhead lifts or intense workouts too soon can cause the tendon to re-tear, setting your recovery back by weeks or months.

Waiting Too Long to Get Help

Hoping the pain will “go away on its own” is a risky move. The longer a tear goes untreated, the more likely the tendon and surrounding muscles will weaken.

In severe cases, the muscle can shrink or turn into fat, making surgery more likely and recovery harder⁵.

What Happens If You Don’t Treat It?

If you ignore a supraspinatus tear, the pain and weakness often get worse. Daily tasks like lifting a grocery bag, reaching overhead, or sleeping on your side can become painful or impossible.

Long-term, untreated tears can lead to serious muscle loss, joint problems, and the need for surgery.

Types of Scans

Here are the three most common scans and what we look for in each one as part of your diagnosis:

Ultrasound

This is a quick, non-invasive scan we often use. It lets us see your shoulder in real time while you move it.

We look for:

Swelling or inflammation around the tendon
Changes in tendon shape or thickness
Partial tears or irregular movement patterns

It’s especially helpful for early signs of injury or supraspinatus tendinopathy treatment.

MRI (Magnetic Resonance Imaging)

An MRI gives a very detailed image of your shoulder. It’s the best tool for spotting:

Full-thickness tears
How far the tendon has pulled back from the bone
Fat build-up in the muscle (which slows recovery)

This scan is often used when non-surgical rotator cuff treatment hasn’t worked, or if surgery is being considered.

X-ray

While an X-ray doesn’t show the tendon itself, it helps us rule out other problems. We look for:

Bone spurs that might be pressing on the tendon
Joint space narrowing (which could cause impingement)
Signs of arthritis that may be adding to the pain

Each scan offers a piece of the puzzle, and together they help us choose the best path to shoulder pain relief and full recovery.

Is Surgery Needed?

The good news is, surgery for a supraspinatus tear isn’t always needed. Many people improve with the right rehab plan, strength training, and supraspinatus tear physiotherapy.

But in some cases—especially when the tear is large or not healing—surgery becomes the best option to get your shoulder working properly again.

When Surgery Might Be Considered

You’ve had pain and weakness for more than 3 to 6 months.
You’ve already tried physiotherapy for shoulder injury, rest, and other treatments without success
You can’t lift your arm or do daily tasks like getting dressed, reaching, or carrying bags
Scans show a full-thickness tear or the tendon has pulled far from the bone
Your shoulder is still weak, unstable, or painful even after rehab

Surgery is done to reattach the torn tendon to the bone. Many surgeons now use small incisions and a camera (arthroscopic surgery), which means less scarring and a quicker recovery^4,2.

But remember—surgery is only step one. Recovery depends heavily on your post-op rehab. That’s where supraspinatus tear physiotherapy comes in. We’ll guide you through:

Gentle movement in the early phase to prevent stiffness
Gradual strengthening of the rotator cuff and surrounding muscles
Safe progressions back to work, sport, and training

Without proper rehab, even a great surgery won’t give you full results. A structured plan with your physio is the key to long-term strength, comfort, and confidence.

Treatment Options for a Supraspinatus Tear

As a physiotherapist, my goal is to help you recover from your supraspinatus tear without surgery when possible.

With the right care, most people can heal fully using evidence-based techniques and a tailored rehab plan. Here’s what that may include:

Exercises for Rotator Cuff Tear

Builds strength in the rotator cuff and shoulder blade muscles
Improves shoulder control and posture
Reduces pain and risk of re-injury

We’ll start with mobility and stability exercises, then progress to resistance training as your shoulder gets stronger. These shoulder pain physio exercises are key to improving your supraspinatus tear recovery time⁹.

Myofascial Release

Relieves tightness in the upper back, neck, and shoulder
Improves blood flow and mobility
Reduces discomfort from stiffness or poor posture

This hands-on technique is helpful if you’ve developed muscle tightness from guarding the injury or poor movement habits¹.

Orthopedic Manual Therapy

Restores shoulder movement by gently mobilizing joints
Reduces stiffness and improves range of motion
Works well alongside exercises for faster recovery

This is often part of early treatment, especially if your shoulder feels “stuck” or painful to move⁴.

Laser Therapy for Shoulder Pain

Speeds up healing by reducing inflammation
Improves blood flow to the tendon
Helpful for long-standing or hard-to-heal tears

This is a great tool for those with supraspinatus tendinopathy or chronic tears where pain has lasted months⁶.

Dry Needling

Releases deep muscle tightness and trigger points
Improves shoulder flexibility and function
Great for people with muscle guarding or stress-related tightness

Many people who have shoulder pain after lifting benefit from dry needling as part of a full rehab program¹.

Strapping and Taping

Supports the shoulder during daily activity or rehab
Improves posture and reduces strain on the tendon
Boosts confidence during movement and exercise

This is especially useful for people returning to sport or following rotator cuff tear rehab.

Combining the Right Treatments

The best outcomes come from combining these approaches. A mix of manual therapy, laser, targeted exercise, and needling—delivered by a qualified physiotherapist in Sandton for shoulder issues—can help you avoid surgery and get back to full strength.

Conclusion

As a physiotherapist, I want you to know that a supraspinatus tear doesn’t have to hold you back. With the right steps and a strong supraspinatus tear physiotherapy plan, you can return to training, lifting, and daily life—pain-free and confident.

I’ve worked with many people frustrated by ongoing shoulder pain. With the right support, smart exercise, and a consistent plan, they’ve come back stronger than ever—often without surgery.

If you’re looking for guidance—whether it’s expert advice, rehab support, or a trusted shoulder pain physio—I’m here to help you feel like yourself again.

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References

Chawla, K., Khan, Z. and Dhar, N., 2023. Physiotherapist’s perspective to importance of pathophysiology of supraspinatus tendonitis in proper rehabilitation of pain and dysfunction. IARS’ International Research Journal, 13(1), pp.6–9. Available at: https://www.iarconsortium.org/articles/physiotherapist-s-perspective-to-importance-of-pathophysiology-of-supraspinatus-tendonitis-in-proper-rehabilitation-of-pain-and-dysfunction/
Mall, N.A., Lee, A.S., Chahal, J., Romeo, A.A., Verma, N.N., Cole, B.J. and Bach, B.R., 2013. An evidence-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 29(2), pp.366–376.e4. https://doi.org/10.1016/j.arthro.2012.06.024
Tennent, T.D. and Green, R.A., 2020. Partial articular supraspinatus tendon avulsion: should we repair? A systematic review. Shoulder & Elbow, 12(4), pp.253–264. https://doi.org/10.1177/1758573219864101
Osti, L., Buda, M., Massari, L. and Del Buono, A., 2017. Transtendon repair in partial articular supraspinatus tears: a systematic review of clinical and imaging outcomes. Muscles, Ligaments and Tendons Journal, 7(4), pp.478–484. https://doi.org/10.1093/bmb/ldx023
Tenbrunsel, T., Whaley, J., Mazzocca, A. and Arciero, R., 2019. Efficacy of imaging modalities in assessing fatty infiltration of the rotator cuff: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 35(7), pp.2089–2100. https://doi.org/10.1016/j.arthro.2019.01.040
Elattar, M., Halawa, A., Sadek, A.F. and El-Sayed, M., 2021. Management of calcific supraspinatus tendinitis: a systematic review of outcomes. Orthopedic Reviews, 13(3), p.22334. https://dx.doi.org/10.21608/bjas.2021.169812
Redondo-Alonso, R., Chamorro-Moriana, G., Párraga-Montilla, J.A. and Jiménez-Rejano, J.J., 2014. Relationship between chronic pathologies of the supraspinatus tendon and the long head of the biceps tendon: a systematic review. Revista Española de Cirugía Ortopédica y Traumatología (English Edition), 58(6), pp.380–386. https://doi.org/10.1186/1471-2474-15-377
Zhao, J., Luo, M., Liang, G., Wu, M., Pan, J., Zeng, L., Yang, W. and Liu, J., 2021. Risk factors for supraspinatus tears: A meta-analysis of observational studies. Orthopaedic Journal of Sports Medicine, 9. Available at: https://doi.org/10.1177/23259671211042826
Edwards, P.K., Ebert, J.R., Joss, B.K., Bhabra, G., Ackland, T.R. and Janes, G.C., 2017. A systematic review of electromyography studies in normal shoulders to inform postoperative rehabilitation following rotator cuff repair. Physical Therapy in Sport, 25, pp.30–40. https://doi.org/10.2519/jospt.2017.7271

Supraspinatus Tear: 5 Proven Steps to Treat It

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