Resolving Rotator Cuff Shoulder Pain Using Strength Testing and Targeted Rehab at McFerran Physio

Introduction
Shoulder pain during overhead activities or workouts is often caused by rotator cuff dysfunction — a group of small but crucial muscles that stabilize and rotate the shoulder joint. At McFerran Physio, we regularly assess and treat this condition using a combination of strength testing, targeted rehab, and movement education. In this case study, we share how a 42-year-old gym-goer regained pain-free function after months of discomfort.

Patient Background
This 42-year-old male was healthy, active, and regularly attending the gym. For the previous 2–3 months, he had experienced intermittent shoulder pain, particularly during:

• Overhead gym exercises.
• Everyday movements like reaching into cupboards.
• Playing with his children.

He had tried:

• Paracetamol and anti-inflammatory medication.
• Sports massage therapy.
• Exercise modification in the gym.

Unfortunately, none of these interventions provided lasting relief.

Assessment & Diagnosis

Clinical Examination Findings

• Full range of motion in the shoulder.
• Slight discomfort with active elevation and abduction.
• No pain with passive movements.
• Weakness detected on internal rotation strength testing of the affected shoulder.

Gym-Based Functional Testing

Using the cable machine at McFerran Physio, we tested internal rotation strength in both arms:

• The non-affected side performed well under load.
• The affected side showed a clear strength deficit.

This confirmed a diagnosis of rotator cuff-related shoulder pain, likely involving the subscapularis muscle — a key internal rotator in the shoulder’s rotator cuff complex.

Patient Education

We explained:

• The anatomy and role of the rotator cuff.
• How the rotator cuff muscles stabilize and guide movement of the shoulder.
• How imbalances or weakness in even one muscle can lead to shoulder dysfunction.

The patient was reassured that this type of issue responds well to targeted strengthening and progressive load — and that surgery or invasive treatment would not be necessary.

Treatment Approach

Phase 1: Internal Rotation Strengthening

• Cable machine internal rotation drills.
• Progressed to reactive internal rotation (releasing and catching resistance).
• Introduced unstable surface work using a Swiss ball against the wall.

Phase 2: Functional Scapular Control

• Scapular stabilisation exercises.
• Modified gym routines to avoid aggravation while preserving strength.

Phase 3: Gym Reintegration

• Reintroduced previously painful movements once internal rotation strength had improved.
• Used cable machine testing to track strength symmetry between sides.
• Reinforced good loading habits to prevent future flare-ups.

Outcome

After just 4–5 sessions, the patient:

• Reported no pain at home or at work.
• Was playing with his kids without twinges or restrictions.
• Fully returned to all gym exercises pain-free, including overhead work.
• Achieved symmetry in internal rotation strength between both shoulders.

Conclusion

This case highlights the benefit of combining:

• Accurate clinical diagnosis.
• On-site gym-based strength testing.
• Progressive, patient-led rehab.
• Education and reassurance.

At McFerran Physio, our ability to move from consultation room to fully equipped gym allows us to test, train, and treat in real-time — accelerating recovery and improving long-term outcomes.

If you’re struggling with shoulder pain in the gym or during daily life, our expert team can help restore strength and function.

Book your assessment today and let’s get your shoulder working again.