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Physiotherapy · Rotator cuff tear

Rotator cuff tear physio in Phuket

A torn cuff is not the whole story. Our physios work out which kind of tear you have, build your shoulder strength with check points at weeks 6 and 12, and arrange a surgical opinion when the numbers say so.

For a tear found on a scan, a recent shoulder injury, or rehab after a repair.

Book a free physio assessment

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Rated 5.0 from 57 Google reviews

What the research says

A scan tear is not a verdict

Rotator cuff tears become more common with age, and many cause no pain.1 Some do well with exercise, some need a surgeon, and injuries differ from wear.

  • 2 in 3

    full-thickness tears found on screening in one Japanese village caused no symptoms at all.1

  • 27%

    of 432 people followed with wear-related tears in one US study had surgery within 10 years. Shoulder scores held steady in the rest.2

  • 2wks

    If you still cannot lift your arm two weeks after an injury, a shoulder specialist should see you urgently.3

Exercise first suits wear-related tears. Injuries and some tears need a surgeon. Testing shows which path is yours.4

How we work

Know the tear, load, measure, decide

We start by working out which kind of tear you have. Wear-related tears start with progressive exercise. Injuries go to a specialist quickly. After surgery, we follow your surgeon’s plan.

  • Sort the tear first

    A tear from gradual wear and a tear from a fall are different problems. Sudden weakness after an injury needs a specialist check, not a home program.3

  • Exercise first for wear

    A Dutch guideline advises starting with exercise for wear-related tears, and considering surgery if you are not improving after 3 to 6 months.4 We build cuff and shoulder strength step by step.

  • Measure, then decide

    We test strength on both arms and score your shoulder at the start, at week 6 and at week 12. If you are not improving, we arrange a surgical opinion with real numbers.

  • Honest odds

    In one trial of small-to-medium tears, repair gave better shoulder scores than physio 15 years later.5 Another trial of small tears in people over 55 found no difference.6 We tell you which group you resemble.

Your recovery

Four phases, two check points

Times are typical, not targets. After surgery, your early weeks follow your surgeon’s plan first.

  1. 01

    Typically 0 to 2 weeks

    Settle and keep moving

    Calm a sore shoulder without resting it completely. Your physio checks the type of tear, tests both arms and teaches gentle loading: wall holds, table slides and light band rows.

    Move on whenNight pain is easing, daily tasks up to shoulder height are manageable, and wall holds stay green the next morning, with no new weakness.

  2. 02

    Typically 2 to 6 weeks

    Build cuff strength

    Rotator cuff and shoulder blade work with weights and bands, three times a week, adding a little load whenever the traffic light stays green.

    The week 6 checkThree sessions a week for 2 weeks, all green, loads rising, strength holding or better, and your shoulder score improving. Your physio signs it off.

  3. 03

    Typically 6 to 12 weeks

    Overhead strength

    A coach runs your sessions to your physio’s plan: rotation at shoulder height, a pressing ladder, rows, pulldowns and controlled carries, two to three times a week.

    The week 12 retestShoulder score at least 13 points better,7 strength at least 80% of the other arm, and 8 overhead presses green the next morning. Not there? We arrange a surgical opinion.4

  4. 04

    From about 12 weeks

    Power and return

    An S&C coach builds speed, power and sport loading in 4-week blocks: medicine ball throws, heavy presses and pulls, and sport ladders for padel, swimming, golf and Muay Thai.

    Full return whenStrength at least 90% of the other arm, two weeks of full training all green, and your sport ladder completed. These are clinic standards.

A known tear is worth a yearly strength check: about a third of unrepaired tears grew over five years in one trial.8

Between sessions

Your traffic light for every session

Mild discomfort while you train is fine. What matters is how your shoulder responds by the next morning.

Check three things: pain during exercise (about 3 out of 10 is fine), the next morning, and your strength and reach.

  • Green: progress

    Pain 3 out of 10 or less, no worse next morning, strength and reach unchanged. Keep going and progress as planned.

  • Amber: hold

    Pain up to 5 out of 10, or a little sore next morning but settled within 24 hours. Repeat the same dose.

  • Red: step back

    Pain over 5, worse next day or at night, new weakness or lost reach. Drop back a step and tell your physio within 48 hours.

Get medical help today if

  • Chest pain or sudden breathlessness: call 1669 now
  • A painful, swollen calf or arm after surgery
  • Fever, or a hot, red or leaking wound
  • The arm will not lift, or looks deformed, after an injury
  • A hot, swollen shoulder and you feel unwell
  • New weakness or numbness spreading down your arm

See a doctor within days if you are over 40 after dislocating, or cannot lift your arm to shoulder height two weeks after an injury.3

Had cuff surgery?

Protect it early, then rebuild

Your surgeon’s protocol always comes first. After small-to-medium repairs, starting movement early gave similar results to waiting, and may reduce stiffness.9,10 One trial found three weeks in a simple sling did as well as six weeks in a brace.11 Very large repairs may need a slower start.12

In one trial, supervised physio after repair was no better than a well-taught home program at one year.13 So we teach, test and progress you, rather than book sessions for their own sake.

75%

of overhead athletes in published studies returned to sport after repair14

6.4 mo

average time to return; 63% returned at their previous level14

Patient reviews

What our patients say

Rated 5.0 from 57 Google reviews

  • “I had an impingement in my shoulder an Karim solved it within three sessions! Really amazing! I can only recommend going there.”

    Julian BarthGoogle review

  • “I have been working with Khun Meaw on some strengthening exercises for my shoulders, hips and knees. … Her goal has been to give me the tools I need to work on my specific areas of need and not to keep me in an endless cycle of needing help……so professional and a joy to work with.”

    Catlin McCrackenGoogle review

  • “I honestly can’t thank Karim at Optimisefit enough … I’ve lived in five different countries and, unfortunately, had to deal with many injuries, so I’ve seen quite a few physios over the years. But no one has ever come close to the level of knowledge, care, and clarity that he brings.”

    Unfiltered OpinionsGoogle review

  • “Optimise is a fantastic set up, I have been working with Khun Meaw on a physio front, and she is awesome and really gets to the root of the problem and starts from there – could not recommend highly enough. Having seen a couple of different physios on the island, Khun Meaw is certainly number 1.”

    Jamie AllworkGoogle review

  • “Meaw has been incredible. She helped me recover from long term neck and lower back pain and gave me personalized exercises that I now do daily. These have made a huge difference in my strength, mobility, and overall well-being. I’m so grateful for her expertise and highly recommend her to anyone looking for real, lasting results!”

    Jeff CraigGoogle review

  • “I have been seeing Karim for long term issues with my neck and the results have been fantastic. I have attended several physios in the past and none compare to Karim. His skills and knowledge helped to pinpoint the exact cause of the issues and the treatment plan has made massive improvements.”

    joyce billingtonGoogle review

  • “I started seeing Khun Maew last August for a knee issue and within 15 minutes she had identified a multitude of issues I’d been dealing with for more than 20 years … I have been pain free for 6 months and am now in the gym working to rebuild my mobility and strength.”

    Michelle LawlorGoogle review

Read all 57 reviews on Google

Questions

Rotator cuff tear questions

Does a torn tendon always need surgery?

No. Many tears cause no pain at all.1 In one large study of wear-related tears, 27% of 432 people had surgery over 10 years, and scores held steady in the rest.2

Does exercise work as well as surgery for every tear?

Not for every tear. In one trial of small-to-medium tears, repair gave better shoulder scores 15 years later.5 Tear type, size, age and goals all matter.

Will my tear keep getting bigger?

About a third of unrepaired tears grew in one trial, but not all.8 In a 10-year study, only 1 in 432 people needed a shoulder replacement.2 Yearly strength checks catch change early.

After surgery, is longer in the sling safer?

For small-to-medium repairs, early and later movement gave similar results.9 One trial found three weeks in a sling did as well as six weeks in a brace.11 Always follow your surgeon’s plan.

Does surgery stop the shoulder wearing out?

In one trial in people over 55, repair did not slow joint wear compared with physio over about six years.6

What happens at the free physio assessment?

Your physio works out whether your tear is from wear or injury, tests both arms and screens for anything that needs a doctor first. You leave with a clear plan. It’s free, with no obligation.

Physio team

Your physio team

Meaw leads our clinical standards and checks every handover to your coach.

How physiotherapy works here
  • Meaw, Head Physiotherapist at Optimise

    Meaw

    Head Physiotherapist

  • Karim, Physiotherapist at Optimise

    Karim

    Physiotherapist

Also on the team Sukanya, Physiotherapist

Next step

Know your numbers before you decide

Message us on WhatsApp to book your free physio assessment. Scan result, recent injury or fresh repair, you leave with a measured plan.

Book a free physio assessment

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Questions first? WhatsApp +66 65 914 1604

Low back painSciaticaShoulder painKnee arthritisRunner’s kneeACL rehabAnkle sprainNeck painTendon painHamstring strainMeniscus tearsHeel painHip arthritisFrozen shoulderKnee and hip replacement
Sources (14)
  1. Minagawa H, Yamamoto N, Abe H, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. J Orthop. 2013;10(1):8-12.
  2. Kuhn JE, Dunn WR, Sanders R, et al. The predictors of surgery for symptomatic, atraumatic full-thickness rotator cuff tears change over time: ten-year outcomes of the MOON Shoulder Prospective Cohort. J Bone Joint Surg Am. 2024;106(17):1563-1572.
  3. Craig R, Holt T, Rees JL. Acute rotator cuff tears. BMJ. 2017;359:j5366.
  4. Lambers Heerspink FO, Veen EJD, Dorrestijn O, et al. Update of guideline for diagnosis and treatment of subacromial pain syndrome, Part 2. Acta Orthop. 2026;97:99-104.
  5. Moosmayer S, Lund G, Seljom US, et al. Fifteen-year results of a comparative analysis of tendon repair versus physiotherapy for small-to-medium-sized rotator cuff tears. J Bone Joint Surg Am. 2024;106(19):1785-1796.
  6. Kukkonen J, Ryösä A, Joukainen A, et al. Operative versus conservative treatment of small, nontraumatic supraspinatus tears in patients older than 55 years: over 5-year follow-up of a randomized controlled trial. J Shoulder Elbow Surg. 2021;30(11):2455-2464.
  7. Roy JS, MacDermid JC, Woodhouse LJ. Measuring shoulder function: a systematic review of four questionnaires. Arthritis Rheum. 2009;61(5):623-632.
  8. Moosmayer S, Lund G, Seljom US, et al. Tendon repair compared with physiotherapy in the treatment of rotator cuff tears: a randomized controlled study in 103 cases with a five-year follow-up. J Bone Joint Surg Am. 2014;96(18):1504-1514.
  9. American Academy of Orthopaedic Surgeons. Management of Rotator Cuff Injuries: Evidence-Based Clinical Practice Guideline. Rosemont, IL: AAOS; 2025.
  10. Hao B, Li H, Liang A. Effects of early exercise and immobilization after arthroscopic rotator cuff repair surgery: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord. 2025;26(1):254.
  11. Jenssen KK, Lundgreen K, Madsen JE, et al. No functional difference between three and six weeks of immobilization after arthroscopic rotator cuff repair: a prospective randomized controlled non-inferiority trial. Arthroscopy. 2018;34(10):2765-2774.
  12. Kluczynski MA, Nayyar S, Marzo JM, Bisson LJ. Early versus delayed passive range of motion after rotator cuff repair: a systematic review and meta-analysis. Am J Sports Med. 2015;43(8):2057-2063.
  13. Karppi P, Ryösä A, Kukkonen J, et al. Effectiveness of supervised physiotherapy after arthroscopic rotator cuff reconstruction: a randomized controlled trial. J Shoulder Elbow Surg. 2020;29(9):1765-1774.
  14. Migliorini F, Asparago G, Cuozzo F, et al. Patient outcomes and return to play after arthroscopic rotator cuff repair in overhead athletes: a systematic review. J Orthop Traumatol. 2023;24(1):3.

This page is general information based on the research listed here. It is not a diagnosis. Your physio will tailor the plan to you, and your surgeon’s or doctor’s instructions come first. Clinically reviewed by Meaw, Head Physiotherapist at Optimise, November 2026.