Which activity typically worsens pain in rotator cuff syndrome?

• A. Overhead lifting
• B. Pain worsens with rest
• C. Pain improves with overhead activity
• D. No relation to activity

Answer: (A)

Overhead lifting and elevation worsen pain in rotator cuff syndrome because the supraspinatus tendon (and nearby tendons) is compressed under the acromion as the arm is raised. This subacromial impingement irritates a tendon that is already inflamed or torn, making pain come on with overhead movements like reaching, lifting, or throwing. The pain is mechanical and activity-related, often improving with rest when the tendon has time to recover.

Pain that worsens with rest would suggest a non-use-related process or inflammatory pain rather than impingement. A pattern where pain improves with overhead activity doesn’t fit rotator cuff impingement, and no relation to activity would ignore the hallmark mechanical nature of this condition.