Rotator cuff disease is a complex condition. It includes a variety of pathologies, ranging from tendinosis to complete tear. The cause seems to be multifactorial and is most likely a combination of major trauma, microtrauma from daily wear and tear, and age related degeneration. When establishing a program for the patient with rotator cuff dysfunction, the rehabilitation specialist should consider biomechanical factors, the patient's functional goals, and issues beyond the shoulder that may affect the course of the disease.