Objective To investigate the therapeutic efficacy of the combination of upper limb rehabilitation robots （ULRR） and ultrasound-guided extracorporeal shock wave （ESW） in the treatment of mild to moderate rotator cuff injuries. Methods A total of 90 patients with mild to moderate rotator cuff injuries， who were admitted to the Second Affiliated Hospital of Anhui Medical University between January 2023 and March 2024， were selected and randomly assigned to three groups： Group A （basic rehabilitation）， Group B （basic rehabilitation + ESW）， and Group C （basic rehabilitation + ESW + ULRR）， with 30 patients in each group. Before and after treatment， shoulder pain was assessed using the visual analogue scale （VAS）. Proprioception was evaluated based on shoulder joint position reproduction error. The integral electromyography （iEMG） and root mean square （RMS） values of the median tract， supraspinatus， infraspinatus， and deltoid muscles on the affected side were measured using surface electromyography （sEMG）. The active range of motion （AROM） for external rotation， abduction， and forward flexion of the affected shoulder was measured using a standard goniometer. Overall shoulder function was evaluated using the Constant-Murley Shoulder Score （CMS）. The clinical efficacy rate and patient satisfaction levels were compared among the three groups. Results After treatment， the VAS score and shoulder position reproduction deviation angle in all three groups significantly decreased. Additionally， the iEMG and RMS values of the middle deltoid， supraspinatus， and infraspinatus muscles； the AROM of shoulder external rotation， abduction， and forward flexion； and the CMS scores （including pain， activities of daily living， active range of motion， and muscle strength） all showed significant improvement. Furthermore， the degree of improvement in all evaluated parameters in Group C was significantly greater than that observed in Groups A and B （P < 0.05）. Moreover， Group C demonstrated a significantly higher clinical response rate and greater patient satisfaction compared to Groups A and B （P < 0.05）. Conclusion For patients with mild to moderate rotator cuff injuries， the integration of an upper limb rehabilitation robot with extracorporeal shock wave therapy demonstrates superior therapeutic outcomes， effectively alleviating pain， enhancing motor function and proprioception， and increasing overall patient satisfaction.