Background: Rotator cuff injuries are a leading cause of chronic shoulder pain and functional disability. In Ayurveda, these presentations are categorized under Avabahuka and Snayu Marma Abhighata. Methods: A 58-year-old male with an MRI-confirmed full-thickness rotator cuff tear and poorly controlled Type 2 Diabetes Mellitus was treated with a multimodal Ayurvedic protocol. Treatment included internal medications (Rasnerandadi Kashayam), external therapies (Jadamayadi Lepam), and Panchakarma (Nasya, Njavara Theppu), integrated with structured physiotherapy. Results: Following the inpatient protocol, the patient achieved an increase in flexion from 40° to 180° and abduction from 25° to 120°. Pain was completely resolved, and the patient regained the ability to perform activities of daily living (ADL) without surgical intervention. Conclusion: Ayurvedic management serves as an effective non-surgical alternative for chronic musculoskeletal injuries, even in patients with complex systemic comorbidities.