A while ago one of our final year Exercise Physiology students performed a thorough literature analysis on the effectiveness of exercise therapy for rotator cuff problems. Three different databases were searched for randomised controlled trials investigating exercise treatment effectiveness on rotator cuff problems in adult patients. Following the exclusion criteria, four studies were selected for further analysis. Of the four studies analysed, all 4 displayed results in favour of a structured exercise treatment program.

This did not surprise us as we always knew that exercise therapy is the only long-term solution for most musculoskeletal system pathologies, with rotator cuff problems being no exception. What’s important, though, is for the exercises to be specific both to the individual and their pathology, for the program to be supervised by trained physiotherapists and exercise physiologists with a sound understanding of the pathology and for the program to be based on the outcomes a thorough diagnostic assessment. If these points are neglected, the results of the exercise program can be detrimental to the patient rather than beneficial.

Here are a few interesting points from the data analysis:

• significant improvements in outcome measures were found when the exercise program contained resisted shoulder movements such as abduction, internal/external rotation, and flexion
• utilization of closed chain exercises such as wall push-ups were shown to be effective at improving patient symptoms
• there was consensus in this review that it’s recommended that program duration be of a minimum 8 weeks
• the studies analysed stress the importance of maintaining strong adherence to programming set by professionals as data became limited when participants did not adhere to programming

Overall, exercise programmes containing open and closed chain exercises that are prescribed and monitored by a trained professional can be an effective strategy in improving shoulder pain and function.

This last point was very reassuring to us as our Clinical Pilates program for rotator cuff pathologies already includes those elements. Further to this, we place a strong emphasis on postural correcting, thus strengthening the rotator cuff in correct shoulder alignment.

References:

Bennell L., Wee E., Coburn S., Green S., Harris A., Staples M., et al. (2010). Efficacy of Standardised

Manual Therapy and Home Exercise Programme for Chronic Rotator Cuff Disease: Randomised

Placebo Controlled Trial. BMJ. 340. DOI: 10.1136/bmj.c2756

Lombardi I., Magra A G., Fleury A M., Da Silva A C., Nat our J. (2008). Progressive Resistance Training

in Patients with Shoulder Impingement Syndrome: A Randomized Controlled Trial. Arthritis Rheum,

59(5). 615-622.

Heron R S., Woby R S., Thompson P D. (2017). Comparison of Three Types of Exercise in the Treatment of Rotator

Cuff Tendinopathy/Shoulder Impingement Syndrome: A Randomised Controlled Trial. Journal of Physiotherapy.

103(2). 167-173. DOI: 10.1016/j.physio.2016.09.001

Schedler S., Brueckner D., Hagen M., Muehlbauer T. (2020). Effects of a Traditional versus an Alternative

Strengthening Exercise Program on Shoulder Pain, Function and Physical Performance in Individuals with

Subacromial Shoulder Pain: A Randomized Controlled Trial. MDPI Journals. 8(4). 48. DOI: 10.3390/sports8040048