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What is the best type of exercise for rotator cuff tendinopathy?

Updated: Dec 8, 2019


It is important to strengthen muscle and tendon tissue following rotator cuff injury

Shoulder pain is the third most common musculoskeletal injury reported to physiotherapy clinics. The shoulder has tremendous functional mobility and limited structural stability, often leading to injury during sport. 


The rotator cuff is a group of muscles that provide dynamic stability and control of the shoulder complex, keeping the ball firmly situated in its shallow socket. One the most common injuries occurring in the shoulder is a rotator cuff tendinopathy.


Typical presentation includes:

  • Pain in the shoulder

  • Painful and limited range of motion

  • Weakness 

  • Pain with reaching, especially overhead

  • Pain and weakness with lifting

  • Often pain at night with sleeping on that side


A recent randomized controlled trial by Heron et al. (2017) looked at the effectiveness of three types of treatment programs.

  1. Open chain exercises

  2. Closed chain exercises

  3. Minimally loaded range of motion exercises 


The results showed significant decreases in Shoulder Pain and Disability Index score for all three programs, with no significant differences between the groups. However, more participants deteriorated in the range of motion group after 6 weeks.


What this shows is the importance of loading muscle and tendon tissue as it relates to managing rotator cuff pathology. If you are experiencing shoulder pain or have a rotator cuff injury, conservative management includes a strengthening program developed by a physiotherapist.


Comparison of three types of exercise in the treatment of rotator cuff tendinopathy/shoulder impingement syndrome: A randomized controlled trial. Heron SR, Woby SR, Thompson DP.Physiotherapy. 2017 Jun;103(2):167-173

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