Cochrane inCORR®: Manual Therapy and Exercise for Rotator Cuff Disease

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Rotator cuff disease accounts for more than 70% of shoulder complaints and is one of the most common musculoskeletal disorders in the adult population [11]. Among the general population, its prevalence ranges from 7% to 26% [8]. The term is broad and encompasses acute and chronic pathology affecting the shoulder joint, including rotator cuff tears, tendonitis, and other similar pathologies. Individuals affected by this condition commonly describe debilitating pain with movement, particularly during overhead activities, as well as pain being worse at night. In the United States, rotator cuff tendinopathy accounts for approximately 4.5 million annual physician visits, with treatment and management reaching an estimated USD 3 billion annually. If we include indirect costs, such as lost time from work, this number is even larger [6].
Generally, initial treatment options include manual therapy including joint mobilization and manipulation, as well as specific exercise regimens and/or anti-inflammatory medications. The goal of physical therapy is to increase ROM, promote healing, strengthen periscapular musculature, and improve the stabilizing function of the rotator cuff [4, 7]. When nonsurgical approaches are unsuccessful, surgical treatment includes rotator cuff débridement or repair and often subacromial decompression This Cochrane review of randomized control trials evaluated the efficacy of exercise and/or manual therapy in the management of rotator cuff disease.
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