Physiotherapists' recommendations for examination and treatment of rotator cuff related shoulder pain: A consensus exercise

Chris Littlewood*, Marcus Bateman, Clare Connor, Jo Gibson, Ian Horsley, Anju Jaggi, Val Jones, Adam Meakins, Martin Scott

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

21 Citations (Scopus)


BACKGROUND: Disorders associated with the rotator cuff are regarded as the most common shoulder pain presentation. The range of diagnostic terms used to explain this problem reflect uncertainty in relation to causative mechanisms, diagnosis, prognosis, and the most effective treatments. The aim of this consensus exercise was to facilitate a shared understanding as a means of reducing mixed messages, informing clinical practice and providing a foundation for future research. METHODS: Nine physiotherapists with clinical and academic expertise in shoulder pain participated in an online and face-to-face consensus exercise. RESULTS: This consensus exercise suggests specific factors in the history and physical examination that might raise the index of suspicion of Rotator Cuff Related Shoulder Pain. The suggestions for non-surgical management include a minimal number of exercises prescribed to challenge the functional deficit of the patient over a minimum 12-week period. Apart from aiding exclusion of red flag pathology, imaging is not regarded as useful unless the patient does not respond as expected. Steroid injections wouldn't be considered a first-line intervention unless pain was severe and preventing engagement with exercise. CONCLUSION: This consensus exercise provides a benchmark for clinical reflection while highlighting areas of uncertainty that still exist and require further research.

Original languageEnglish
Pages (from-to)87-94
Number of pages8
JournalPhysiotherapy Practice and Research
Issue number2
Early online date13 Sep 2019
Publication statusPublished - 1 Dec 2019


  • diagnosis
  • exercise
  • physiotherapy
  • Rotator cuff


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