Physiotherapists recommendation for the examination and treatment of rotator cuff related shoulder pain: a consensus exercise.

Key Points

1. There is a lot of uncertainty with regard to what consists as optimal non-surgical management in those presenting with rotator cuff related shoulder pain (RCRSP).

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BACKGROUND & OBJECTIVE

The patient presenting with a non-traumatic painful, mobile shoulder is often provided with a wide range of diagnostic labels attributed to describe the cause of their shoulder pain - subacromial bursitis, subacromial impingement, subacromial pain syndrome, rotator cuff tendinopathy, rotator cuff related shoulder pain (RCRSP). This wide range of diagnostic labels reflects uncertainty with regard to causative mechanism, diagnosis and prognosis. Further, some of these terms have the potential to act as a barrier to engagement with physiotherapy (1).

A consensus process was undertaken to provide clinical and academic insight to understanding the most appropriate diagnostic term, examination procedure, guidance on prognosis and optimal non-surgical management approach given the limited and conflicting messages seen within the published literature.

Some diagnostic labels for shoulder pain have the potential to act as a barrier to engagement with physiotherapy.

Non-surgical management strategies should consider the functional limitations, expectations and beliefs of the individual when designing the wider rehabilitation programme.

METHODS

A consensus exercise was undertaken based upon similar previous work. 10 physiotherapists with recognised expertise in the management of shoulder pain from both a clinical and academic perspective were involved. An initial list of questions was circulated, refined and agreed

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