Reviewed by Kirsten Hales, SPT

Introduction

Rotator cuff tendonitis (RTC) is a common musculoskeletal condition, often associated with shoulder pain and dysfunction resulting from repetitive motion, aging, or poor posture. Conservative management strategies such as rest, physical therapy, and anti-inflammatory medications, are frequently used. However, the role of resistance exercise (RE) in alleviating pain and improving function in RTC tendonitis is still under investigation. The article “Effect of Resistance Exercise on Pain and Function in Rotator Cuff Tendonitis,” aims to provide insight into the effectiveness of resistance training in addressing pain and functional limitations in individuals with RTC tendonitis.

Methods

This systematic review and meta-analysis included data from 10 randomized controlled trials (RCTs) involving 552 patients diagnosed with RTC tendonitis. The different studies assessed the effects of RE programs on pain reduction, functional improvement, and overall quality of life in patients with chronic shoulder pain related to RTC injuries. Key outcomes analyzed were pain intensity (measured via the VAS) and functional improvement (assessed with the SPADI, and DASH).

Results

The systemic review revealed several key findings:

  • Pain Reduction: Participants who engaged in RE programs demonstrated significant reductions in shoulder pain compared to control groups. Pain intensity scores improved by 35-45% after 6-12 weeks of resistance training.
  • Functional Improvement: Functional outcomes, as measured by SPADI and DASH scores, showed that resistance exercise resulted in a 20-30% improvement in shoulder strength and ROM.
  • Exercise Protocols: The studies varied in terms of the exercise duration (ranging from 6 to 12 weeks) and frequency (2-3 sessions per week). The most effective programs incorporated moderate to high-intensity exercises targeting both the rotator cuff muscles and scapular stabilizers.
  • Long-Term Outcomes: While RE yielded immediate improvements in pain and function, the authors noted that the  long-term benefits were less clear. Follow-up data at 3 to 6 months showed some sustained improvements in strength and function, but not all patients maintained pain relief after completing the exercise programs.

Discussion

The authors concluded that RE can be effective in short-term interventions for reducing pain and improving function in patients with RTC tendonitis. By strengthening the muscles around the shoulder joint, RE can help stabilize the joint, reduce strain on the tendons, and promote healing. Additionally, resistance training may enhance neuromuscular control and proprioception, which play a critical role in preventing re-injury and improving overall shoulder function.

However, the review also highlighted several limitations. The diversification of the exercise protocols (such as variations in type, intensity, and duration) across studies makes it difficult to determine the most optimal approach for all patients. The absence of high-quality, long-term data leaves the question of long-term benefits unresolved.

Conclusion

The review concludes that RE is a promising intervention for managing pain and improving function in individuals with RTC tendonitis. Based on the article, clinicians are encouraged to incorporate RE into rehabilitation programs, particularly for patients with chronic shoulder pain. They are also encouraged to combine it with other conservative treatment strategies. In my clinical experience as a student PT, I have observed that incorporating RE into treatment plans for patients with RTC tendonitis can significantly improve pain and function in the short term and the long term. While I have witnessed the benefits of RE  firsthand, the variability in protocols highlights the need for individualized and carefully tailored programs to meet each patient’s needs. This approach ensures that treatment is not only effective but also adaptable to the unique challenges and goals of each patient. However, similar to the authors’ conclusions, further research is necessary to establish standardized protocols and determine the long-term efficacy of RE in managing RTC tendonitis.

Reference:

https://www.schoudernetwerk.nl/wp-content/uploads/2021/06/SR.TypeExerciseinRCRSPpatients.Nauntonetal.Pedro_.ClinRehab.2020.pdf