Shoulder pain is one of the most common reasons patients seek the care of a primary care physician and Physical Therapist. Shoulder impingement or the compression of soft tissue structures, including the rotator cuff tendons, between the bones and ligaments of the shoulder remains the most common diagnosis behind these symptoms. Physical Therapy is the first line treatment for this condition due to our clinical and cost effectiveness compared to physician visits, medication, and surgical interventions. Mobility and strengthening exercises make up the foundation of our interventions with manual therapy interventions utilized primarily in the early phases of treatment. A recent review of the available evidence confirms the importance of this practice pattern.
Pieters and colleagues conducted a systematic review on the available evidence supporting treatment of patients with subacromial impingement or subacromial shoulder pain (JOSPT. 2020). Authors reviewed the evidence in 16 systematic reviews on the topic. They reported strong support for the utilization of mobility and strengthening exercises to reduce pain and disability in both the short and long term. Strong recommendations were made for the use of manual therapy in the short term to reduce pain and facilitate a transition to a higher level exercise program. Conversely, there was moderate evidence of no effect of modalities including laser, shockwave therapy, magnets, or ultrasound. Patients are encouraged to work with a local Physical Therapist first to accelerate their recovery from shoulder pain and impingement.
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