Manual therapy treatment for supraspinatus tendinopathy

Rotator cuff injuries, and in particular those of the supraspinatus tendon are incredibly common. By the age of 60, a full 80% of the athletic population will have suffered some type of rotator cuff strain, tear, or other injury. Most tears occur between the ages of 25 and 55. Differing approaches to treatment exist; rest, exercise, manual therapy, injections of cortisone and surgery- depending on the degree of injury and the capacity of the patient.

Senbursa et al 2011 conducted a study of 77 patients aged 30-55 with grade 1 supraspinatus tears. The first group was given a supervised exercise program in clinic, the second group was given the same exercise program with manual therapy and the third group was given a home-based exercise program.

Assessments were completed at the start of the study, at week 4 and at week 12. All groups showed decreases in pain and increases in function (p <0.05) by week 12. Interestingly, at week 4, only the manual therapy group had a decrease in pain, an increase in function and an increase in sleep quality.

This would tend to indicate that while manual therapy is not necessary (and exercise IS necessary) the inclusion of manual therapy in rehabilitation (or in pre-hab) will decrease pain and return one to normalized function faster than exercise alone.

Take home message- if you get a rotator cuff injury, a 3-4 week course of physiotherapy integrated with progressive exercise will get you back to the gym faster.