Senbursa et al 2011 completed a randomized control study of shoulder rehabilitation. Patients diagnosed with a stage 1 supraspinatus sprain were randomly assigned to 3 groups. Group 1 (n = 25) was a supervised exercise group; group 2 (n = 30) was the manual therapy group; group 3 completed a home-based exercise program. The exercises used were to stabilize the scapula to the thoracic wall and to increase the strength of the gleno-humeral joint.

All groups showed less pain and improved active range of motion by week 4  but the manual therapy group improved more (p<0.05). By week 12 though, all the groups were within the margin of error for active range of motion and pain levels.  The manual therapy group continued to show the greatest level of improvement but all groups were within the margin of error.

While all groups improved significantly by week 12, the manual therapy group improved fastest. I have never encountered a pure manual therapist who will not give their clients exercises to complete (if they felt the client was capable and competent) but this lends support to the idea that early intervention manual therapy supported with rehabilitative exercise will improve many injuries faster than most other forms of treatment.

Keep in mind; this was specifically for a stage 1 supraspinatus tear and not a complete tear or multiple tear situation.