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Table 1 Physiotherapy intervention overview

From: A comparison of isometric, isotonic concentric and isotonic eccentric exercises in the physiotherapy management of subacromial pain syndrome/rotator cuff tendinopathy: study protocol for a pilot randomised controlled trial

Treatment

 

Aim

Exercise

Description

Session 1

Retrain scapular movement patterns.

Scapular stability/retraining: optimise the position of the scapular and humeral head during shoulder motion, restoring normal scapulo-humeral rhythm.

Scapular setting.

Scapular shrugs.

Scapular setting in standing at 0° with scapular rotation/ tilt correction (based on individual deficits).

Build scapular stability-progression to scapular shrugs.

Session 2

Improve rotator cuff strength.

Improve rotator cuff strength (in optimal scapulo-humeral movement pattern).

Shoulder external rotation strengthening in neutral.

External rotation in standing with elastic (isotonic) or rigid (isometric) resistance band. Shoulder adducted to side and elbow at 90°.

Session 3

Improve rotator cuff strength.

Improve rotator cuff strength (in optimal scapulo-humeral movement pattern).

Shoulder internal rotation strengthening in neutral.

Internal rotation in standing with elastic (isotonic) or rigid (isometric) resistance band. Shoulder adducted to side and elbow at 90°.

Session 4

Build posterior musculature and restore flexibility.

Improve posterior muscle strength.

Standing rows at 45° or 90°.

Bilateral standing rows progressing from 45° to 90° shoulder abduction with resistance band.

Improve flexibility of upper quadrant soft tissues.

Anterior shoulder stretch.

Active thoracic extension.

Lateral neck stretches.

Bilateral anterior chest stretch using room corner/door jamb. Sternal lift in sitting with lumbar-thoracic dissociation. Neck stretches in stand/sit.