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Related Experiment Video

Updated: Mar 19, 2026

Modified Long Head of Biceps Tendon Rerouting and Fixation as Partial Capsular Reconstruction for Massive Irreparable Rotator Cuff Tears
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Modified Long Head of Biceps Tendon Rerouting and Fixation as Partial Capsular Reconstruction for Massive Irreparable Rotator Cuff Tears

Published on: March 6, 2026

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Manual therapy and exercise for rotator cuff disease.

Matthew J Page1, Sally Green, Brodwen McBain

  • 1School of Public Health & Preventive Medicine, Monash University, Level 1, 549 St Kilda Road, Melbourne, Victoria, Australia, 3004.

The Cochrane Database of Systematic Reviews
|June 11, 2016
PubMed
Summary

Manual therapy and exercise for rotator cuff disease showed no clinically important differences compared to placebo in one high-quality trial. While adverse events were more frequent, they were mild.

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Author Spotlight: Treating Frozen Shoulder with Small Needle Knife Therapy
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Area of Science:

  • Orthopedics and Sports Medicine
  • Physical Therapy and Rehabilitation

Background:

  • Rotator cuff disease management commonly involves physical therapy integrating manual therapy and exercise.
  • This review updates previous Cochrane reviews on physiotherapy interventions for shoulder pain.

Purpose of the Study:

  • To synthesize evidence on the benefits and harms of manual therapy and exercise for rotator cuff disease.
  • To evaluate these interventions when used alone or in combination.

Main Methods:

  • Systematic search of multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL Plus) and clinical trial registries up to March 2015.
  • Inclusion of randomized and quasi-randomized trials involving adults with rotator cuff disease.
  • Assessment of manual therapy and exercise interventions against placebo, no intervention, other therapies, or injections, focusing on pain, function, and adverse events.

Main Results:

  • Sixty trials were included, but only 10 addressed key comparisons; meta-analysis was not possible due to heterogeneity.
  • One high-quality trial showed no clinically important differences in pain or function between manual therapy/exercise and placebo.
  • Adverse events were more frequent with manual therapy/exercise but mild; evidence comparing it to injections or surgery was low quality.

Conclusions:

  • A single high-quality trial found manual therapy and exercise comparable to placebo for rotator cuff disease, with mild adverse events.
  • Evidence suggests potential similarity to glucocorticoid injection and arthroscopic subacromial decompression, though based on low-quality data.
  • Future trials should use realistic placebos and have strong rationales for investigating isolated or combined manual therapy and exercise.