Rotator Cuff Disorders: Practical Recommendations for Conservative Management Based on the Literature

Area of Science:

• Orthopedics
• Sports Medicine
• Physical Therapy

Background:

• Conservative management of rotator cuff disorders lacks a unified, evidence-based framework.
• Current recommendations often address isolated care components, leading to inconsistent strategies.

Purpose of the Study:

• To propose a global, pragmatic protocol for non-surgical management of rotator cuff lesions.
• To provide a stepwise approach integrating diagnosis, prognosis, rehabilitation, and follow-up.

Main Methods:

• Comprehensive diagnostic process combining history, clinical examination, and targeted imaging.
• Stratification of rotator cuff disorders into three prognostic categories (good, borderline, poor).
• Rehabilitation structured around four domains: pain control, mobility, strengthening, and anatomy preservation.

Main Results:

• A prognostic categorization guides treatment adaptation and identifies candidates for early surgery.
• Individualized rehabilitation plans address specific patient needs and recovery goals.
• Monitoring integrates clinical reassessment, ultrasound, and functional milestones, including return-to-play criteria.

Conclusions:

• Precise diagnosis and individualized rehabilitation optimize conservative rotator cuff disorder management.
• The proposed protocol provides a clear, evidence-informed roadmap for clinicians.
• Aligning treatment with prognostic and functional goals enhances patient satisfaction and recovery.