Comparison of isotonic (concentric and eccentric) and isometric exercises in the treatment of patients diagnosed with rotator cuff tendinopathy/subacromial pain syndrome

Shoulder disorders are a leading cause of pain and disability in our society. Recurrence is common and symptoms often persistent. The rotator cuff muscles are considered the prime source of symptoms with a diagnosis of rotator cuff tendinopathy/sub-acromial pain syndrome (SPS) accounting for approximately 30% of all diagnoses made by GPs.

Several researchers have investigated the most effective physiotherapy approach for rotator cuff tendinopathy/SPS with some evidence to suggest that a structured physiotherapy exercise program is the most effective. However, definitive conclusions have not been drawn regarding which specific types of exercise, including intensity, duration and frequency, are most effective in the treatment of this condition. Although eccentric exercises have long been used in the treatment of lower limb tendinopathy and increasingly extrapolated to treatment of tendons in other body regions the benefits of this mode of strengthening has not been demonstrated in SPS.

More recently, the effects of isometric exercises in lower limb tendinopathy have been investigated with improvements in pain and strength observed following heavy load isometric contractions in patella tendinopathy. The use of isometric exercises in the treatment of SPS has not been investigated.

The aim of this study is to compare the effects of isometric, isotonic concentric and isotonic eccentric rotator cuff contractions when incorporated into a structured exercise-based physiotherapy rehabilitation program in patients diagnosed with rotator cuff tendinopathy/SPS.

Staff involved: Rita Kinsella, Sally Cowen, Tania Pizzari