Current Concepts of Shoulder Tendinopathies: An Exercise & Manual Therapy Approach

Course overview

The shoulder is an area that is highly susceptible to tendon-related pain and injury. Given the complexity of tendon overlay at this area and high level of mobility in the shoulder complex, tendinopathy can be a difficult condition to manage conservatively. The rotator cuff and biceps tendons are common sources of pain generation. Characterized by painful mechanical loading of an involved tendon, tendinopathy is a common clinical condition associated with significant limitations in daily activities. Recent research has improved the understanding and management of tendinopathy; however, clinical management of this condition continues to be variable in both type and theory of intervention. Current standard of physical therapy practice has yet to leverage the latest literature for effective treatment of tendinopathy. Progressive mechanical loading has been found to be an effective management strategy, but the research is variable between the upper and lower extremities. Different modes of strength training, including isometric, isotonic, isolated eccentric, and isokinetic, can be used to control pain, improve motor control, and enhance function in pathological tissue. Tendinopathy of the upper extremities can have profound negative effects on an individual's ability to participate in and return to their previous level of functional activities. This presentation will highlight current available evidence related to shoulder tendinopathy and provide simple, effective, and easy-to-implement clinical management strategies for pain, progression of functional activities, and treatment of the entire kinetic chain. The emphasis of this course will be on exercise and manual therapy strategies.