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Rotator cuff injuries often are managed initially in primary care settings with physical therapy, corticosteroid injection, or both. In a Cochrane review, researchers found insufficient evidence for the clinical effectiveness of physical therapy (Cochrane Database Syst Rev 2016; 6:CD012224), and which types of exercise might yield the best outcomes is unclear. Steroid injections have shown short-term benefit, but their longer-term benefits and harms are unknown.
British researchers enrolled 700 primary care patients with shoulder pain attributed to rotator cuff disorders, with onset during the previous 6 months; patients with substantial shoulder trauma or other shoulder disorders were excluded. Patients were randomized to progressive exerci…