Rotator Cuff Tendinopathy Clinical Practice Guidelines (2025)
Editorial Note: These are some of the highlights of the guidelines without analysis or commentary. For more information, go directly to the guidelines by clicking the link in the reference.
Clinical practice guidelines on the diagnosis and treatment of adults with rotator cuff tendinopathy were published in April 2025 in the Journal of Orthopaedic & Sports Physical Therapy.[1]
In place of visual estimation, an inclinometer, a goniometer, or a smartphone inclinometer/goniometer application should be employed by clinicians in the objective measurement of active and passive range of motion (ROM) of the shoulder. The unreliability and limited validity of scapular ROM measures mean that they 'should not be used by clinicians to objectively measure dynamic scapular ROM.'
Oral nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended by clinicians for short-term pain reduction in adults with rotator cuff tendinopathy.
An active rehabilitation exercise program should be prescribed or recommended by clinicians as an initial treatment for pain and disability reduction in adults with rotator cuff tendinopathy. This 'may include motor control and/or resistance training exercises with various loads.'
To aid in short-term pain reduction in adults with rotator cuff tendinopathy, spinal and/or upper limb manual therapy can be employed either by themselves 'or in combination with other interventions such as exercise.' Soft tissue techniques and/or joint mobilizations or manipulations can be included in manual therapy.
In adults with rotator cuff noncalcific tendinopathy, therapeutic ultrasound should not be used (or recommended for use) as a means of pain and disability reduction, either alone or in combination with an active rehabilitation program.
For more information, please go to Rotator Cuff Disease, Rotator Cuff Injury, and Rotator Cuff Pathology.
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