title: Rotator cuff related shoulder pain: Assessment, management and uncertainties.
abstract: BACKGROUND
  Rotator cuff related shoulder pain (RCRSP) is an over-arching term that encompasses a spectrum of shoulder conditions including; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, and symptomatic partial and full thickness rotator cuff tears. For those diagnosed with RCRSP one aim of treatment is to achieve symptom free shoulder movement and function. Findings from published high quality research investigations suggest that a graduated and well-constructed exercise approach confers at least equivalent benefit as that derived from surgery for; subacromial pain (impingement) syndrome, rotator cuff tendinopathy, partial thickness rotator cuff (RC) tears and atraumatic full thickness rotator cuff tears. However considerable deficits in our understanding of RCRSP persist. These include; (i) cause and source of symptoms, (ii) establishing a definitive diagnosis, (iii) establishing the epidemiology of symptomatic RCRSP, (iv) knowing which tissues or systems to target intervention, and (v) which interventions are most effective.
  
  
  OBJECTIVE
  The aim of this masterclass is to address a number of these areas of uncertainty and it will focus on; (i) RC function, (ii) symptoms, (iii) aetiology, (iv) assessment and management, (v) imaging, and (vi) uncertainties associated with surgery.
  
  
  CONCLUSIONS
  Although people experiencing RCRSP should derive considerable confidence that exercise therapy is associated with successful outcomes that are comparable to surgery, outcomes may be incomplete and associated with persisting and recurring symptoms. This underpins the need for ongoing research to; better understand the aetiology, improve methods of assessment and management, and eventually prevent these conditions.
authors.affiliation: Department of Allied Health Professions and Midwifery, School of Health and Social Work, Wright Building, College Lane Campus, University of Hertfordshire, Hatfield AL10 9AB, Hertfordshire, UK. Electronic address: jeremy.lewis@LondonShoulderClinic.com.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000000981:diagnostic imaging*; D000070636:Rotator Cuff Injuries / Q000150:complications* / Q000628:therapy*; D019534:Shoulder Impingement Syndrome / Q000175:diagnosis* / Q000628:therapy*; D020069:Shoulder Pain / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy
keywords: Assessment; Management; Rotator cuff; Shoulder pain