Physiotherapy Interventions


If the tendinopathy has flared up due to an acute event the immediate goals of treatment are to promote tissue healing and reduce pain and inflammation. Establishing the non-painful range of motion, scapula control and strength of the supraspinatus muscle is very important for rehabilitation progression. Initial rehabilitation is recommended to be limited to passive assisted range of motion exercises and static rotator cuff strengthening exercises, within in pain range. This approach ensures that there is no further damage done to the tendon in the early stages of healing.


Brukner and Kahn (2006) states that the treatment of a rotator cuff tendinopathy should be considered in two parts. First the tendinopathy itself needs to treated by avoiding aggravating activities and applying ice. Second is to address the abnormalities that may be associated with the tendinopathy (e.g. instability, weakness, scapula control).




Tendinopathies need exercise to help the healing process and has been shown to be one of the most effective treatment modalities for supraspinatus tendinopathy.  It assists collagen to be repaired correctly and also increases the strength of the structures involved to help prevent re-injury. Exercises used may be similar to those used in diagnosis of supraspinatus tendinopathy such as the empty can test (see “Special Tests tab”). There is some debate over the use of ‘full can’ or ‘empty can’ exercise to preferentially strengthen the supraspinatus or the deltoid muscle (Thigpen, 2006).


Exercises should be designed to re-establish range of motion, correct abnormailities in scapula control or glenohumeral stability, strengthen any weakened muscles or stretch any tight muscles.


(a) Stretches


 Posterior shoulder strech 1


  • Stand upright and cross one arm across your body
  • Using the opposite arm, pull the elbow of the arm being stretched towards the opposite shoulder
  • Hold for between 10 and 30 seconds


Posterior shoulder stretch 2

  •  Stand with your hand on the middle of your back and the elbow pointing out
  • Use the other hand to pull the elbow forwards
  • Make sure you keep your back hand still
  • Hold for between 10 and 30 seconds

Supraspinatus stretch

  •  Place your hands on your hips and move the elbows forwards
  • Don't move your hands, just your elbows!
  • Hold for between 10 and 30 seconds

(b) Strengthen and stabilise

The pictures below demonstrate some exercises that may be performed to strengthen the shoulder and scapula. The exercises are high level exercises and would need to be modified to suit the stage of the tendinopathy.   Your physiotherapist will need to guide you in these exercises.