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. 2025 Apr 8:13:1560597.
doi: 10.3389/fbioe.2025.1560597. eCollection 2025.

Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis

Dianxuan Wu #  1   2   3 , Zhicheng Wen #  1   2   3 , Haolin Ke #  2   3   4 , Jiexin Zhang  1   2   3 , Shaozi Zhong  1   2   3 , Jiachen Teng  1   2   3 , Lan Xu  2   5 , Jintao Li #  1   2   3 , Yan Shao #  1   2   3   4 , Chun Zeng #  1   2   3   4
Affiliations

Specific modes of exercise to improve rotator cuff-related shoulder pain: systematic review and meta-analysis

Dianxuan Wu et al. Front Bioeng Biotechnol. .

Abstract

Objective: To investigate the effect of specific modes of exercise on rotator cuff-related shoulder pain (RCRSP) patients, aiming to provide a theoretical reference for conservative treatment and exercise prescription.

Methods: Data sources included PubMed/MEDLINE, Web of Science, ScienceDirect, and CNKI, covering studies from database inception to June 2024. Study selection followed pre-set inclusion/exclusion criteria. Cochrane methods guided quality assessment and data extraction. Outcome measures included VAS, CMS, and DASH scores. Publication bias assessed via funnel plots; forest plots created using RevMan 5.4.

Results: 13 studies (n = 690) met inclusion criteria for RCRSP exercise interventions. It is indicated that: (1) specific exercises led to modest improvements in performance of pain (SMD = -0.31, 95% CI: 0.46 to -0.16, P < 0.0001) and function, with enhancements in CMS (SMD = 0.59, 95% CI: 0.44 to 0.74, P < 0.00001) and DASH (SMD = -0.60, 95% CI: 0.80 to -0.39, P < 0.00001). (2) Interventions lasting less than 2 months were slightly more effective than those lasting 2 months or longer, observed in VAS (SMD = -0.35, 95% CI: 0.56 to -0.15, P = 0.0007), CMS (SMD = 0.71, 95% CI: 0.47 to 0.96, P < 0.00001), and DASH (SMD = -0.71, 95% CI: 0.99 to -0.43, P < 0.00001). (3) Subgroup analyses revealed that handgrip strength exercises enhanced shoulder pain relief, shoulder mobilization/stretching improved both function and pain levels over 2 months, scapular stabilization exercise improved pain and DASH performance over 2 months, eccentric exercises boosted CMS and DASH performance over 2 months, while proprioceptive exercises showed no significant improvement in pain or CMS performance.

Conclusion: Compared to non-specific exercises, specific exercise programs moderately alleviate RCRSP symptoms, with shorter interventions (<2 months) demonstrating marginally superior outcomes. Efficacy varies by exercise type, emphasizing the need for individualized prescriptions.

Systematic review registration: PROSPERO (CRD42024550602).

Keywords: chronic sports injuries; exercise therapy; meta-analysis; rotator cuff-related shoulder pain; specific exercise.

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Conflict of interest statement

The authors declare that this research was conducted without any commercial or financial relationships that could be perceived as potential conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of search and study selection.
FIGURE 2
FIGURE 2
Characteristics of the studies included.
FIGURE 3
FIGURE 3
Risk of bias graph.
FIGURE 4
FIGURE 4
Effect of specific exercise intervention, compared with general exercise or routine physical therapy on shoulder pain over VAS.
FIGURE 5
FIGURE 5
Effect of specific exercise intervention, compared with general exercise or routine physical therapy on shoulder function over CMS.
FIGURE 6
FIGURE 6
Effect of specific exercise intervention, compared with general exercise or routine physical therapy on shoulder function over DASH.
FIGURE 7
FIGURE 7
Effects of different exercise interventions on shoulder function over VAS.
FIGURE 8
FIGURE 8
Effects of different exercise interventions on shoulder function over CMS.
FIGURE 9
FIGURE 9
Effects of different exercise interventions on shoulder function over DASH.
See this image and copyright information in PMC

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