Q: Can't I just do exercises on my own?

A: Patients with subacromial impingement syndrome that perform exercise only (specific prescribed exercise) or the same exercises plus manual therapy with a physical therapist may both experience significant decreases in pain and improvements in function.  However, these improvements may be significantly MORE for those that receive manual therapy.  Also, those that receive manual physical therapy may exhibit greater strength gains than those that do not. (1)

Another study (2) compared a group who performed active range of motion, stretching and strengthening exercise program including rotator cuff muscles and scapular muscles with an elastic band at home at least seven times a week for 10-15 min (group 1) with a group that received 12 sessions of joint and soft tissue mobilization techniques, an exercise program, and patient education in clinic for three times per week.  Subjects in both groups experienced significant decreases in pain and increases in shoulder function and range of motion, but there was significantly more improvement in the manual therapy group compared to the exercise group. (2)

Kachingwe et al (3) compared groups of patients receiving exercise only, exercise with specific manual therapy techniques, or advice only.  The groups receiving manual therapy demonstrated the best decrease in pain.  The three groups receiving intervention showed the best improvement in function. This pilot study suggests that with a therapist performing glenohumeral mobilizations and mobilization with movement in combination with a supervised exercise program, a greater decrease in pain and improved function may be seen.

1. Bang MD, Deyle GD.Comparison of supervised exercise with and without manual physical therapy for patients with shoulder impingement syndrome. J Orthop Sports Phys Ther. 2000 Mar;30(3):126-37.
2. Senbursa G, Baltaci G, Atay A.Comparison of conservative treatment with and without manual physical therapy for patients with shoulder impingement syndrome: a prospective, randomized clinical trial.  Knee Surg Sports Traumatol Arthrosc. 2007 Jul;15(7):915-21.
3. Kachingwe AF, Phillips B, Sletten E, Plunkett SW.  Comparison of manual therapy techniques with therapeutic exercise in the treatment of shoulder impingement: a randomized controlled pilot clinical trial.  J Man Manip Ther. 2008;16(4):238-47.