Multimodal Manipulative Therapy for Shoulder Pain

Manipulation, soft tissue procedures, rehabilitation exercises. The active therapeutics include a combination of manipulation, soft tissue therapy and rehabilitation exercises (multimodal therapy) Manipulation involves a high velocity low amplitude procedure directed at either the low cervical spine, upper thoracic spine, glenohumeral or acromioclavicluar joints dependent on clinical finings i.e. detection of manipulable lesion or fixated joint. Soft tissue therapy includes ischaemic pressure massage administered to tight or spasmed muscles and tight muscle stretches. Rehabilitation exercises including isometric followed by isotonic strengthening exercies directed at the rotator cuff muscles. These exercises are to be performed at home by the participants. The duraion of each treatment session is between 15-20 minutes. Each participant will recieve a total of 8 treatments at a frequency of 2 times per week for 4 weeks.