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Acute rotator cuff tendinopathy: does ice, low load isometric exercise, or a combination of the two produce an analgaesic effect?
  1. Phillip J Parle1,
  2. Diane L Riddiford-Harland2,
  3. Chris D Howitt3,
  4. Jeremy S Lewis4
  1. 1The Illawarra Sports Medicine Clinic, Gwynneville, New South Wales, Australia
  2. 2Biomechanics Research Laboratory, Faculty of Science, Medicine and Health, University of Wollongong, New South Wales, Australia
  3. 3Southern Orthopaedics, Wollongong, New South Wales, Australia
  4. 4School of Health and Social Work, University of Hertfordshire, Hertfordshire, UK
  1. Correspondence to Phillip J Parle, The Illawarra Sports Medicine Clinic, Foley's Rd, Gwynneville, NSW 2500, Australia; philparle{at}

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Rotator cuff tendinopathies are the most commonly diagnosed musculoskeletal shoulder conditions and are associated with pain, weakness and loss of function.1 Tendon swelling may be associated with tendinopathy and may result from acute overload.2–3 An increase in tendon cells (tenocytes) and upregulation of large molecular weight proteoglycans, such as aggrecan, may increase tendon water content.2 There is uncertainty as to whether the swelling is related to the pain or is instead an observed but unrelated phenomenon. Weakness detected clinically may be due to pain inhibition.4–5

Early treatment of acute rotator cuff tendinopathy involves patient education and relative rest, and may include non-steroidal anti-inflammatory drugs (NSAIDs) to reduce pain, swelling and inflammation. Subacromial corticosteroid injections are also used to achieve the same purpose. These techniques show low to moderate evidence of reducing short-term pain but they do not improve function.6 The medications have side effects such …

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  • Twitter Follow Phillip Parle at @Phillip Parle@Philparle

  • Competing interests None declared.

  • Ethics approval The University of Wollongong Human Research Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Full results from the unpublished full manuscript are available for discussion at