Shoulder Rehab: Rotator Cuff, Impingement and Instability
How the three big shoulder pathologies are managed in modern PT, and what good progress looks like.
9 min read
The shoulder is the most mobile joint in the body, and most outpatient shoulder cases fall into three buckets: rotator cuff disease, subacromial impingement, and instability.
Rotator cuff disease ranges from tendinopathy to full-thickness tear. Many full-thickness tears in older adults are managed conservatively with PT and yield outcomes comparable to surgery at one year.
Subacromial impingement is largely a motor-control problem. Strengthening the rotator cuff and scapular stabilizers, plus posture and movement re-education, resolves most cases.
Instability cases — common in younger throwing athletes — focus on neuromuscular control of the glenohumeral joint. Surgical stabilization is considered after structured PT fails or after recurrent dislocations.
Progress markers include painless overhead reach, symmetric strength testing, and return to sport-specific or work-specific tasks without compensation.