Modifications for rotator cuff tendinopathy?/Physical Therapy

[Mark Rippetoe]

An article from the NASM entitled 'Preventing shoulder and rotator cuff injuries through corrective exercise programming' popped up in my Facebook feed last night that does a really good job of illustrating their approach (here's the link, feel free to remove it):

But for injury prevention and proper strengthening of the shoulder complex it is important to progress clients appropriately with a multi-phased approach including motor control, isolated strengthening and integrated dynamic movements.

Does it explain why it is important to do this?

[JoshGayou]

I had shoulder trouble for years that resulted from having a son (held him on the same arm every day for about three years straight). This and constant low back pain were just a thing I had gotten used to. I started deadlifting consistently every week. The muscles in my back strengthened up and everything seems to have pulled back to where it should be. Haven't experienced back trouble or shoulder issues in I can't remember how long.

Coincidentally, I was talking to a guy the other day who described the exact same shoulder trouble I had experienced for years. He told me he had spoken to a therapist about the issue. The prescription was...wait for it...lat pull downs.

[AEsg81]

I'll speak from the PT world as that I work as a PTA (I didn’t want to spend the $ on the bullshit DPT) in an outpatient clinic at a major university, a hospital, and various other settings. It truly is disappointing what patients are being asked to do for their rehab what exercises have become demonized. I fight this every day.

Moving your shoulder through full range and getting stronger is the only thing that is going to help it feel better. Most people have a limited ROM and the mess up with pressing because they cannot get their arms vertically overhead with no weight let alone a barbell. This is where the chins or pulls ups are helpful. In fact just doing hanging with straight arms for time should feel good. Then pressing.

I have shoulder/ neck problems and the only things that have helped me are pressing and pullups/chin ups. Even my patients who are having pain from impingement or other reasons, once I have them at full range of motion pressing and hanging is therapeutic.
Don’t go back to that PT as they probably have never had their hands on a barbell.

[hollismb]

Does it explain why it is important to do this?

Why they're isolating muscles in an attempt to strengthen them individually, as opposed to strengthening them together while allowing each muscle to contribute its appropriate share during normal movement patterns which can be loaded and strengthened incrementally? Nope. The article just skips right from the part about proper motor control (which we normally refer to as 'correct technique'), and then goes right into the isolation exercises.