The objective of this study was to evaluate and compare two different post-surgical rehabilitation strategies, Rehabilitation supervised by a physical therapist including exercises with progressive early activation of the rotator cuff versus basic home exercises regarding shoulder function, pain, health related quality of life and return to work after arthroscopic subacromial decompression.

Patients scheduled for surgery (arthroscopic subacromial decompression)and in the age 25-65 were offered to participate in the study. After surgery they were randomized to either Supervised Physical therapy with early activation of the rotator cuff (PT-group) or to home exercises (H-group). Patients in the PT group met the physical therapist twice a week for exercises and in between these visits they did their exercises at home daily. The H-group did home exercises daily. Shoulder function and pain(primary outcomes)and health related quality of life, returning to work(secondary outcomes)were assessed before surgery, one week after(baseline), 1,2,3 and 6 months after surgery by an independent physical therapist.

Inclusion Criteria:

• Subacromial impingement verified with Neer impingement test

• At least 6 month duration of pain

• Treated in primary care without satisfactory results for at least three months.

• Typical history and pain location. Scheduled for surgery (subacromial decompression)

• Three of these four tests must be positive:

  • Neer impingement test
  • Hawkins-Kennedy impingement sign Jobe supraspinatus test
  • Painful arc 60-120 degree

Exclusion Criteria:

• Radiological findings of malignancy osteoarthritis, fractures
• Polyarthritis or fibromyalgia
• Pathological hyper laxity
• Lack of communication skills that prevent the use of outcome measurements
• Cervical spine pathology