Background: Degeneration with continuous mechanical load on the shoulder leads to inflammation and vascular disruption of the rotator cuff tendons. With eccentric strengthening, a sufficient load is placed on the inflamed tendon, re-initiating collagen remodelling and neo-vascularization, while mobilization will correct the positional faults and improve joint play. With these benefits in consideration, determining whether a combination of eccentric strengthening and acromioclavicular joint mobilization can further help in pain reduction and improve function is the purpose of the present case study.

Methods: A case of a 60-year-old female with recurrent rotator cuff tendinopathy presented with the complains of right shoulder pain associated with difficulty in overhead functional activities, painful shoulder flexion, abduction and external rotation. The outcome measures taken were pain intensity as measured using the Numerical Pain Rating Score, shoulder pain measured on a Universal Goniometer and shoulder disability measured using theShoulder Pain and Disability Index score. Eccentric strengthening exercises involving the rotator cuff muscle were given along with acromioclavicular joint Grade 1 mobilization and scapula retraction exercises for 3 weeks, 5 days per week.

Results: The pain intensity reduced from 6/10 to 2/10 post-treatement, as measured on NPRS. The shoulder flexion, abduction and external rotation ranges improved from 80°, 80° and, 70° to 100°, 95° and 80°, respectively. The pre-measurement of shoulder disability on SPADI was 86/130, which reduced to 51/130 post-treatment.

Conclusion: Acromioclavicular joint grade 1 mobilization combined with eccentric strengthening of the rotator cuff muscle is effective in reducing pain, improving shoulder ROM and reducing shoulder disability.