Exercise Programs
We cannot recommend for or against exercise programs (supervised or unsupervised) for patients with rotator cuff tears.

Rationale
When the patient and physician select non-operative management of a rotator cuff tear, the primary objectives are to decrease pain, increase function, and enhance activities of daily living (while mitigating potential long term adverse outcomes). We found no quality evidence that demonstrated a specific impact of an exercise program, compared to the natural history of disease without other interventions. Similarly, we found no reliable evidence demonstrating that the efficacy of an exercise program is predicated upon a specific form of education, supervision, or exercise environment.

Although reliable evidence was not found to definitively support a positive impact, we also found no such evidence to suggest that there are adverse impacts of exercise programs upon rotator cuff disease.

One Level IV study53 addressed a physical therapy program. This study observed statistically significant improvement on the Oxford shoulder disability questionnaire and the SF-36 for General Health at three months in a cohort of ten patients treated with a physical therapy-supervised program for massive irreparable cuff tears. It is not possible to generalize this study across patients with different severities and durations of rotator cuff tears.

A second Level IV study54 reported inconsistent results on the Simple Shoulder Test (SST) but did observe improvement at an average of 2.5 years in three scales with a home exercise program in a larger group of patients with chronic rotator cuff tears.