Effects of Rotator Cuff Drills Versus Progressive Resistance Exercises on Chronic Rotator Cuff Tendinopathy

Rotator cuff tendinopathy is a prevalent condition among overhead athletes, significantly impairing performance and function. While both rotator cuff drills and progressive resistance exercises (PREs) are commonly used in rehabilitation, there remains a lack of comparative evidence on their effectiveness, particularly in sport-specific contexts.

Current literature highlights gaps in optimal exercise progression, long-term outcomes, and objective performance metrics for overhead athletes. This study aims to compare these two interventions to determine which approach better improves pain, stability, and functional performance in athletes with chronic rotator cuff tendinopathy, addressing a critical need for evidence-based rehabilitation protocols in sports medicine. A single-blinded randomized clinical trial was conducted with 30 male overhead athletes (17-35 years) recruited from cricket clubs and sports complexes in Faisalabad. Participants were randomized into Group A (rotator cuff drills: plyometric medicine ball throws, wall dribbles) or Group B (PREs: resistance band exercises with progressive loading). Both groups underwent 12-week interventions (3 sessions/week) following the FIIT principle (Frequency, Intensity, Time, Type), preceded by a standardized 20-minute warm-up. Outcomes were assessed using the Numeric Pain Rating Scale (NPRS), Shoulder Pain and Disability Index (SPADI), Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST), and Upper Limb Rotation Test (ULRT) at baseline, 6 weeks, and 12 weeks. Data were analyzed using SPSS v24, with statistical significance set at *p* ≤ 0.05. Descriptive statistics (mean, SD) summarized continuous variables, while frequencies/percentages described categorical data. Normality was confirmed via Kolmogorov-Smirnov test. Between-group differences were analyzed using independent *t*-tests, and within-group changes via paired *t*-tests. The study's rigorous blinding and standardized protocols minimized bias, ensuring robust comparisons between interventions.

Inclusion criteria

• Professional male overhead athletes aged 17-35 years
• Male overhead athletes playing competitive sports like volleyball, tennis, baseball, cricket, swimming, badminton, and basketball for at least 6 hours a week. Painful arc of movement during flexion or abduction.
• Positive Neer's or Kennedy-Hawkins test

Exclusion criteria

• Had a previous shoulder surgery.
• Trauma history. Corticosteroid injection within the previous 6 weeks
• Other injuries rather than Rotator cuff tendinopathy