Association between changes in pain or function scores and changes in scapular rotations in patients with subacromial shoulder pain: a prospective cohort study.

Only 25 participants were recruited at baseline and only 20 were assessed at follow-up, so the estimates are imprecise. The study did not provide treatment, so it cannot show what any therapy caused. 5 participants dropped out, and missing follow-up data were imputed, which could affect the results. Participants were free to seek care, and only 5 received treatments including medication, home-exercise, and soft tissue massage therapy; the contribution of any one component cannot be separated. The authors noted that 8 weeks may not have been enough for clinical changes to occur. Scapular internal/external rotation was not reported because the measurement method had poor reliability. Other factors that may influence pain, function, or scapular movement were not controlled, including symptom duration, age, sex, pain catastrophizing, and physical demands.

Do not conclude that changing scapular rotation improves pain or function. The study found no association between those changes, and it gave participants no treatment, so it cannot show what caused the small average improvements.