The Evidence Drop That Changes Your Shoulder Playbook

Stop relying on short-term pilot studies or anecdotal evidence to justify your hands. A brand-new, high-level Randomized Clinical Trial (RCT) from Michener et al. (2024), published in JOSPT Open, just delivered the definitive answer we've been waiting for.

This wasn't a quick six-week intervention. This study compared two groups with subacromial shoulder pain:

1. Exercise-Only (EX): A standardized, well-designed exercise program.

2. Exercise + Manual Therapy (EX+MT): The exact same exercise program plus targeted spinal and shoulder manual therapy.

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And the best part? The researchers followed these patients for a full 52 weeks (one year).

The results are a clear, clinical, and patient-centered win for the integrated approach. At the 6-month and 1-year follow-up, the EX+MT group significantly outperformed the Exercise-Only group across all primary outcome measures.

• Superior Function: The EX+MT group had a clinically meaningful 6.7-point advantage on the DASH score at 52 weeks. That’s the difference between a patient still struggling with daily tasks and a patient who is thriving.

• Happier Patients: The integrated group reported significantly higher patient satisfaction and a greater percentage of patients reporting a successful outcome (GROC success).

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This isn't about a fleeting analgesic effect. This is proof that Manual Therapy facilitates superior, more durable functional change than exercise alone.

MT is Not a Fix; It's the Conduit

If you're still treating with an either/or mentality, you are shortchanging your patient's long-term potential. This study validates the core principle of Modern Manual Therapy: Hands-on care is a neuro-modulator that creates the window of opportunity for effective exercise.

We don't use a Grade IV mobilization to "fix" a supraspinatus tear. We use it to change the immediate sensorimotor output, reduce the threat, and allow the patient to access a higher quality of movement and greater load during the corrective and strengthening exercises that follow.

This is your new clinical playbook. You now have high-level evidence to confidently tell your patients, referral sources, and even skeptical colleagues WHY your combined approach leads to better outcomes and more satisfied patients a year down the road.

Stop debating. Start integrating.

Scroll down for the full infographic breakdown of the Michener 2024 RCT and a clinical playbook on how to implement this multimodal gold standard for shoulder pain starting tomorrow.