Editing Rotator cuff (section)

===Impingement===
{{Main|Impingement syndrome}}
The accuracy of the physical examination is low.<ref name="pmid17720798">{{cite journal  |vauthors=Hegedus EJ, Goode A, Campbell S, etal |title=Physical examination tests of the shoulder: a systematic review with meta-analysis of individual tests |journal=British Journal of Sports Medicine |volume=42 |issue=2 |pages=80–92 |date=February 2008 |pmid=17720798 |doi=10.1136/bjsm.2007.038406|doi-access=free }}</ref> The [[Hawkins-Kennedy test]]<ref>{{cite web |url=http://www.shoulderdoc.co.uk/education/article.asp?article=580 |author1=ShoulderDoc.co.uk Shoulder |author2=Elbow Surgery |name-list-style=amp |title=Hawkins-Kennedy Test |access-date=2007-09-12 |url-status=dead |archive-url=https://web.archive.org/web/20071015085708/http://shoulderdoc.co.uk/education/article.asp?article=580 |archive-date=15 October 2007}} (video)</ref><ref name="Brukner14">{{cite web |url=http://www.clinicalsportsmedicine.com/chapters/14d.htm |title=Chapter 14: Shoulder Pain |access-date=2007-08-30 |vauthors=Brukner P, Khan K, Kibler WB |url-status=dead |archive-url=https://web.archive.org/web/20070810165243/http://www.clinicalsportsmedicine.com/chapters/14d.htm |archive-date=10 August 2007}}</ref> has a [[sensitivity (tests)|sensitivity]] of approximately 80% to 90% for detecting impingement. The infraspinatus and supraspinatus<ref>{{cite web |url=http://www.shoulderdoc.co.uk/education/article.asp?article=582 |title=Empty Can/Full Can Test |author1=ShoulderDoc.co.uk Shoulder |author2=Elbow Surgery |name-list-style=amp |access-date=2007-09-12 |url-status=dead |archive-url=https://web.archive.org/web/20071015085715/http://shoulderdoc.co.uk/education/article.asp?article=582 |archive-date=15 October 2007}} (video)</ref> tests have a [[specificity (tests)|specificity]] of 80% to 90%.<ref name="pmid17720798"/>

A common cause of shoulder pain in rotator cuff impingement syndrome is [[tendinosis]], which is an age-related and most often [[Self-limiting (biology)|self-limiting]] condition.<ref>{{Cite journal|last1=Mohamadi|first1=Amin|last2=Chan|first2=Jimmy J.|last3=Claessen|first3=Femke M. A. P.|last4=Ring|first4=David|last5=Chen|first5=Neal C.|date=January 2017|title=Corticosteroid Injections Give Small and Transient Pain Relief in Rotator Cuff Tendinosis: A Meta-analysis|journal=Clinical Orthopaedics and Related Research|volume=475|issue=1|pages=232–243|doi=10.1007/s11999-016-5002-1|issn=1528-1132|pmc=5174041|pmid=27469590}}</ref>

Studies show that there is moderate evidence that hypothermia (cold therapy) and exercise therapy used together are more effective than simply waiting for surgery and they suggest the best outcome for non-surgical treatment of subacromial impingement syndrome. The group of patients who participated in the exercise group were found to use significantly lower amounts of non-steroidal anti-inflammatory drugs (NSAIDS) and analgesics than the control group with no intervention. <ref>{{Cite journal|last1=Gebremariam|first1=Lukas|last2=Hay|first2=Elaine M.|last3=Sande|first3=Renske van der|last4=Rinkel|first4=Willem D.|last5=Koes|first5=Bart W.|last6=Huisstede|first6=Bionka M. A.|date=2014-08-01|title=Subacromial impingement syndrome—effectiveness of physiotherapy and manual therapy|url=https://bjsm.bmj.com/content/48/16/1202|journal=British Journal of Sports Medicine|language=en|volume=48|issue=16|pages=1202–1208|doi=10.1136/bjsports-2012-091802|issn=0306-3674|pmid=24217037|s2cid=27383041 |access-date=9 March 2021|archive-date=19 April 2021|archive-url=https://web.archive.org/web/20210419025001/https://bjsm.bmj.com/content/48/16/1202|url-status=live|url-access=subscription}}</ref>