Progressive Resistance Exercises plus Manual Therapy Is Effective in Improving Isometric Strength in Overhead Athletes with Shoulder Impingement Syndrome: A Randomized Controlled Trial Saurabh Sharma,1 Amer K. Ghrouz,2,3 M. Ejaz Hussain,1 Shalini Sharma,4 Mosab Aldabbas,1 and Sumbul Ansari1 The most common pathologies associated with shoulder pain are shoulder impingement syndrome, rotator cuff tears and tendinopathy, bursitis, joint oedema and glenohumeral instability. 5 -7 The consequences of such pathologies can be incredibly severe for wheelchair users, as it may prevent individuals from being physically active, which can The patient revisited the clinic on March 18, 2021. The pain VAS was 0, and no symptoms remained . Figure 6: shoulder impingement, and knee arthritis. Miyamori T, Tumilty S. The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2016;30:1141-55. This review included exercise programs with components of home-exercises, manual therapy and other modalities Manual therapy and exercises for shoulder impingement revisited. Phys Ther Rev. 2013;18(4):263-84. Article Google Scholar Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A, Sim J. The effectiveness of This systematic review update provides some further evidence supporting the effectiveness of manual therapy and exercises for shoulder impingement, but methodological deficits/risk of bias warrant cautious interpretation. 21 The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. Physical therapy, in particular therapeutic exercise, is a common first-choice treatment for subacromial impingement syndrome (SAIS) 1; however, the benefits of physical therapy exercises and their optimal clinical application remain unclear.This uncertainty is reflected not only in the wide range of approaches and exercise interventions used for SAIS but also in the subjectivity of their Background. Shoulder pain (SP) is a common musculoskeletal condition that can influence negatively the function of the entire upper limb [].The prevalence of SP ranged between 7 and 26% within the general population, increasing with age [].Most of the patients affected by SP describe the symptoms as "troublesome pain" [].When these symptoms become persistent and recurrent, the demand for This is a well conducted systematic review which aimed to update the evidence regarding the role of manual therapy for RC tendinopathy due to the publication of new randomised controlled trials since the last systematic review on this topic (Braun et al, 2013). Some points are worth noting when considering the results of this review. Shoulder impingement is a common condition believed to contribute to the development or progression of rotator cuff disease (van der Windt et al., 1995, Michener et al., 2003).A number of impingement categories have been identified including subacromial impingement or "external impingement"; internal impingement, which can be further divided into anterior or posterior (Edelson and Teitz Purpose Although many conservative management options are available for patients with non-surgical shoulder conditions, there is little evidence of their effectiveness. T