Journal Article

The efficacy of Mulligan mobilization and corticosteroid injection on pain, functionality, and proprioception in rotator cuff tears: A randomized controlled trial

Menek, Merve Yilmaz, Menek, Burak

2025

Overview

Treatment of rotator cuff (RTC) tears commonly involves manual therapy, exercise, and injection methods. These treatments are typically administered together as components of a physical therapy intervention. However, it is not known which intervention is more effective. The objective of this study was to examine the impact of mobilization with movement (MWM) mobilization, a technique from Mulligan approaches, and corticosteroid (CS) injection on pain, functionality, and proprioception in cases of RTC tears. This was a single-blinded randomized clinical trial. Participants with RTC tears (n = 60) were divided into Mulligan mobilization (MM) and CS groups. The participants in the MM group performed mobilization with movement and a conventional exercise program; the CS group received a CS injection in addition to conventional exercises. The Visual Analog Scale, The Disabilities of the Arm, Shoulder, and Hand questionnaire, active range of motion (AROM), and joint position sense (JPS) were evaluated. The outcomes were analyzed using effect size, minimum clinically important difference, minimal detectable change, Wilcoxon test, and Mann-Whitney U test. Both groups significantly improved in all measured outcomes at 3 weeks. The MM group showed significantly better (p < 0.05, Cohen d range 0.82-3.2) results in pain, AROM (Flexion, abduction, extension, external rotation, internal rotation), and proprioception (30° and 60° of flexion and abduction). Between-group differences in AROM were also clinically meaningful as they exceeded their MDC90 and minimum clinically important difference values. Although both of these treatment methods may be successful in the short-term management of chronic RTC, the MM approach combined with conventional exercises seems to be a more effective approach for improving shoulder pain, function, and proprioception in this patient population. NCT05933382 •CS and MWM techniques are effective treatments for individuals with RTC tear.•The MWM technique has more advantages in the improvement of JPS and AROM.•The MWM technique, without side effects, could benefit those with RTC tear.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adrenal Cortex Hormones - administration & dosage / Adrenal Cortex Hormones - therapeutic use / Adult / Aged / Arm / Corticosteroid / Effectiveness / Exercise / Exercise Therapy - methods / Female / Humans / Injection / Injections, Intra-Articular / Injuries / Male / Manipulative therapy / Manual therapies / Middle Aged / Mobilization with movement rotator cuff injuries / Musculoskeletal Manipulations - methods / Pain / Pain Measurement / Physical therapists / Proprioception / Proprioception - physiology / Questionnaires / Range of motion / Range of Motion, Articular - physiology / Rehabilitation / Rotation / Rotator cuff / Rotator Cuff Injuries - physiopathology / Rotator Cuff Injuries - rehabilitation / Rotator Cuff Injuries - therapy / Shoulder / Single-Blind Method / Steroids / Treatment Outcome