'It's really, really just exercise I put my faith in now': Patients’ perspectives on rotator cuff tendinopathy management: A qualitative study

Objectives: Rotator cuff tendinopathy (RoCuTe) negatively impacts quality of life, occupations, and mental health. Despite inclusion of patients’ values being recommended in evidence-based practice, they are rarely present in guidelines. We sought to inform clinical practice and guideline development by exploring patient's experience of, and perspectives on, RoCuTe management. Design, setting and participants: Semi-structured online interviews with 14 people, with RoCuTe internationally (8F; age: 21–81 y; symptom duration: 18–300 m). Interviews were recorded, transcribed verbatim, and analysed thematically using the framework method. Results: Thirty-three subthemes were identified across three themes. (A) Patients prioritised clarity around symptom onset and treatment outcomes, valuing clinicians who listened and validated their pain experience: One thing I say… [to] professionals who work in the medical field: listen to the patient, (P004) and When it comes to a pain like that oh it's impossible (P012). (B) Patient–clinician interactions shaped behaviour, with clinical recommendations facilitating greater engagement in rehabilitation activities: I don't think I would have pushed myself to do those things unless I'd been recommended to. (P016). (C) Treatment was perceived as most effective when delivered through structured demonstration, explanation, and supported practice: demonstrate, explain, imitate and practice. So that was part of what they were doing (P008). Conclusion: RoCuTe want to be included in the decision making around their diagnostic process and treatment. They value quality care, wanting their shoulder pain and its impact to be understood and addressed using treatment options with which they can engage. Contribution of the Paper: • Patients believe self-management plays an important role on Rotator Cuff Tendinopathy management and want to be involved in the diagnostic decision-making process. • Patients highlighted the overwhelming nature of pain, sleep disruption, and the importance of pain control given the impact of shoulder pain on daily life. • Patients emphasise how important the prescription of tailored exercises and delivery of high-quality education are for the recovery of shoulder pain and function.