(English) Episode 258-Why movement beats shoulder surgery

This clinical practice guideline provides evidence-based recommendations for the diagnosis, treatment, and occupational reintegration of adults suffering from rotator cuff disorders. Developed by a multidisciplinary team of experts, the document outlines 73 specific clinical recommendations and three decision-making algorithms to streamline patient care. It emphasizes that initial assessments should prioritize physical examinations and patient histories, utilizing specialized imaging only in cases of trauma or suspected severe tears. For treatment, the guide advocates for active rehabilitation programs and education over passive modalities, while noting that surgery is most effective for specific full-thickness tears rather than general tendinopathy. Furthermore, the guideline highlights the necessity of early return-to-work planning through coordinated efforts between healthcare providers, employers, and patients to minimize long-term disability. Ultimately, these standards serve as a comprehensive framework to improve clinical outcomes and workforce productivity for individuals with shoulder injuries.Lafrance S, Charron M, Roy JS, Dyer JO, Frémont P, Dionne CE, et al. Diagnostic, prise en charge et soutien au retour au travail des adultes atteints de lésions de la coiffe des rotateurs : recommandations de pratique clinique. J Orthop Sports Phys Ther [Internet]. 2022 ;52(10) :647-64. Disponible sur : http://dx.doi.org/10.2519/jospt.2022.11306