Physiotherapy management of rotator cuff tendinitis with associated subacromial bursitis in a tertiary hospital in Nigeria: a case report

Rotator cuff tendinitis with associated subacromial bursitis is a prevalent cause of shoulder pain and disability, often managed with corticosteroid injections. However, injections alone may not address underlying neuromuscular deficits, highlighting a need for structured post-injection rehabilitation to ensure sustained recovery. This case study examines the outcomes of a multimodal physiotherapy program following a corticosteroid injection in a patient with this condition. A single-case longitudinal design was used to evaluate the effects of a 10-week multimodal physiotherapy program. Outcome measures included pain intensity using the Numerical Pain Rating Scale (NPRS), shoulder function using the Shoulder Pain and Disability Index (SPADI), active range of motion (AROM), and muscle strength assessed by the Oxford Scale. Assessments were conducted at baseline and post-intervention. Descriptive statistics, including absolute change and percentage improvement, were used, and clinical significance was determined based on Minimal Clinically Important Difference (MCID) thresholds. The case involves a 71-year-old female with rotator cuff tendinitis and subacromial bursitis, presenting with sudden-onset right shoulder pain approximately three weeks prior to presentation, marked functional limitation, and restricted mobility. At baseline, the patient reported severe shoulder pain on the Numerical Pain Rating Scale (NPRS) of 7/10, functional disability on the Shoulder Pain and Disability Index (SPADI) of 67.7%, and restricted active range of motion (AROM). Following a 10-week physiotherapy program, worst pain decreased to 2/10 (absolute change: -5) and SPADI improved to 16.3% (absolute change: -51.4%), exceeding Minimal Clinically Important Difference (MCID) thresholds. AROM increased substantially in flexion (110° → 168°), abduction (85° → 166°), external rotation (40° → 75°), and internal rotation (37° → 75°). Shoulder muscle strength improved by one grade on the Oxford Scale, while distal joint changes (elbow and wrist) were minimal. This case demonstrates the significant effectiveness of a structured, multimodal physiotherapy program in reducing pain, improving function, and restoring range of motion in a patient with rotator cuff tendinitis and subacromial bursitis following a corticosteroid injection. The findings underscore the critical role of timely, active rehabilitation as an essential component of comprehensive management to promote sustained functional recovery and a favorable prognosis.