Effects of different frequencies of percussion massage therapy on pain, range of motion, functionality, joint position sense, and quality of life in individuals with rotator cuff tears: a randomized controlled trial

Rotator cuff tears often cause persistent pain, limited mobility, impaired proprioception, and functional decline. While conventional physiotherapy (CT) is the standard treatment, percussion massage therapy (PMT) has emerged as a vibration-based modality that may enhance neuromuscular activation and sensorimotor function. However, optimal PMT frequency parameters remain unclear. This randomized controlled trial examined the effects of two PMT frequencies (16.7 Hz and 33 Hz), combined with CT, on pain, range of motion (ROM), joint position sense (JPS), functionality, and quality of life in individuals with partial rotator cuff tears. Forty-eight adults with supraspinatus partial tears were screened, and 45 were randomized into three groups: CT (n = 15), PMT at 16.7 Hz + CT (n = 15), and PMT at 33 Hz + CT (n = 15). Interventions were applied for three weeks. Primary outcomes included JPS (60° flexion and abduction). Secondary outcomes included Visual Analog Scale (VAS) for resting and activity-related pain, active ROM in all planes, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, and Rotator Cuff Quality of Life (RC-QoL). Assessments were conducted pre- and post-intervention. All groups showed significant improvements (p < 0.05), but both PMT groups demonstrated substantially greater gains than CT alone. The 33 Hz group showed the largest improvements, including + 71.7° flexion, + 77.0° abduction, and marked reductions in VAS-activity (r = − 0.89) and DASH (d = − 2.59). The 16.7 Hz group also improved significantly (flexion + 65.0°, abduction + 72.0°; DASH d = − 2.10). No between-group differences were observed in JPS, although all groups improved meaningfully. PMT at both 16.7 Hz and 33 Hz, when added to CT, significantly improved pain, ROM, functional disability, and quality of life in individuals with rotator cuff tears, outperforming CT alone. Frequency-specific differences were not evident for proprioception, suggesting that additional sensorimotor training may be needed to optimize JPS recovery. PMT appears to be a safe and effective adjunct in shoulder rehabilitation. Prospectively registered in the ClinicalTrials.gov registry (NCT06899945) on 21/03/2025.