‘There is a very distinct need for education’ among people with rotator cuff tendinopathy: An exploration of health professionals' attitudes

Abstract Background Clinical practice guidelines recommend non-surgical care in the management of rotator cuff tendinopathy prior to considering imaging or surgery. However, this requires effective education to promote adherence to treatment. Objectives To explore expert shoulder clinician's experiences with managing rotator cuff tendinopathy including practice beliefs towards providing education. Design An in-depth qualitative study. Method We conducted interviews (n = 8) with an international sample of expert shoulder clinician-researchers. Data were analysed using an inductive thematic approach with constant comparison. Results Three key themes emerged: (1) The need for early, focused education: “Some beliefs can be detrimental to rehabilitation options”, (2) Developing therapeutic alliance: “If a patients trust you then you are generally going to get much better results” and (3) What is required moving forward in current day RT management: “Maybe we can get better.” Conclusions Our findings highlight the importance of education to alleviate potential barriers to effective conservative care (including exercise) and self-management for rotator cuff tendinopathy. We also identified actionable ways to promote a collaborative therapeutic alliance however, this hinges on sufficient clinical time to educate patients adequately, which may be a barrier in busy clinical settings. Further, there is need for targeted education to facilitate development of clinical skills required to implement effective patient education strategies.