This is a well conducted systematic review which aimed to update the evidence regarding the role of manual therapy for RC tendinopathy due to the publication of new randomised controlled trials since the last systematic review on this topic (Braun et al, 2013). Some points are worth noting when considering the results of this review. Manual therapy and exercises for shoulder impingement revisited. Phys Ther Rev. 2013;18:263-84. Article Google Scholar Borstad J, Woeste C. The role of sensitization in musculoskeletal shoulder pain. Page MJ, Green S, Kramer S, Johnston RV, McBain B, Chau M, Buchbinder R. Manual therapy and exercise for adhesive capsulitis (frozen Progressive Resistance Exercises plus Manual Therapy Is Effective in Improving Isometric Strength in Overhead Athletes with Shoulder Impingement Syndrome: A Randomized Controlled Trial Saurabh Sharma,1 Amer K. Ghrouz,2,3 M. Ejaz Hussain,1 Shalini Sharma,4 Mosab Aldabbas,1 and Sumbul Ansari1 Purpose Although many conservative management options are available for patients with non-surgical shoulder conditions, there is little evidence of their effectiveness. This review investigated one manual therapy approach, thrust manipulation, as a treatment option. Methods A systematic search was conducted of the electronic databases from inception to March 2016: PubMed, PEDro, ICL, CINAHL The most common pathologies associated with shoulder pain are shoulder impingement syndrome, rotator cuff tears and tendinopathy, bursitis, joint oedema and glenohumeral instability. 5 -7 The consequences of such pathologies can be incredibly severe for wheelchair users, as it may prevent individuals from being physically active, which can Shoulder impingement is a common condition believed to contribute to the development or progression of rotator cuff disease (van der Windt et al., 1995, Michener et al., 2003).A number of impingement categories have been identified including subacromial impingement or "external impingement"; internal impingement, which can be further divided into anterior or posterior (Edelson and Teitz This systematic review update provides some further evidence supporting the effectiveness of manual therapy and exercises for shoulder impingement, but methodological deficits/risk of bias warrant cautious interpretation. 21 The effectiveness of physiotherapy exercises in subacromial impingement syndrome: a systematic review and meta-analysis. The patient revisited the clinic on March 18, 2021. The pain VAS was 0, and no symptoms remained . Figure 6: shoulder impingement, and knee arthritis. Miyamori T, Tumilty S. The effects of manual therapy or exercise therapy or both in people with hip osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2016;30:1141-55. This review included exercise programs with components of home-exercises, manual therapy and other modalities Manual therapy and exercises for shoulder impingement revisited. Phys Ther Rev. 2013;18(4):263-84. Article Google Scholar Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A, Sim J. The effectiveness of Effectiveness of conservative interventions including exercise, manual therapy and medical management in adults with shoulder impingement: a systematic review and meta-analysis of RCTs. Heintsch J, et al. Manual therapy and ex