Abstract
Physiotherapy rehabilitation for rotator cuff-related shoulder pain includes patient education, manual therapy, and exercise prescription. Recent guidelines highlight the importance of holistic, biopsychosocial strategies in managing common musculoskeletal disorders. This qualitative study explored physiotherapists' care for patients with persistent rotator cuff-related shoulder pain, focusing on the content and reasoning behind their choice of interventions. Semi-structured interviews or focus groups were held with 12 physiotherapists across New Zealand with more than three years’ clinical experience. Data were analysed using reflexive thematic analysis. Three themes demonstrate the importance of physiotherapists’ perspectives and beliefs. “Physiotherapist clinical worldview” reflected how professional education and clinical experience shaped their backgrounds and beliefs. “Physiotherapy interventions and rationale” described practice based on individual assessment, primarily involving manual therapy, exercise prescription, and adjunct modalities. “Education and advice” examined the content and delivery of patient education, which was largely grounded in biomechanical principles. Variability was evident in the application of biopsychosocial approaches. Some participants incorporated patient goals, beliefs, and lifestyle factors into their clinical reasoning and education, while others also integrated self-management principles and pain neuroscience concepts. A general inclination was evident towards providing interventions and patient education based on postural, biomechanical, and biomedical principles. Some participants discussed education, advice, and treatments through a psychosocial lens.