Physiotherapy — Advice Letter on Home Exercises for a Rotator Cuff Strain
A physiotherapist writes an advice letter to a 38-year-old man explaining the home exercise programme for a rotator cuff strain sustained during sport. This is a beginner advice case: a single diagnosis, a short exercise programme, and a clear safety net — the ideal starting point for practising patient-facing physiotherapy letters before more complex cases.
Letter type
Advice
Write to
Patient
Target length
180–200 words
The case notes
Patient: Mr Jason Webb, 38 years old, recreational tennis player
Diagnosis: Right rotator cuff strain (supraspinatus tendinopathy); diagnosed clinically and confirmed on ultrasound
Cause: Overuse injury; worsened during recent increase in tennis training
Current symptoms: Aching pain in right shoulder, especially overhead movements and sleep on that side; NRS 5/10 on aggravating movements; improving over last 2 weeks with rest
Home exercise programme: (1) Pendulum swings: 20 circles clockwise and anticlockwise, twice daily, pain-free range. (2) External rotation with theraband: 15 repetitions x 3 sets, elbow at side. (3) Scapular squeeze: hold 5 seconds x 10 repetitions. — All exercises to stay within a 3/10 pain limit.
Activity modification: Pause tennis until reviewed in 4 weeks; avoid overhead lifting above shoulder height; swimming backstroke is fine; sleep on the unaffected side or with a pillow under the arm
Pain management: Paracetamol or ibuprofen for pain; ice after exercises for 10 minutes
When to seek help: If pain significantly worsens, numbness or tingling develops in the arm, or no improvement after 4 weeks — return to the clinic
Task: Write an advice letter to Mr Webb explaining his home exercise programme and how to manage his shoulder at home.
Writing task
Write an advice letter to Mr Webb explaining his home exercise programme and how to manage his shoulder at home.
What to include, what to cut
The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.
Include
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The three exercises with repetitions, sets and the pain limit (3/10)
The patient must be able to perform the programme without guidance. Vague instructions like 'do your shoulder exercises' are not actionable. The 3/10 pain limit is the safety guide for self-progression.
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Activity modifications: pause tennis, no overhead lifting, sleep position
Continuing aggravating activities is the most common reason rotator cuff injuries do not recover. Concrete activity restrictions are as important as the exercises.
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The safety net: return if pain worsens, numbness develops, or no improvement at 4 weeks
The patient must know what to watch for and when to seek help. Numbness is a red flag that signals possible nerve involvement — different from tendinopathy.
Leave out
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The anatomy of the rotator cuff and the supraspinatus
A patient needs to know what the injury is in plain terms, not an anatomy lesson. 'A strain of one of the tendons that stabilises your shoulder joint' is one sentence; naming the four rotator cuff muscles is not needed.
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The ultrasound findings in detail
Tell the patient the ultrasound confirmed the diagnosis. The detailed findings — thickness, echogenicity — belong in the clinical record, not the patient letter.
Criterion in focus · Conciseness & Clarity
Physiotherapy advice letters are graded on whether the patient can follow the instructions without clarification. Each exercise must have three elements: what to do, how many times, and any limit. 'Pendulum swings: 20 circles in each direction, twice daily, moving your arm gently within a range that stays below 3 out of 10 pain' is complete. 'Do the pendulum exercise' is not.
Now write the letter — and find out what is blocking your Grade B
Write a 180–200 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.