OBJECTIVE: To investigate the efficacy of a programme of manual therapy and exercise treatment compared with placebo treatment delivered by physiotherapists for people with chronic rotator cuff disease. DESIGN: Randomised, participant and single assessor blinded, placebo controlled trial. SETTING: Metropolitan region of Melbourne, Victoria, Australia. PARTICIPANTS: 120 participants with chronic (>3 months) rotator cuff disease recruited through medical practitioners and from the community. INTERVENTIONS: The active treatment comprised a manual therapy and home exercise programme; the placebo treatment comprised inactive ultrasound therapy and application of an inert gel. Participants in both groups received 10 sessions of individual standardised treatment over 10 weeks. For the following 12 weeks, the active group continued the home exercise programme and the placebo group received no treatment. MAIN OUTCOME MEASURES: The primary outcomes were pain and function measured by the shoulder pain and disability index, average pain on movement measured on an 11 point numerical rating scale, and participants perceived global rating of overall change.