Seventy-two patients with shoulder tendinopathies were randomized to receive therapeutic exercise (n=36) or myofascial trigger point therapy (n=36). The primary outcome was pain intensity assessed by the Numerical Rating Scale. Secondary outcomes included pressure pain threshold and range of motion in multiple directions. Outcomes were measured at baseline and after 10 treatment sessions over five weeks. Overall, both interventions significantly improved pain intensity and range of motion. However, therapeutic exercise demonstrated a greater reduction in pressure-induced pain compared to myofascial trigger point therapy. These findings suggest that therapeutic exercise offers comparable efficacy to manual therapy with potential cost and accessibility benefits.