Ninety-seven patients with long-standing subacromial pain were randomized to receive either specific exercises targeting rotator cuff and scapular stabilizers (n=51) or control exercises consisting of unloaded range of motion (n=46). The primary outcome of interest was shoulder function and pain at 10 years measured by the Constant-Murley Score (CMS). Secondary outcomes included the proportion of patients opting for surgery, Disabilities of the Arm, Shoulder and Hand (DASH) scores, pain ratings, and progression of rotator cuff tears. Outcomes were assessed at baseline, 3 months, 1 year, 5 years, and 10 years. Overall, the results of the study revealed sustained improvements in both groups, but nonoperated patients had significantly better shoulder function than those who underwent surgery. Moreover, fewer patients in the specific exercise group chose surgery compared to the control group. These findings suggest that specific exercise treatment effectively reduces the long-term need for surgery and offers superior outcomes for patients with subacromial pain.