46 patients with shoulder impingement syndrome (SIS) were randomized to undergo exercise alone or in combination with manual therapy in order to investigate the effects of additive manual therapy on scapular kinematics, pain, and function. Scapular mechanics and functional outcomes were largely unaffected by the interventions, however pain outcomes were affected differently by both treatments. Exercise and manual therapy together improved the least pain during the prior week outcome, while the exercise only group reported better outcomes in pressure pain thresholds in the involved insfraspinatus, and both the involved and uninvolved sides of the C5-6 vertebrae. Further study that controls for type of manual therapy administered is necessary in order to provide more applicable results.