Tele-Rehabilitation and Tele-Diagnostics in Shoulder Disorders: Current Evidence, Challenges, and Future Directions—A Narrative Review

Background/Objectives: Shoulder disorders are among the most prevalent musculoskeletal conditions, with lifetime prevalence reaching 67% and substantial associated disability and economic burden. Geographic barriers and workforce shortages impede access to optimal rehabilitation. This narrative review aims to synthesize current evidence on tele-diagnostics and tele-rehabilitation in shoulder disorders, evaluate clinical outcomes and implementation factors, and explore models for integrating these complementary approaches. Methods: A structured but non-systematic literature search was conducted across PubMed, Scopus, and Web of Science covering publications from January 2010 through December 2025, using terms related to telehealth, tele-rehabilitation, tele-diagnostics, and shoulder disorders. Priority was given to randomized controlled trials, systematic reviews, feasibility studies, and clinical practice guidelines in adult populations. A total of 97 articles were included in the final narrative synthesis. Results: Tele-diagnostic approaches demonstrate acceptable reliability for range-of-motion assessment and general diagnostic classification, though glenohumeral instability evaluation remains challenging remotely. Multiple randomized controlled trials suggest non-inferior outcomes for tele-rehabilitation compared to conventional physiotherapy across rotator cuff repair, shoulder arthroplasty, and conservative management, with generally high patient satisfaction. Certainty of evidence is currently low to moderate due to short follow-up durations, modest sample sizes, and heterogeneous protocols. Key implementation barriers include the digital divide, inability to deliver manual therapy, and insufficient long-term outcome data. Conclusions: Current evidence supports telehealth as a viable complement to conventional shoulder care, with the strongest evidence base for postoperative tele-rehabilitation. Hybrid care models appear clinically feasible, though widespread adoption requires standardized outcomes, longer-term trials, and strategies addressing health equity barriers.