Biography

Dr Littlewood is a physiotherapist and Senior Lecturer in Clinical Trials with extensive experience in relation to musculoskeletal disorders. He has developed a special interest in the ‘rotator cuff’ born out of clinical observation in tandem with the assumed complexity and mystique that surrounds these disorders.

In addition to further clinical training, Chris previously completed an MSc in Health Services Research & Technology. In 2011 he was awarded a UK Department of Heath Fellowship to undertake a PhD relating to the assessment & management of the rotator cuff. Chris has published numerous peer-reviewed papers relating to the rotator cuff and is regularly invited to national and international conferences to discuss this topic.

In addition to his clinical and research experience, Chris has a background in education, having previously worked as a Senior Lecturer in Physiotherapy and gained a postgraduate certificate in learning and teaching. While continuing to pursue a programme of research, Chris supervises MSc and PhD students and is also an associate editor for the journal 'Shoulder & Elbow'.

Selected Publications

  • Mitham K, Mallows A, Yeowell G, Littlewood C. 2021. Management of recent onset tendon-related pain in a primary contact setting: A survey of practice. Musculoskeletal Care. link> doi>
  • Littlewood C, Wade J, Butler-Walley S, Lewis M, Beard D, Rangan A, Bhabra G, Kalogrianitis S, Kelly C, Mehta S, Singh HP, Smith M, Tambe A, Tyler J, Foster NE. 2021. Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study). Pilot Feasibility Stud, 17, vol. 7(1). link> doi>
  • Stephens G, Littlewood C, Foster NE, Dikomitis L. 2020. Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial. Clin Rehabil, 269215520984025. link> doi> full text>
  • Littlewood C, Bateman M, Butler-Walley S, Bathers S, Bromley K, Lewis M, Funk L, Denton J, Moffatt M, Winstanley R, Mehta S, Stephens G, Dikomitis L, Foster NE. 2020. Rehabilitation following rotator cuff repair: A multi-centre pilot & feasibility randomised controlled trial (RaCeR). Clin Rehabil, 269215520978859. link> doi> full text>
  • Malliaras P, Cridland K, Hopmans R, Ashton S, Littlewood C, Page R, Harris I, Skouteris H, Haines T. 2020. Internet and Telerehabilitation-Delivered Management of Rotator Cuff-Related Shoulder Pain (INTEL Trial): Randomized Controlled Pilot and Feasibility Trial. JMIR Mhealth Uhealth, e24311, vol. 8(11). link> doi>

Full Publications Listshow

Journal Articles

  • Mitham K, Mallows A, Yeowell G, Littlewood C. 2021. Management of recent onset tendon-related pain in a primary contact setting: A survey of practice. Musculoskeletal Care. link> doi>
  • Littlewood C, Wade J, Butler-Walley S, Lewis M, Beard D, Rangan A, Bhabra G, Kalogrianitis S, Kelly C, Mehta S, Singh HP, Smith M, Tambe A, Tyler J, Foster NE. 2021. Protocol for a multi-site pilot and feasibility randomised controlled trial: Surgery versus PhysiothErapist-leD exercise for traumatic tears of the rotator cuff (the SPeEDy study). Pilot Feasibility Stud, 17, vol. 7(1). link> doi>
  • Stephens G, Littlewood C, Foster NE, Dikomitis L. 2020. Rehabilitation following rotator cuff repair: A nested qualitative study exploring the perceptions and experiences of participants in a randomised controlled trial. Clin Rehabil, 269215520984025. link> doi> full text>
  • Littlewood C, Bateman M, Butler-Walley S, Bathers S, Bromley K, Lewis M, Funk L, Denton J, Moffatt M, Winstanley R, Mehta S, Stephens G, Dikomitis L, Foster NE. 2020. Rehabilitation following rotator cuff repair: A multi-centre pilot & feasibility randomised controlled trial (RaCeR). Clin Rehabil, 269215520978859. link> doi> full text>
  • Malliaras P, Cridland K, Hopmans R, Ashton S, Littlewood C, Page R, Harris I, Skouteris H, Haines T. 2020. Internet and Telerehabilitation-Delivered Management of Rotator Cuff-Related Shoulder Pain (INTEL Trial): Randomized Controlled Pilot and Feasibility Trial. JMIR Mhealth Uhealth, e24311, vol. 8(11). link> doi>
  • Rohun J, May P, Littlewood C. 2020. Rehabilitation following proximal humeral fracture in the UK National Health Service: A survey of publicly facing information. Musculoskeletal Care. link> doi>
  • Littlewood C, Mazuquin B, Moffatt M, Bateman M. 2020. Rehabilitation following rotator cuff repair: A survey of current practice (2020). Musculoskeletal Care. link> doi>
  • Funk L and Littlewood C. 2020. Letter to the Editor. Knee Surg Sports Traumatol Arthrosc. link> doi>
  • Cuff A, Parton S, Tyer R, Dikomitis L, Foster N, Littlewood C. 2020. Guidelines for the use of diagnostic imaging in musculoskeletal pain conditions affecting the lower back, knee and shoulder: A scoping review. Musculoskeletal Care, 546-554, vol. 18(4). link> doi> full text>
  • Littlewood C, Astbury C, Bush H, Gibson J, Lalande S, Miller C, Pitt L, Tunnicliffe H, Winstanley R. 2021. Development of a physiotherapist-led exercise programme for traumatic tears of the rotator cuff for the SPeEDy study. Physiotherapy, 66-73, vol. 111. link> doi>
  • Stephens G, O'Neill S, Mottershead C, Hawthorn C, Yeowell G, Littlewood C. 2020. "It's just like a needle going into my hip, basically all of the time". The experiences and perceptions of patients with Greater Trochanteric Pain syndrome in the UK National Health Service. Musculoskelet Sci Pract, 102175, vol. 47. link> doi>
  • Littlewood C, Morgan M, Pitt L, Moffatt M, Edwards P, Davies R, Peach C. 2020. Rehabilitation following shoulder arthroplasty in the United Kingdom National Health Service: A survey of publicly facing information. Musculoskeletal Care, 359-364, vol. 18(3). link> doi>
  • Smythe A, White J, Littlewood C, Bury J, Haines T, Malliaras P. 2020. Physiotherapists deliver management broadly consistent with recommended practice in rotator cuff tendinopathy: An observational study. Musculoskelet Sci Pract, 102132, vol. 47. link> doi>
  • Brindisino F, Bury J, McCreesh K, Littlewood C. 2020. ROTATOR CUFF DISORDERS: A SURVEY OF CURRENT (2018) ITALIAN PHYSIOTHERAPY PRACTICE. Physiotherapy Practice and Research, 11-22, vol. 41(1). doi> link> full text>
  • Mallows A, Jackson J, Littlewood C, Debenham J. 2020. The association of working alliance, outcome expectation, adherence and self-efficacy with clinical outcomes for Achilles tendinopathy: A feasibility cohort study (the MAP study). Musculoskeletal Care, 169-176, vol. 18(2). link> doi>
  • Smith BE, Riel H, Vicenzino B, Littlewood C. 2020. Elephant in the room: how much pain is ok? If physiotherapy exercise RCTs do not report it, we will never answer the question. Br J Sports Med, 821-822, vol. 54(14). link> doi>
  • Stephens G, O'Neill S, Clifford C, Cuff A, Forte F, Hawthorn C, Littlewood C. 2019. Greater trochanteric pain syndrome in the UK National Health Service: A multicentre service evaluation. Musculoskeletal Care, 390-398, vol. 17(4). link> doi> full text>
  • van der Windt DA, Burke DL, Babatunde O, Hattle M, McRobert C, Littlewood C, Wynne-Jones G, Chesterton L, van der Heijden GJMG, Winters JC, Rhon DI, Bennell K, Roddy E, Heneghan C, Beard D, Rees JL, Riley RD. 2019. Predictors of the effects of treatment for shoulder pain: protocol of an individual participant data meta-analysis. Diagn Progn Res, 15, vol. 3. link> doi> full text>
  • Keene DJ, Soutakbar H, Hopewell S, Heine P, Jaggi A, Littlewood C, Hansen Z, Barker K, Hamilton W, Carr AJ, Lamb SE. 2020. Development and implementation of the physiotherapy-led exercise interventions for the treatment of rotator cuff disorders for the 'Getting it Right: Addressing Shoulder Pain' (GRASP) trial. Physiotherapy, 252-266, vol. 107. link> doi> full text>
  • Pieters L, Voogt L, Bury J, Littlewood C, Feijen S, Cavaggion C, Struyf F. 2019. Rotator CUFF disorders: A survey of current physiotherapy practice in Belgium and the Netherlands. Musculoskelet Sci Pract, 45-51, vol. 43. link> doi> full text>
  • Littlewood C, Bateman M, Cooke K, Hennnings S, Cookson T, Bromley K, Lewis M, Funk L, Denton J, Moffatt M, Winstanley R, Mehta S, Stephens G, Dikomitis L, Chesterton L, Foster NE. 2019. Protocol for a multi-centre pilot and feasibility randomised controlled trial with a nested qualitative study: rehabilitation following rotator cuff repair (the RaCeR study). Trials, 328, vol. 20(1). link> doi> full text>
  • Mallows A, Littlewood C, Jackson J, Debenham J. 2019. Managing Achilles Pain (the MAP study) - A process evaluation of data collection methods. Musculoskelet Sci Pract, 60-66, vol. 42. link> doi> full text>
  • Roberts S, Dearne R, Keen S, Littlewood C, Taylor S, Deacon P. 2019. Routine X-rays for suspected frozen shoulder offer little over diagnosis based on history and clinical examination alone. Musculoskeletal Care, 288-292, vol. 17(2). link> doi> full text>
  • Babatunde OO, Legha A, Littlewood C, Chesterton LS, Thomas MJ, Menz H, Van Der Windt D, Roddy E. 2019. Comparative Effectiveness of Treatment Options for Plantar Heel Pain: A Systematic Review with Network Meta-Analysis. British Journal of Sports Medicine. doi> full text>
  • Babatunde OO, Legha A, Littlewood C, Chesterton LS, Thomas MJ, Menz HB, van der Windt D, Roddy E. 2019. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis. Br J Sports Med, 182-194, vol. 53(3). link> doi> full text>
  • Stephens G, O'Neill S, French HP, Fearon A, Grimaldi A, O'Connor L, Woodley S, Littlewood C. 2019. A survey of physiotherapy practice (2018) in the United Kingdom for patients with greater trochanteric pain syndrome. Musculoskelet Sci Pract, 10-20, vol. 40. link> doi> full text>
  • Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A. 2020. Effectiveness of formal physical therapy following total shoulder arthroplasty: A systematic review. Shoulder Elbow, 136-143, vol. 12(2). link> doi> full text>
  • Walker T, Salt E, Lynch G, Littlewood C. 2019. Screening of the cervical spine in subacromial shoulder pain: A systematic review. Shoulder Elbow, 305-315, vol. 11(4). link> doi> full text>
  • Smith BE, Hendrick P, Bateman M, Holden S, Littlewood C, Smith TO, Logan P. 2018. Musculoskeletal pain and exercise: challenging existing paradigms and introducing new: an educational review. British Journal of Sports Medicine. doi> full text>
  • Mallows AJ, Debenham JR, Malliaras P, Stace R, Littlewood C. 2018. Cognitive and contextual factors to optimise clinical outcomes in tendinopathy. Br J Sports Med, 822-823, vol. 52(13). link> doi> full text>
  • Drake C, Mallows A, Littlewood C. 2018. Psychosocial variables and presence, severity and prognosis of plantar heel pain: A systematic review of cross-sectional and prognostic associations. Musculoskeletal Care, 329-338, vol. 16(3). link> doi> full text>
  • Littlewood C, Rangan A, Beard DJ, Wade J, Cookson T, Foster NE. 2018. The enigma of rotator cuff tears and the case for uncertainty. Br J Sports Med, 1222, vol. 52(19). link> doi> full text>
  • Meakins A, May S, Littlewood C. 2018. Reliability of the Shoulder Symptom Modification Procedure and association of within-session and between-session changes with functional outcomes. BMJ Open Sport Exerc Med, e000342, vol. 4(1). link> doi> full text>
  • Littlewood C, Bury J, O'Shea A, McCreesh K, O'Sullivan K. 2018. How should clinicians integrate the findings of The Lancet's 2018 placebo-controlled subacromial decompression trial into clinical practice?. Br J Sports Med, 883-884, vol. 52(14). link> doi> full text>
  • Lowe A, Littlewood C, McLean S. 2018. Understanding physical activity promotion in physiotherapy practice: A qualitative study. Musculoskelet Sci Pract, 1-7, vol. 35. link> doi> full text>
  • Bury J and Littlewood C. 2018. Rotator cuff disorders: a survey of current (2016) UK physiotherapy practice. Shoulder Elbow, 52-61, vol. 10(1). link> doi> link> full text>
  • Bateman M, Littlewood C, Rawson B, Tambe AA. 2019. Surgery for tennis elbow: a systematic review. Shoulder Elbow, 35-44, vol. 11(1). link> doi> full text>
  • Lowe A, Littlewood C, McLean S, Kilner K. 2017. Physiotherapy and physical activity: a cross-sectional survey exploring physical activity promotion, knowledge of physical activity guidelines and the physical activity habits of UK physiotherapists. BMJ Open Sport Exerc Med, e000290, vol. 3(1). link> doi> full text>
  • Cuff A and Littlewood C. 2018. Subacromial impingement syndrome - What does this mean to and for the patient? A qualitative study. Musculoskelet Sci Pract, 24-28, vol. 33. link> doi> full text>
  • Littlewood C and Cools AMJ. 2018. Scapular dyskinesis and shoulder pain: the devil is in the detail. Br J Sports Med, 72-73, vol. 52(2). link> doi> full text>
  • Hopewell S, Keene DJ, Maia Schlüssel M, Dritsaki M, Dutton S, Carr A, Hamilton W, Hansen Z, Jaggi A, Littlewood C, Soutakbar H, Heine P, Cureton L, Barker K, Lamb SE. 2017. Clinical and cost-effectiveness of progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of rotator cuff disorders: protocol for a 2x2 factorial randomised controlled trial (the GRASP trial). BMJ Open, e018004, vol. 7(7). link> doi> full text>
  • Edwards PK, Ebert JR, Littlewood C, Ackland T, Wang A. 2017. A Systematic Review of Electromyography Studies in Normal Shoulders to Inform Postoperative Rehabilitation Following Rotator Cuff Repair. J Orthop Sports Phys Ther, 931-944, vol. 47(12). link> doi> full text>
  • Munoz-Organero M, Littlewood C, Parker J, Powell L, Grindell C, Mawson S. 2017. Identification of Walking Strategies of People With Osteoarthritis of the Knee Using Insole Pressure Sensors. IEEE SENSORS JOURNAL, 3909-3920, vol. 17(12). link> doi>
  • Mallows A, Littlewood C, Malliaras P. 2018. Measuring patient-reported outcomes (PROs/PROMs) in people with Achilles tendinopathy: how useful is the VISA-A?. Br J Sports Med, 1221, vol. 52(19). link> doi> full text>
  • Lowe A, Gee M, McLean S, Littlewood C, Lindsay C, Everett S. 2018. Physical activity promotion in physiotherapy practice: a systematic scoping review of a decade of literature. Br J Sports Med, 122-127, vol. 52(2). link> doi> full text>
  • Mallows A, Debenham J, Walker T, Littlewood C. 2017. Association of psychological variables and outcome in tendinopathy: a systematic review. Br J Sports Med, 743-748, vol. 51(9). link> doi> full text>
  • Bury J, West M, Chamorro-Moriana G, Littlewood C. 2016. Effectiveness of scapula-focused approaches in patients with rotator cuff related shoulder pain: A systematic review and meta-analysis. Man Ther, 35-42, vol. 25. link> doi> full text>
  • Littlewood C, Mawson S, May S, Walters S. 2015. Understanding the barriers and enablers to implementation of a self-managed exercise intervention: a qualitative study. Physiotherapy, 279-285, vol. 101(3). link> doi>
  • Littlewood C, Bateman M, Brown K, Bury J, Mawson S, May S, Walters SJ. 2015. A self-managed single exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy: a randomised controlled trial (the SELF study). Clinical Rehabilitation, 686-696, vol. 30(7). link> doi> link> full text>
  • Littlewood C, Malliaras P, Mawson S, May S, Walters S. 2014. Patients with rotator cuff tendinopathy can successfully self-manage, but with certain caveats: a qualitative study. Physiotherapy, 80-85, vol. 100(1). link> doi>
  • Littlewood C, Malliaras P, Mawson S, May S, Walters SJ. 2014. Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy: a pilot randomised controlled trial. Physiotherapy, 54-60, vol. 100(1). link> doi>
  • McLean SM, Burton M, Bradley L, Littlewood C. 2010. Interventions for enhancing adherence with physiotherapy: a systematic review. Man Ther, 514-521, vol. 15(6). link> doi>
  • May S, Chance-Larsen K, Littlewood C, Lomas D, Saad M. 2010. Reliability of physical examination tests used in the assessment of patients with shoulder problems: a systematic review. Physiotherapy, 179-190, vol. 96(3). link> doi>
  • Chance-Larsen K, Littlewood C, Garth A. 2010. Prone hip extension with lower abdominal hollowing improves the relative timing of gluteus maximus activation in relation to biceps femoris. Man Ther, 61-65, vol. 15(1). link> doi>
  • Littlewood C and May S. 2007. Measurement of range of movement in the lumbar spine-what methods are valid? A systematic review. PHYSIOTHERAPY, 201-211, vol. 93(3). link> doi>
  • Littlewood C and May S. 2007. A contractile dysfunction of the shoulder. Man Ther, 80-83, vol. 12(1). link> doi>
  • May S, Littlewood C, Bishop A. 2006. Reliability of procedures used in the physical examination of non-specific low back pain: a systematic review. Aust J Physiother, 91-102, vol. 52(2). link> doi>

Other

  • Cuff A and Littlewood C. 2017. Subacromial impingement syndrome – what does this mean to and for the patient: a qualitative study. Physiotherapy (pp. e68-e69, vol. 103). Chartered Society of Physiotherapists. doi> link>
  • Drake C, Mallows A, Littlewood C. 2017. The association of psychosocial variables and plantar heel pain: a systematic review. Physiotherapy (p. e118, vol. 103). Chartered Society of Physiotherapists. doi> link>
  • Babatunde OO, ensor, littlewood, jordan JL, roddy, foster, van der windt. 2017. Comparative effectiveness of treatment options for subacromial shoulder conditions: A network meta-analysis. Cochrane Library. Update Software Ltd.. link> full text>