Subacromial Pain Syndrome

What is subacromial pain syndrome?

Subacromial pain, also known as rotator cuff related shoulder pain, is a condition affecting structures which lie in between the acromion and the humeral head (the subacromial space), such as the subacromial bursa and rotator cuff tendons.

Pain in this area is commonly caused by rotator cuff tendinopathy, predominantly affecting the supraspinatus tendon. The rotator cuff muscles are a group of muscles that sit in and around the shoulder blade and provide strength and stability for shoulder function.

Subacromial pain presents as pain and tenderness in the shoulder, sometimes referring to the upper arm. It can be aggravated by reaching overhead or repetitive overhead activities, reaching behind your back and sleeping on the affected side. As well as pain, you may notice some weakness in your shoulder, and your shoulder movement may be reduced due to pain.

What causes subacromial pain?

Subacromial pain is multifactorial, and can be affected by factors such as anatomy, muscle imbalances, static postures, and increased age. It commonly affects individuals who participate in repetitive overhead activities, as this can lead to progressive overload of the supraspinatus tendon.

When this happens, the tendon has exceeded its load tolerance capacity, and can’t cope with the demands of the activity, therefore causing pain. If the amount of load placed on the tendon isn’t managed appropriately, it can become chronic through continued overloading of the tendon.

How can physiotherapy help?

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm the diagnosis, help you manage pain and return to normal activity.

Treatments that can help subacromial pain:

• Home exercises – your physiotherapist will provide you with education and advice regarding modifying activities to reduce aggravating your symptoms, and a progressive exercise programme to strengthen the rotator cuff muscles and tendons.
• Taping – application of kinesiology tape can help with postural awareness – this can reduce the amount of load/compression on the tendon and therefore relieve pain.
• Soft tissue massage – this can help to reduce any muscular tension in the surrounding muscles.
• Shockwave therapy – this has been shown to be effective in the management of chronic tendon conditions. See our page on shockwave therapy for further information on this
• Corticosteroid injection – this can be used as an adjunct to exercise management to relieve pain