Subacromial Pain Syndrome

Subacromial Pain Syndrome

What is subacromial pain syndrome? 

Subacromial pain, also known as rotator cuff related shoulder pain, is a common shoulder 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 many health and wellbeing factors such as anatomy, muscle imbalances, static postures, mental health 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 is unable to 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.

What can I do?

Most cases of subacromial pain will resolve quickly without the need for treatment, however, your attitude and the actions you take are the most important factors in preventing long-term problems. The most effective way to manage symptoms of subacromial pain are to

  1. Identify what factors may be contributing to your pain (eg slumped postures, repeated overhead activity, smoking and stress) and modifying your activity to try to minimise these factors.
  2. Talk to your GP or pharmacist about what pain relief or anti-inflammatory medication may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication such as ibuprofen would help to reduce any inflammation present.
  3. Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.

When should I seek further help?

If symptoms are worsening after 1 week of trying the above strategies, contact your GP surgery for further assistance. They may refer you to a physiotherapist who can

  1. Assess your symptoms,
  2. Help you understand your condition
  3. Help identify the factors that may be have caused or be aggravating your symptoms and providing advice on how to minimise these,
  4. Develop symptom management strategies so you always feel in control
  5. Provide an individualised exercise program to improve mobility and strengthen the rotator cuff muscles and tendons
  6. Provide manual therapies to improve postural awareness and minimise muscular tension in surrounding muscles.


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