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shoulder pain

Healing Shoulder Pain Due to Subacromial Pain Syndrome

What is Subacromial Pain Syndrome (SAPS)?

Subacromial pain syndrome is a condition that occurs when the subacromial bursa or the tendons of the rotator cuff become irritated and painful. A rotator cuff is a group of four muscles that support and move the shoulder joint. These muscles run from the shoulder blade to the top of the arm bone. The subacromial bursa is a fluid-filled sac that decreases friction. If the bursa becomes irritated it can cause pain.

Physio for Shoulder Pain

What Causes Subacromial Pain Syndrome?

Subacromial pain syndrome (SAPS) happens due to overuse or an injury to a rotator cuff tendon or irritation of the subacromial bursa. The tendon that is usually affected is the one attached to the supraspinatus muscle which helps to raise the arm. This tendon is susceptible to irritation as it passes through a small space between the top of the arm bone and the point of the shoulder. This tendon can rub against the edges of the bony space with repetitive use resulting in irritation.


Common Symptoms of SAPS

SAPS often causes pain in the top of the upper arm. This pain usually occurs when the arm is lifted above shoulder height and usually develops slowly. Sometimes the pain is only felt following exercise, and tightness or stiffness may also be associated with SAPS.


Other common symptoms associated with SAPS include:

  • Pain when lying on the affected shoulder
  • Pain or clicking sounds when reaching behind the body
  • Muscle weakness
  • Pain during rest when the condition becomes worse


Treatment for SAPS

SAPS usually doesn’t get better on its own if the cause of the injury isn’t addressed. Your treatment will depend on many factors since there are numerous structures in the shoulder that may be affected. It’s important to understand why the injury happened in the first place to ensure a successful short and long-term solution.


How Does Physiotherapy Help?

Physiotherapy for shoulder pain aims to restore normal function and eliminate pain. Some of the ways physio can help include:

  • Pain management – The initial goal of physiotherapy is to reduce pain and inflammation while preventing any further tissue damage. The manual treatment of tight structures can help with
  • Strengthening – Strengthening is an important part of completing the rehabilitation process. This not only helps to improve function but also reduces the risk of another injury in the future.
  • Correction of faulty movement patterns.
  • Improving posture – Your physiotherapist will use techniques to help you to improve your posture which eases pain and reduces the risk of further damage or injury.


The time it takes to heal from subacromial pain syndrome can vary between patients. However, to improve healing time it’s essential not to continue the activity that caused the injury initially. Participating in overhead sporting activities will continually re-inflame the shoulder structures. Improving posture, correcting faulty movement patterns, and restoring tissue flexibility can help resolve the condition quickly.


Physiotherapy is shown to be a very effective treatment for subacromial pain syndrome. Manual therapy is more effective in reducing pain compared to other forms of treatment. Shoulder pain physio treatments in combination with home exercises show progressive improvement in the strength and flexibility of the shoulder while effectively showing long term sustainable improvements for this condition.

Director & Senior Physiotherapist at Integrity Physiotherapy, Leslie Trigg, has over 13 years of experience in clinical practice. He has graduated with a degree in Human Biology (Anatomy and Physiology) from Curtin University in 2001 and later completed a Masters of Physiotherapy in 2007. He has tremendous experience in musculoskeletal, orthopaedic, neurosurgical and sports physiotherapy. In his spare time, he enjoys swimming, listening to music and spending time with his family.