What the heck is that?

The correct term (there is a new one every year it seems!) is sub acromial pain syndrome.

It refers to pain arising from irritation of one or more of the tendons or bursa (a fluid filled sac) that sit between the humerus (the ball)  and the acromion (the arch over the top of the socket).

Have I got it?

Typically pain is felt in the top of the upper arm when lifting your arm above shoulder height.

It can also be painful to lie on in bed.  If this sounds familiar then yes you may very well have it as it is the most common shoulder problem.

Why have I got it?

Good question! There are usually a  number of factors contributing towards pain developing. Every person has different factors which is why there is not a one size fits all rehab for the problem. Usual contributors are poor posture, tightness in the back of the shoulder & chest and weakness in the rotator cuff muscles.  It is not, as is commonly thought, generally due to bony spurs rubbing the tendon away.

What are the rotator cuff muscles?

The rotator cuff muscles are a group of four muscles which help to keep the ball centred on the socket.  The analogy we use is like a golf ball on a golf tee.  One of these called the supraspinatus is often affected along with the biceps (which is not one of the rotator cuff).  Tears are normal, a couple of scientific studies have shown that a lot of us are walking around with pathology but no pain or loss of function so the questions begs – does it matter?! In one study half of all the people scanned in their 50’s had a tear but no symptoms and it went up to two thirds of people over 60. So it just shows a scan and evidence of a tear is not everything.  

Do I need surgery?

In the majority of cases the answer is no.  Well that’s the simple answer but let’s back that up.

There have been a few studies which have looked at surgery v rehab.  They found that the outcomes in the short and long term are the same but surgery is more expensive, more risky and means more pain and longer rehab. If you are boring like us and want to read references, they are down below.

How do I get rid of it?

First it is important to get an accurate diagnosis by taking your history and completing some physical examination tests.  You usually do not require an ultrasound or MRI scan unless it appears that you have a more severe muscle injury – this is not usually the case though.

I will emphasize this point….GREAT rehab will resolve pretty much all cases. So get booked in get GREAT rehab and get it sorted!

Ketola (2013) No evidence of long term benefit of arthroscopic acromioplasty in the treatment of SIS. Bone & Joint Research.

Toliopoulus (2014) Efficacy of surgery for RC tendinopathy. Clinical Rheumatology.

Tashjian (2013) Is there evidence in favour of surgical interventions for SIS. Clinical Journal of Sports Medicine.