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Subacromial Impingement Syndrome: Shoulder Pain Explained

Is shoulder pain keeping you from doing the things you love? Subacromial Impingement Syndrome (SAIS) is one of the most common causes of shoulder discomfort, especially during overhead movements. Fortunately, with the right care, it’s highly treatable. At Spinal and Sports Care, we specialise in diagnosing and treating this condition through a combination of chiropractic care, physiotherapy, exercise physiology and targeted medical interventions. In this article, we will provide an overview of SAIS, its symptoms, and effective management strategies to help you regain shoulder function and alleviate pain.

Who Is Affected by Subacromial Impingement?

  • Age: Most commonly affects individuals aged 40–60 years.
  • Risk Factors:

    • Repetitive overhead motions (common in athletes, manual laborers, and those who work at desks)
    • Poor posture, such as rounded shoulders or forward head posture
    • Previous shoulder injuries, including dislocations or fractures
    • Rotator cuff weakness or muscle imbalances

Symptoms Of Subacromial Impingement

If you’re experiencing shoulder pain, it could be related to subacromial impingement. Look for the following symptoms:

  • Pain in the front or side of the shoulder, especially during overhead activities
  • Difficulty reaching behind the back or lifting objects overhead
  • Night pain or discomfort when lying on the affected side
  • Limited shoulder movement due to pain or mechanical restriction
  • Painful arc of motion, particularly between 60–120° of abduction
  • Positive results from specific tests (e.g., Neer’s Test, Hawkins-Kennedy Test)

Subacromial Impingement Anatomy

How We Can Help: Chiropractic & Physiotherapy Care

At our clinic, we take a multidisciplinary approach to subacromial impingement. Here’s how chiropractic and physiotherapy can help:

  • Acute pain management 
  • Cold laser therapy or low-level laser therapy (LLLT) and advice 
  • Soft tissue work 
  • Utilised to restore tissue patency following spasm in response to pain and/or any compensatory mechanisms 
  • Joint mobilisation and adjustments
  • Restoring range of motion 
  • Exercise prescription 
  • Targeted strengthening, specifically for rotator cuff to promote blood flow which aids in healing, as well as modifying muscular imbalances in shoulder mechanics.
  • Movement assessment and modifications
  • Assessing technique and form through range of motion. 
  • Postural correction 
  • Modifying postural compensations which predispose to SAIS. 

Injection Guidelines: When is It Necessary?

In some cases, conservative treatments may not provide enough relief. For these situations, corticosteroid injections can be used to reduce inflammation and pain. These injections are typically administered directly into the subacromial bursa under ultrasound guidance to ensure precision.

When Are Injections Considered?

  • Persistent pain despite physical therapy intervention
  • Severe functional limitation due to pain
  • Severe inflammation of the bursa or rotator cuff tendons

Important Considerations

  • Injections are usually limited to three per year to avoid weakening the tendons.
  • These should be combined with rehabilitative therapy to optimise recovery and prevent recurrence.

Prognosis & Recovery

With appropriate treatment, most patients experience significant improvement within 6 to 12 weeks. While some may need more intensive interventions, the majority of individuals can return to normal activities and prevent future episodes with a focused rehabilitation plan.

Get The Right Treatment For Your Shoulder Pain With Spinal & Sports Care

If you’re experiencing shoulder pain, don’t wait. Our team of chiropractors and physiotherapists can help you move better, feel stronger, and get back to the activities you love—pain-free! Reach out to our team today for a personalised treatment plan tailored to your needs.