What is it?

Generally speaking, Subacromial Pain Syndrome or “SAPS” refers to pain and irritation of the shoulder structures below the collarbone. Its definition is centre of frequent debate and has also been labelled shoulder impingement, subacromial impingement syndrome (SIS) and rotator cuff pathology.

It is the most common cause of shoulder pain, accounting for 44% – 65% of shoulder pain cases and is usually atraumatic in origin.


What are the symptoms?


  • Pain in shoulder when performing overhead activities (combing hair, reaching for overhead items)
  • Pain when when putting on clothes and/or disrobing 
  • Pain when sleeping on side of affected shoulder
  • Pain between 60 and 120 degrees of lateral abduction

*Pain can be in varying locations such as top, front or back of the shoulder and can be focal or diffuse in presentation. Patients often report feeling weak and unstable in the affected shoulder as well.


What causes it?

There are multiple causes of SAPS. In this article we’ll focus on “secondary impingement” which refers to functional causes rather than structural.

Generally speaking there is a combination muscle tightness (commonly the pectoralis minor, bicep, anterior deltoid and levator scapulae) and weakness/poor motor control of the lower trapezius and serratus anterior.  The tightness of the above muscles pull the arm bone and scapula into disadvantageous positions which can irritate the shoulder joint structures over time, leading to SAPS.


How is it managed?

Conservative management is usually the first line of treatment for SAPS. Michael aims to reduce stiffness of the above listed muscles through therapeutic massage, stretching and dry needling in combination with a progressive exercise program aimed at developing normal shoulder mechanics and strength.


Contact us

Michael is available for consultation. He is a Melbourne based chiropractor who consults from Medical clinics in Croydon. For more information please contact Michael on 0430 300 257. Chiropractic care is covered by Private Health Insurance (depending on your plan) and some patients may be eligible for a Medicare EPC referral.

Call Now