Common Conditions

Shoulder Pain

Symptoms, Common Causes and Treatments

Understanding Shouder Pain (Subacromial impingement syndrome)

Shoulder is a ball and socket joint which is made up of the arm bone (humerus) and a socket from the shoulder blade (scapula). There is a bony landmark called acromion over the scapula. The space between acromion and the shoulder joint is called subacromial space.

Subacromial impingement syndrome is a generic term describing pain localized around subacromial space due to soft tissue lesion during lifting the arm. The underlying structures involved may include rotator cuff tendons, bursa, ligaments or joint capsule.

It is one of the most common shoulder pain which affects people between the ages of 35 and 75, especially in over-head sports athletic and labouring populations.

Symptoms and Management

There are various symptoms for subacromial pain:

Weakness when lifting shoulder
Sharp/ catching pain over anterolateral shoulder when the arm is lifted up especially 90-120 degree (painful arc)
Dull ache or soreness over anterior and mid deltoid region which may radiating down to mid shaft of humerus or elbow
More painful during the shoulder internal rotation e.g. pouring tea, wearing clothes or scratching catch

Causes and Risk Factors

There are multiple factors contributing subacromial impingement syndrome:

Internal factors

refers to the structures or changes over shoulder joint

Shape of Acromion Bone

Everyone has different bone shapes. People with hooked or curved acromion shape may have a higher chance of getting subacromial pain due to reduced joint space.

Aging

Our rotator muscles and tendons would get weaker due to the natural aging process. Once the tendons develop small tears, it may lead to poor joint gliding and muscle control, resulting in more subacromial pain.

Weak Rotator Cuff Muscles

Rotator cuff muscles are the main muscles group that control the shoulder joint gliding during shoulder movement. Weakness over rotator cuff muscles would lead to reduced control over shoulder joints and lead to irritation over subacromial space.

External Factors

refers to external pressure or forced on the shoulder

Poor Posture

Rounded shoulder posture may reduced and narrowed down subacromial space which leads to shoulder pain

Sudden Increase in Loading Over Shoulder Joint

Sudden increase in loading over shoulder joint due to workplace changes or increased exercise intensity especially over-head sports e.g. baseball, badminton or volleyball

Inappropriate Exercise Form

Inappropriate posture/ intensity during gym exercise

Prolonged Pressure Over Shoulder

Prolonged pressure over shoulder such as sleeping on the shoulder and carrying heavy bags

Other Risk Factors

Other risk factors for subacromial impingement syndrome includes:

Diabetes
Rheumatoid arthritis
Smoking
Obesity

Treatment as physiotherapists

Treatment methods depend on the stage and irritability of the symptoms of patients. During the acute phase, physiotherapists would implement more pain relieving and anti-inflammatory treatment including ultrasound therapy, laser therapy and induction therapy. Dry needling would be used to relieve tense muscles. Active mobilization exercise would be encouraged to maintain mobility of the shoulder joint. Physiotherapists would also provide advice for lifestyle adjustment.

During the late phase of rehabilitation, functional performance would be the main treatment focus. Individualized rehabilitation exercises would be prescribed for patients to improve their shoulder strength and mobility depending on the requirement of each patient.

Conclusion

Subacromial impingement syndrome is a very common shoulder problem which would lead to daily life inconvenience. However, with an appropriate and individualized treatment plan, the symptoms should be improved within 6 to 12 weeks. Therefore, people with shoulder pain should seek for professional advice as soon as possible.

Testimonials & Reviews

Excellent service. The physiotherapists are very professional, easy to communicate with and also give clear instructions on some home exercises that can help ease my pain.

As a stay at home mom, I need a lot of strength on my daily routine and whenever I have any pain and problems I go to Avery for therapies and he is always helpful and caring Highly recommended!

Samantha Lee

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I had never been a believer in physio therapy in the past or that my experience with multiple chain medical physiotherapy center had brought me nothing but temporary improvements. Until I had came across mobilize physiotherapy where they take the extra mile to examine your situation and tailor a physiotherapy session. The physiotherapists at Mobilize not only identifies the root cause and provide massages for pain relievers but also to provide take home exercises for improvements. I was never rush out the door for the next session and they ensure that I had receive the right treatment before the session ends.
I would highly recommend this physiotherapy center.

Edmond Chan

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Will was very professional. He was very thorough with the assessment and suggested different exercises for me to improve my condition. Recommended 👍🏾

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passionate, precise and comprehensive physiotherapy service, highly recommended for sudden onset or prolonged pain with unknown reason.

Sam Sam

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I can't recommend my physio partner enough! They are always patient and provide valuable guidance to help me relieve chronic pain and improve my performance in jiu-jitsu. Their expertise has been invaluable to me. Highly recommended!

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Nice and patient physiotherapy place, went the extra mile and even taught me a few exercises to work on it myself!

Hogan Lam

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