Subacromial Pain

Subacromial pain is a term used to describe pain arising from the subacromial space of the shoulder. This is an area of the shoulder joint that contains the tendons of the rotator cuff muscles and the subacromial bursa. It can be also known as ‘rotator cuff related pain’ , ‘subacromial impingement’ or ‘subacromial bursitis’. This is a common problem and affects 1 in 4 adults at some point in their life.  The rotator cuff is a group of four muscles and tendons that surround the ‘ball and socket’ of the shoulder joint and act as a ‘cuff’ around it. The subacromial bursa is a sack of fluid that helps to reduce friction during movement of the shoulder.

Symptoms

Pain mainly felt in the shoulder and upper arm. It is usually worse on lifting the arm, reaching or lying on the affected shoulder

Causes

It is common for this pain to start slowly over time or it can begin quite suddenly after an injury or after a demanding activity such as painting or gardening. If your job or hobby involves overhead activity you may be more likely to develop these symptoms.  An injury or repetitive activity can cause inflammation of the rotator cuff tendons and bursa causing pain.

Treatment

For most people this pain will settle with rest, activity modification (changing how you carry out painful tasks to reduce stress on the shoulder) and shoulder exercises.  The British Elbow and Shoulder Society (BESS) have developed an exercise programme specifically for subacromial pain. To try this program, please watch the two introduction videos followed by the three exercise videos. There is also a link below for the programme in a written format.

Please follow the links below to the videos. Start with the two introduction videos, then have a go at the three exercises. Go gently and stop if any significantly increase your pain.

BESS Subacromial exercise program Video one: Introduction

BESS Subacromial exercise program Video two: Introduction 2

BESS Subacromial exercise program Exercise one

BESS Subacromial exercise program Exercise two

BESS Subacromial exercise program Exercise three

BESS Subacromial exercise program Written Document

Physio prescribed Early shoulder exercises

Video: Correct Shoulder Posture

Video: Shoulder Isometrics

Video: Table Weight Bearing

Video: Wall Slide Cuff Activation

Physio prescribed Intermediate shoulder exercises

Video: Shoulder Rotation Side Lying

Video: Shoulder Rotation Supine Lying

Video: Shoulder Rotation Prone Lying

Video: Floor Weight Bearing

Why does my shoulder still hurt?

Video: Why does my shoulder still hurt?

When to seek advice

If you have severe pain affecting your sleep and daily activities, if you have had a serious injury or you have symptoms that have not improved with self-management, you should contact your GP practice. If you have a red, hot swollen joint please ring 111