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Subacromial Impingement Syndrome

17th October, 2013

Research has shown that subacromial impingement syndrome (SIS) of the shoulder joint is one of the most likely causes of shoulder pain. Although the initial condition causes pain, if left untreated this may progress to a decrease in mobility.

Patient presentation

  • Pain around the front of the shoulder (glenohumeral) joint
  • Pain with active lifting of the arm in front and to the side
  • Tenderness to touch the soft tissues around the shoulder
  • Gradual development of symptoms following repetitive movements or post-trauma

The acromioclavicular joint connects the collar bone to the shoulder blade. Situated under this structure are both the subacromial bursa (a fluid filled sac to help joint movement) and the supraspinatus tendon (supraspinatus being 1 of 4 muscles and tendons in a group called the rotator cuff that stabilises the shoulder).


  • There are numerous reported causes of SIS, including:
  • Inflammation of the supraspinatus tendon
  • Inflammation of the subacromial bursa
  • Poor shoulder blade movement
  • Weak or dysfunctional rotator cuff muscles
  • Instability of the shoulder joint
  • Forward head carriage

The two main causes of SIS are degeneration and/or inflammation of the supraspinatus tendon and/or subacromial bursa often due to weakness and instability of the shoulder joint.

A detailed case history and physical examination of the shoulder complex (comparing the affected shoulder with the unaffected shoulder) is carried out in addition to special orthopaedic tests for suspected SIS.

Early stages of SIS can be helped by manual therapy and cold packing the shoulder joint until symptoms of acute pain have reduced. Then muscle rehabilitation is extremely important for the recovery and maintenance of shoulder health. Postural advice is also beneficial to help improve the mechanics of the shoulder joint and postural taping can be used to correct faulty posture. Corticosteroid injections can be given to help reduce inflammation around the affected structures. The Blackberry Clinic is proud to be able to offer a wide variety of treatments to suit different patient's needs and to help their recovery.

Contributing Author:
Louise Barrett, BSc Osteopathic Medicine