Subacromial Impingement Syndrome

Subacromial impingement syndrome (SIS) is a condition where tendons and soft tissues in the shoulder become pinched between the top bony shelf (acromion) and the ball of the arm bone (humerus). They are sensitive structures and may cause considerable pain.

SIS can occur for a variety of different reasons such as trauma, postural or degenerative change, or repetitive activity. Your physiotherapist will assess and discuss the reasons why you may have SIS.

How common is it?

It is one of the most common shoulder problems and around 20% of people will have symptoms at some time in their lives.

What are the symptoms?

Pain is the most frequent complaint – particularly when raising the arm. Twisting movements, such as putting on a coat, may also hurt. Sleep may also be disturbed because of inflammation.

What should I do?

In the early stages it is important to give your shoulder pain time to settle. Maintain gentle activity but avoid any exercise or activity which has previously worsened your symptoms.

You may also want to try a short course of anti-inflammatories as discussed with your physiotherapist or GP. Another option to reduce inflammation is to have a cortico-steroid injection. Ice can be used to settle pain after exercise.

Are there any exercises I can do?

Yes, exercises are very important and need to be done according to the stage of your recovery. We recommend three stages of rehabilitation:

Phase 1

During this stage it is important to get pain under control and this means only doing very gentle exercises to maintain shoulder movement. Your physiotherapist may also start some postural work with you.

Phase 2

This is the time to strengthen the muscles that support the shoulder. This is done in conjunction with postural work and should not cause pain. It may take several weeks.

Phase 3

This is the time to get the shoulder working normally so that you can return to normal activities

How long will it take to get better?

This can vary depending on the cause of the impingement. In some cases pain can be relieved very quickly but in others it may take several weeks or months.

Overall it can take up to a year for the tendons in your shoulder to heal and settle fully.

What if I don’t get better?

If, after a time, there is limited improvement you may be reviewed regarding a possible corticosteroid injection to your shoulder or possible further investigations such as an X-ray.

Other treatment options may include manual therapy, Shockwave therapy and/or Acupuncture

If symptoms persist you may be referred to see an orthopaedic specialist for further help and possible surgical opinion.

Treatments for SIS

In most cases SIS can be fully treated with conservative physiotherapy. Techniques used can include some or all of the following:

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