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SportsWise Physiotherapy

Shoulder Pain is for SAPS: Subacromial Pain Syndrome


Shoulder pain is a really common complaint. Obviously sometimes the shoulder pain has come on after a fall or a sporting injury, but often it sneaks up on you and can hang around for a long time.

Subacromial Pain Syndrome (SAPS) is a very common cause of shoulder pain. It's particularly common in professions and sports that involve repetitive movements with your arms outstretched or above your head. For example hairdressers, painters, boxers and tennis players.

What is it?

You might have heard of shoulder impingement, or subacromial impingement? Well the powers-that-be have renamed this condition

SAPS. It's caused by irritation of a pocket of fluid that sits above the head of your humerus and acts like a cushion, and/or irritation and overuse of the rotator cuff tendons.

These structures are placed under stress when your arms are are outstretched or you reach above your head and so repetitive movements like this can set off a pain response.

What can you do about it?

SAPS requires a fairly detailed examination by a physiotherapist. This is because the shoulder is a very complex part of the body and there are a number of structures which may be contributing to the load placed on the rotator cuff tendons and the bursa.

Treatment will be tailored to your individual presentation, but it will often include manual therapy to your shoulder and upper back, as well as exercises to improve the function of muscles around your shoulder and your shoulder blade. Taping and activity modification may also be required to help it settle down.

What about a cortisone injection?

Cortisone injections can be helpful in settling the pain and inflammation down. In some instances they don't relieve symptoms at all.

Generally doctors will only perform an injection if more conservative treatment hasn't worked on its own. Some rehabilitation should still be performed after the injection to prevent recurrence once the cortisone has worn off.

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