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Subacromial Pain Syndrome

Subacromial Pain Syndrome is the preferred alternate physical therapy diagnosis for “Shoulder Impingement.”  It was previously believed that structural differences and a loss of space between joint surfaces was the cause of shoulder pain located towards the front/side of the shoulder in absence of known tears in the rotator cuff (group of muscles that hold your shoulder in the socket) or glenoid labrum (a cup that increases coverage over the shoulder bone).  Thanks to Evidence Based Medicine, we now know that the experience of shoulder pain isn’t so closely related to the shape of your bones, which is great news.  Bone shapes don’t change easily. 

What is Subacromial pain syndrome:

It is pain located in the front or to the side of your shoulder and often a precursor for rotator cuff pathology (strains or tears of the rotator cuff muscle at the point of attachment around the front and side of your shoulder).


  • Pain with overhead reaching
  • Pain with reaching out to the side
  • Pain with washing low back
  • Pain shampooing hair
  • Pain with sleep

Risk Factors for Development: 

  • Slightly more common in biological woman than men
  • Complaints increase with age, most common between 50 and 70 years
  • Manual labor, esp. jobs requiring frequent vibration (construction)
  • Instability: overhead and throwing athletes

Common Causes

  • Impaired coordination of muscles
  • Tightness in the back of the shoulder joint
  • Joint Laxity

Why Physical Therapy, Why NOW?!

Shoulder pain is the 3rd most common condition seen in physical therapy and conservative treatment is just as effective as surgery for subacromial pain syndrome and rotator cuff tears.

At LSTC you will Receive…

  • Personalized Care
  • Improved Quality of Life
  • Increased Strength
  • Increased Mobility
  • Reduced/Absent Pain
  • Improved Body-Awareness
  • Education regarding your condition and how to manage it

A Doctor of Physical Therapy (DPT) will evaluate your individual body structure and function, determine which of these factors AND more could be contributing to your pain experience.  While the pain or limitations you feel are at the front or side of the shoulder, the evaluating doctor can determine where and what is causing your pain (even if it’s coming from another region, like your neck or the back of your shoulder).  If the condition proves to require further medical testing, the evaluating therapist will be able to determine that and direct you accordingly.

Whenever pain is a factor, muscle groups stop working efficiently and people avoid pain provoking activities.  The result is weakness, reduced mobility, and more pain.  Waiting to get your shoulder evaluated only extends the time it takes to get you back to living the life you want, participating in activities you enjoy (i.e. gardening or playing catch), and being able to comfortably dress, shower, sleep.  Time is the only thing that you can’t get back.  Spend some time with our team of therapists and athletic trainers, so that you can spend more time focusing on the things and people that matter most!

By Candace Harding, PT, DPT

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Call LSTC at 703-450-4300 to schedule your evaluation!


  1. “Common Injuries of the Shoulder.” Common Injuries of the Shoulder – Health Encyclopedia – University of Rochester Medical Center,
  2. Ellenbecker, T., Manske, R. and Kelley, M., 2016. Current Concepts Of Orthopaedic Physical Therapy: The Shoulder Physical Therapy Patient Management Using Current Evidence. 4th ed. [ebook] Orthopaedic Section, APTA Inc., pp.3-26. Available at: <> [Accessed 9 March 2018].
  3. Harbour, Sarita. The Hartford: Extra Mile, The Hartford, 2020, 
  4. Hegedus, Eric. “Evidence-Based Treatment of the Shoulder: An Update.” MedBridge. 31 Mar. 2021, 

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