Our understanding has come along way in recent years, in terms of shoulder pain that in the past we would have called “subacromial bursitis” or “subacromial impingement”.
We’ve learnt that the cause of this shoulder pain is poorly correlated with imaging results. A significant percentage of people without shoulder pain have issues such as rotator cuff tears, inflamed subacromial bursa, hooked acromion etc show up in scans. Because these can be present in people with no shoulder symptoms, we can’t take scan results as a definite cause of symptoms.
As physios, we have tests we perform which are intended to assess the contribution of certain structures towards symptoms vs others. But these tests do not 100% isolate certain structures over all others.
As a result, we no longer definitively diagnose this type of shoulder pain in terms of specific structures. Rather, we give it the more generic diagnosis of “subacromial pain syndrome”. This represents that the pain is arising from a structure or structures in the subacromial space. These include the subacromial bursa, the rotator cuff tendons, the long head of biceps tendon and them glenoid labrum.
Injuries to these structures have common contributing factors. These include weakness of the rotator cuff muscles, poor upper back posture, and deficiencies in the way the shoulder blade moves during movements of the shoulder.
This means that the specific structure causing shoulder pain is often not overly important to treatment. As physios we treat the presentation, rather than the scan result.
This sort of shoulder pain often doesn’t resolve itself, or if it does it can often take months to years. But usually it’s easily treatable with a combination of hands on treatments and a personalised rehab program to improve function, reduce pain and address the underlying causes.
If your putting up with shoulder pain, see our physiotherapist in Aubin Grove today!
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