You may have heard these terms mentioned from health professionals, friends or even Dr Google. In effect, they all mean the same thing. Ethan Smith recently wrote a blog on bursitis. Click here for more information regarding this. The more widely accepted term now is subacriomal pain syndrome (SAPS). This is described as a shoulder condition that is chartacterised by rotator cuff weakness and pain located around the shoulder region and into the upper arm. It is generally worsened by repetitive overhead activities, especially around 90 degrees of elevation or when lifting a weight. An estimated 44-65% of all longstanding shoulder pain is associated with SAPS. This can result in increased disability and reduced quality of life.
Treatment of any rotator cuff or SAPS injuries should be tailored to you individually. After a thorough assessment of your range of motion, strength, flexibility, special tests, and any imaging, that may be asked for, can we start you on your path to rehabilitation. Initial treatment will focus on reducing your pain and improving your range of motion. This is where manual techniques, such as, massage, joint mobilisations, acupuncture, taping, electrical stimulation, and isometric exercises may be of benefit. Once your pain is under control and your range has been restored, a tailored strengthening program needs to be implemented. One of the most important aspects of any SAPS rehabilitation program is a strengthening program.
Over the last decade, there has been a lot of focus on the scapular-focused rehabilitation. This involves lots of exercises based on retraction, squeezing your shoulder blades down and back. The basis of this is to allow the scapula to fulfil its role in energy absorption and transfer. It also allows a stable base for rotator cuff activation and functionally as a link in the kinetic chain – from the legs.
A recent controlled, randomised clinical trial looked at the effects of adding scapular stabilisation exercises to a general rotator cuff strengthening program in patients with SAPS. They found there was no greater reduction in symptoms for patients with SAPS with the addition of specific scapular stabilisation exercises when compared to a general rotator cuff strengthening program. Strengthening exercises help to reduce your pain and strengthen the rotator cuff/scapular stabilisers thus offloading the subacromial structures thus reducing your pain.
The key to reducing your pain and improving your day to day function is making sure the exercise program tailored to you. This is based off the objective assessment that is undertaken at the beginning. The exercises that can be used in the rehabilitation of your SAPS injury include any combination of isolated rotator cuff exercises, multi-directional or whole-body exercises. Making the exercise program as functional as possible and not prescribing too many exercises, helps you stick to the rehab program. Making sure you do the exercises as prescribed and giving them time to take effect, upwards of 8 weeks, you will see a difference in your pain and strength levels.
If you are having any rotator cuff pain and want to start rehabilitation, contact us today at Cairnhill Physiotherapy to book an appointment.