Best Exercises for Subacromial Pain Syndrome

Jon Grayson

As mentioned in our previous blog treatment for Subacromial Pain Syndrome (SAPS) can be multi-faceted. However, the most important intervention for a long term improvement will always be exercise therapy. The best exercises for Subacromial Pain Syndrome can make a huge difference. In fact, we know the long term effects of good rehab can be as effective, if not better, than having surgery!

Exercise and rehabilitation

The shoulder complex relies upon 33 muscles working in-sync across 5 joints to give us an incredible range of motion to perform a variety of daily tasks. Often due to SAPS these muscles become slow and weak, predisposing the rotator cuff tendons and shoulder joint to unwanted pressures.

Restoring strength & stability around the shoulder complex is the key primary strategy in the treatment of Subacromial Pain Syndrome

Rehab should aim to progressively restore load to the tendons and regain stability around the shoulder joints in preparation for a return to the activities of everyday life and sports.

Best exercises for Subacromial pain syndrome

The following SAPS exercises are based on a gold-standard, evidence-based approach. To give you a taster we have started with what we call Level 1 rehab exercises. Aimed at isolating and activating the right muscles in order to build the foundations for the next steps. Read here for more information on our exercise philosophy and 3 Levels of rehab.

We suggest only doing 2 of the exercises at a time – ideally which ever 2 you find the most useful in reducing your pain.

It is important to note that when tendons are involved, some levels of pain can be expected as part of improving their loading thresholds. Read our ‘Pain | Rest Or Move’ blog to understand what levels are acceptable when exercising.

*If you experience any excessive pain, beyond that advised, during or after each exercise then stop immediately and consult a Physiotherapist*

Subacromial Pain Syndrome Exercises

Isometric Lateral Rotation

How often: x5 sets of 45 seconds holds. x2-3 lots everyday

Instructions: Sitting with your elbows resting on a table/desk. Place the resistance band round your wrists while making a fist and keeping your elbows bent to 90 degrees. Make sure your feet are firmly on the floor and your trunk is upright with shoulders back. Squeeze the wrists apart and hold for 40secs. Repeat x4 sets with a minute rest between.

Top tip: Always begin by performing an isometric exercise before progressing to the next

Goal: Begin strengthening the rotator cuff and place initial load on the tendon when sore or irritable.

Isometric Abduction

How often: x5 sets of 45 seconds holds. x2-3 lots everyday

Instructions: Standing side on next to a wall. Place you forearm flat to the wall with your arm raised out at 45 degrees from your body. Keeping both get firmly on the ground, trunk upright and shoulders back. Imagine you are pushing the wall away, squeezing the arm out. Hold for 40secs. Repeat x4 sets with a minute rest between.

Top tip: Always begin by performing an isometric exercise before progressing to the next exercises below

Goal: Begin strengthening the rotator cuff and place initial load on the tendon when sore or irritable.

Push Squeeze

How often: x3 sets of 15reps. x2-3 lots everyday

Goal: Isolate and activate the rotator cuff and shoulder blade muscles

Instructions: Either sitting or standing at the wall with hands flat. Place the resistance band round the shoulder blades and holding tight around the hands. Keeping feet firmly placed on the ground, trunk upright and shoulders back. Raise the arms up to 90 degrees and slightly apart. Keeping the elbows straight, imagine you are pushing the arms forwards and back so the shoulders blades slide forwards then pinch back. Repeat x3 sets x15 reps.

Ceiling Punch

How often?: x3 sets x15reps. x2-3 lots everyday

Goal: Activate the rotator cuff muscles without pain

Instructions: Either sitting or standing with feet firmly on the ground, trunk upright and shoulders back. Holding a light weight (between 1-3kg). Starting with the elbow bent and slightly out to the side. Slowly straighten the arm up and punch towards the ceiling, before slowly lowering again with control. Repeat x3 sets x15 reps.

How long until I’m better?

Honestly, months! Unfortunately, progression with SAPS rehab is commonly a slow process. That’s because regaining muscle strength physiologically takes times. In the first 3 weeks of exercising you will ‘feel’ yourself getting stronger. This is the nerve signals from your brain to the muscles getting quicker. You will then ‘see’ your strength and control improving after 6 weeks. That’s the muscles getting bigger in size. It then takes up to 12-16 weeks for this improvement to consolidate.

3 weeks to feel it!

6 weeks to see it!

12 weeks to keep it!

Classically a 5-10% improvement month by month is normal. So stick with it!

If you have any questions about your rehab or would like more information in the meantime please call us on 0114 267 8181 or email info@thephysios.londonwordpress.com. Or you can book an appointment here

Best Exercises for Subacromial Pain Syndrome

Jon Grayson

Exercise and rehabilitation

Best exercises for Subacromial pain syndrome