Having a painful shoulder is a common problem affecting around 1 in 3 adults. SAP is thought to make up around 50% of painful shoulders and most common between the ages of 30 and 55.
There are lots of factors which may lead to SAP, but it is commonly seen after repeatedly using the arm above shoulder height.
Pain along front or outer aspect of shoulder and into upper arm. This can make certain daily activities, such as lifting objects, putting on clothes and work tasks painful when you lift and move your arm.
SAP is diagnosed by a Physiotherapist or Doctor. They will take a history from you about your symptoms and carry out necessary examination.
Sometimes tests such as x-rays and ultrasound are necessary if the usual treatments are not effective, but these are not always required.
A well-paced exercise plan, to gradually strengthen the weakened/overused shoulder muscles will make a big difference.
The exercise below can help:
Stand straight with the elbow on your affected arm bent to 90 degrees.
Place your other hand on the outside of your affected wrist.
Keeping your body still, push your wrist outwards into your good hand, resisting the movement.
Make sure you are trying to rotate the arm outwards, and not trying to push outwards with your elbow.
Hold this position.
For some people, improving posture can help improve the amount of pain-free movement they have in the shoulder.
Steroid injections can often be useful with persistent SAP but are not usually a cure. Their short-term effect can be very useful in helping the graded exercise plan where pain is limiting this. The exercises must be re-introduced after the injection, once the pain has settled. This prevents return of pain by improving the muscle control and mechanics of how the shoulder moves, once the effect of the steroid has worn off.
Sub-acromial decompression surgery is an option where pain persists after trying other treatments. Success rates are reported at between 70-90% but many studies also show that the non-surgical treatments are just as effective as surgery for most patients.
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