Subacromial Pain Syndrome AKA Shoulder Impingement Syndrome

Subacromial Pain Syndrome (SAPS), formerly known as Shoulder Impingement Syndrome, is  a common shoulder injury for climbers due to the demands that climbing puts on your shoulder complex by loading the shoulder in vulnerable positions. The subacromial space refers to the space between your acromion and your glenohumeral joint. This space includes structures that can become aggravated with repetitive overhead activity and crossing positions, which are both typically worse under load. A combination of improving mobility of the joint and surrounding structures as well as strengthening the muscles surrounding the joint can help off-load the AC joint.

Physical therapist mobilizing the glenohumeral joint on a patient

The acromioclavicular joint is located at the very top of the shoulder, and pain is often directly on the top, at the front, or the side of the shoulder. The pain is often described as ‘pinching’ and often is worse when sleeping on your side as well as specific climbing movements including crossing, far reaches, gastons, or lock-offs. 

A banded "W" exercise, to strengthen the scapular muscles

Often the pain is occurring from reduced strength and/or reduced range of motion causing more load and irritation at the joint. Improving mobility of the lats, pec minor, posterior shoulder, and thoracic spine can help improve shoulder mobility and therefore reduce load on the acromioclavicular joint. Improving scapular and rotator cuff strength and stability and progressing strength into vulnerable positions can also be useful in the recovery process. 

There is a lot of individual variation in what the focus of rehabilitation should be with this type of injury, so consulting with a physical therapist familiar with the demands of your sport and can do a thorough evaluation is imperative to focusing on the right aspects of rehab. CLICK HERE to book a consultation with The Climb Clinic to take the first step in your recovery process!

References

Fitness Physiotherapy. (n.d.). Subacromial impingement treatment in Newcastle. Fitness Physio. Retrieved August 2025, from Fitness Physiotherapy website: fitnessphysio.com/subacromial-impingement

Beacon Orthopaedics & Sports Medicine. (2017, March 15). Shoulder impingement. Beacon Orthopaedics & Sports Medicine. https://www.beaconortho.com/blog/shoulder-impingement/