(English) Episode 269-Shoulder Pain Is Not a Space Problem

This systematic review and meta-analysis investigates the relationship between the subacromial space and symptoms of subacromial pain syndrome (SAPS) in both athletes and the general population. By analyzing fifteen high-quality studies, the researchers discovered that the acromiohumeral distance (AHD) does not significantly differ between individuals with shoulder pain and healthy controls. Furthermore, the data indicates no consistent link between physical changes in this space and improvements in pain or disability over time. These results challenge the traditional theory that mechanical "impingement" is the primary cause of shoulder discomfort. Consequently, the authors suggest that clinical treatments should shift away from focusing solely on skeletal gaps and instead address broader biopsychosocial factors and muscle health. Ultimately, the evidence implies that widening the subacromial space through surgery or manual therapy may not be the definitive mechanism for patient recovery.(Park SW, Chen YT, Thompson L, Kjoenoe A, Juul-Kristensen B, Cavalheri V, et al. No relationship between the acromiohumeral distance and pain in adults with subacromial pain syndrome: a systematic review and meta-analysis. Sci Rep [Internet]. 2020;10(1):20611. Available from: http://dx.doi.org/10.1038/s41598-020-76704-z)