Context

Shoulder pain is a common presenting problem in primary care; the limited epidemiological data suggest at least half of patients have persistent symptoms at 18 months.1 Subacromial impingement syndrome (SIS) represents the most common clinical group of shoulder pain patients. Conservative management is employed before surgical interventions, with both exercise and corticosteroid injections as useful non-surgical therapies for SIS.2 ,3 It is not totally clear how to optimise use of these therapies. A recent large randomised trial of patients with SIS with at …