There is not a clear understanding of the origin of symptoms perceived by patients with impingement of the soft tissue structures of the subacromial space. Tendinopathy, tendon rupture or other pathologies, are present in asymptomatic subjects and subjects with symptoms and structural integrity can also be found.

Patients diagnosed with subacromial impingement syndrome frequently have myofascial trigger points in the teres major muscle. Travell and Simons reported that the symptoms caused by trigger points in this muscle are similar to those experienced by patients diagnosed with impingement syndrome, but a literature search provides few results regarding relationship between subacromial impingement syndrome and presence of myofascial trigger points in the teres major muscle.

This study aims to provide evidence of the results that can be obtained with a specific approach of teres mayor muscle by two manual techniques, Trigger Point Pressure Release and Diacutaneous Fibrolysis, in subjects with subacromial impingement syndrome, a condition that still representing both a diagnostic and therapeutic challenge. Secondary objective is to compare the outcomes between both techniques to select for each patient the most appropriate to their needs and characteristics.

Inclusion Criteria:

• Age 18 years and over
• Clinical diagnosis of Subacromial Impingement Syndrome.
• Detectable trigger points in teres major muscle.
• Sign informed consent form.

Exclusion Criteria:

• Diacutaneous Fibrolysis contraindications
• Previous shoulder surgery (<1year)
• Language barriers or cognitive issues that limit their ability to provide informed consent and participate in research.
• Patients with a pending litigation or court claim.