Fifty patients with subacromial pain syndrome (SAPS) were randomized to receive supervised exercise (SE) alone (n=25) or SE combined with myofascial release (MFR) (n=25). The primary outcome was shoulder pain and disability measured by the Shoulder Pain and Disability Index (SPADI). Secondary outcomes included visual analog scale (VAS) pain scores, shoulder range of motion (ROM), and surface electromyography (sEMG) measures of periscapular muscle activity. Assessments were conducted before and after a 4-week intervention period. Overall, the results revealed significant improvements in pain, ROM, and SPADI scores in both groups, with the MFR + SE group showing significantly better outcomes in SPADI, activity-related VAS, ROM, and muscle activation. These findings suggest that adding MFR to SE is more effective for managing SAPS.