Subacromial Impingement

Why did I get it?

Although everyone is susceptible to shoulder impingement, the most common sufferers are people who make repeated overhead movements. These include warehouse or shipping workers, painters and carpenters, swimmers and tennis players. You are particularly vulnerable if you make weekend repairs that require a lot of shoulder force since you don't normally use these muscles during the course of the week. Your anatomy may also predispose you if the shape of your acromion (point of your shoulder) decreases the space for your rotator cuff to pass through (see below). Lastly, poor posture is becoming a more frequent cause of bursitis because the shoulder does not work well when the shoulder blade is out of position.

Depending on your anatomy, your rotator cuff may have less space in which to function

What non-surgical options do I have?

Rest
- Avoid activities that will aggravate and inflame the shoulder bursa, such as throwing, lifting, pushing, and pulling.
Ice
- Putting ice on the swollen area reduces inflammation and helps to relieve the pain. Apply an ice pack for about 15 minutes at a time, 2 or 3 times per day. As a convenient alternative, you can use a bag of frozen peas, which will conform easily to your shoulder's shape.
Heat
- A heat application helps to soothe your sore muscles, though it doesn't actually reduce inflammation. Apply heat several times a day for about 10 or 15 minutes at a time. In lieu of a heating pad, you can take a warm bath or shower. Be sure to allow the shower spray to hit directly onto your shoulder.
Medication
- Over-the-counter pain relievers such as aspirin or ibuprofen can be very effective in reducing pain and inflammation. Prescription anti-inflammatory medications may be considered as well. Narcotics are not prescribed for impingement syndrome.
Injection
- If other methods of pain reduction are ineffective, injection of an anti-inflammatory medication (cortisone) directly into the bursa is an option. This type of treatment can eliminate or significantly reduce the pain for several weeks. An ultrasound is used to ensure correct placement of the medication.
Physical Therapy
- A shoulder with impingement syndrome often is tight. By stretching and strengthening the joint, pain can often be relieved. Ultrasound may also be used by the therapist. In this treatment option, a medicated gel is applied to the injured area and painless sound waves are released from a hand-held electronic device. A "full" course of therapy is considered 2 to 3 times a week for 6-8 weeks.

Ultrasound-guided cortisone injection

DO

Alternate hands and techniques when doing repetitive motions
Stand straight, in a relaxed manner
Carry heavy loads close to your body
Sleep on your back on a firm mattress
Stretch properly and exercise your shoulder regularly

DON'T

Repeat the same arm motions, day in and day out
Slump, with your shoulders sagging
Raise your arms above your head for extended periods
Sleep on any shoulder that is tender or weak
Perform any exercises that twist your shoulders unnaturally

When is surgery an option?

If the impingement does not respond to any of the traditional treatments after a minimum of 4-6 months, surgery may be considered. An excellent surgical choice in these cases is arthroscopy, a technique that utilizes tiny incisions and micro-instruments, causing less tissue trauma and promoting a speedier recovery. The surgery involves removing the inflamed bursa, releasing the acromioclavicular ligament, and shaving down any bone spurs. This is officially termed a "subacromial decompression." The ultimate goal is to create more space for the shoulder to move.

What is a "subacromial decompression" surgery?

The surgery is performed arthroscopically using a few small incisions about the shoulder. The inside of the shoulder joint is evaluated first to confirm that the cartilage, ligament, and tendons are all okay. Next, the camera is placed into the subacromial space which is the space in between the rotator cuff and acromion. The irritated bursa is identified and removed. If bone spurs are present, the are shaved down with a surgical bone shaver.

Arthroscopic Subacromial Decompression

How long does it take to recover from surgery?

You will be sent home the day of your surgery (outpatient surgery), and motion of the shoulder is initiated immediately. Physical therapy is usually required for approximately 6-8 weeks. Full recovery usually takes three to four months.

Why did I get it?

What non-surgical options do I have?

Rest

Avoid activities that will aggravate and inflame the shoulder bursa, such as throwing, lifting, pushing, and pulling.

Ice

Putting ice on the swollen area reduces inflammation and helps to relieve the pain. Apply an ice pack for about 15 minutes at a time, 2 or 3 times per day. As a convenient alternative, you can use a bag of frozen peas, which will conform easily to your shoulder's shape.

Heat

Medication

Over-the-counter pain relievers such as aspirin or ibuprofen can be very effective in reducing pain and inflammation. Prescription anti-inflammatory medications may be considered as well. Narcotics are not prescribed for impingement syndrome.

Injection

Physical Therapy

DO

Alternate hands and techniques when doing repetitive motions

Stand straight, in a relaxed manner

Carry heavy loads close to your body

Sleep on your back on a firm mattress

Stretch properly and exercise your shoulder regularly

DON'T

Repeat the same arm motions, day in and day out

Slump, with your shoulders sagging

Raise your arms above your head for extended periods

Sleep on any shoulder that is tender or weak

Perform any exercises that twist your shoulders unnaturally

When is surgery an option?

What is a "subacromial decompression" surgery?

How long does it take to recover from surgery?

You will be sent home the day of your surgery (outpatient surgery), and motion of the shoulder is initiated immediately. Physical therapy is usually required for approximately 6-8 weeks. Full recovery usually takes three to four months.

Clinic Information

Hours

Why did I get it?

What non-surgical options do I have?

Rest

​Avoid activities that will aggravate and inflame the shoulder bursa, such as throwing, lifting, pushing, and pulling.

Ice

Putting ice on the swollen area reduces inflammation and helps to relieve the pain. Apply an ice pack for about 15 minutes at a time, 2 or 3 times per day. As a convenient alternative, you can use a bag of frozen peas, which will conform easily to your shoulder's shape​.

Heat

Medication

Over-the-counter pain relievers such as aspirin or ibuprofen can be very effective in reducing pain and inflammation. Prescription anti-inflammatory medications may be considered as well. Narcotics are not prescribed for impingement syndrome.

Injection

Physical Therapy

DO

Alternate hands and techniques when doing repetitive motions

Stand straight, in a relaxed manner

Carry heavy loads close to your body

Sleep on your back on a firm mattress

Stretch properly and exercise your shoulder regularly

DON'T

Repeat the same arm motions, day in and day out

Slump, with your shoulders sagging

Raise your arms above your head for extended periods

Sleep on any shoulder that is tender or weak

Perform any exercises that twist your shoulders unnaturally

When is surgery an option?

What is a "subacromial decompression" surgery?

How long does it take to recover from surgery?

You will be sent home the day of your surgery (outpatient surgery), and motion of the shoulder is initiated immediately. Physical therapy is usually required for approximately 6-8 weeks. Full recovery usually takes three to four months.

Clinic Information

Hours

Avoid activities that will aggravate and inflame the shoulder bursa, such as throwing, lifting, pushing, and pulling.

Putting ice on the swollen area reduces inflammation and helps to relieve the pain. Apply an ice pack for about 15 minutes at a time, 2 or 3 times per day. As a convenient alternative, you can use a bag of frozen peas, which will conform easily to your shoulder's shape.