SHOULDER IMPINGEMENT

Shoulder Impingement is typically the result of abnormal pressure building up from the shoulder blade (Scapula) on the tendon linking four muscles around the shoulder joint known as the Rotator Cuff.

The pressure and the pain this condition causes is usually most noticeable when the affected arm is lifted. If left untreated this condition often goes on to cause impaired joint mobility, a torn rotator cuff, frozen shoulder, bursitis and/or a debilitating loss of shoulder strength.

Why does Shoulder Impingement Occur?

Shoulder Impingement usually occurs when the Rotator Cuff supporting the shoulder joint muscles becomes trapped and inflamed by the front edge of the shoulder blade (the Acromion). This condition is most common in athletes and workers who are required to repeatedly throw their arms over their head.

How is Shoulder Impingement Treated without surgery?

The use of regular anti-inflammatory medications and enforced rest of the affected shoulder joint for several months can often successfully alleviate this condition if it is caught at an early enough stage. In addition, physiotherapy aimed at progressively relaxing the swollen Rotator Cuff muscle and building up general shoulder strength can also prove useful in avoiding a re-occurrence once an improvement is achieved.

How is Shoulder Impingement treated with surgery?

A surgical procedure to resolve a Shoulder Impingement is typically avoided for all but the more severe and debilitating cases and those that have failed to respond to conservative treatment.

Surgical intervention is aimed at releasing the trapped Rotator Cuff, repairing any damaged tissues and clearing sufficient space around the cuff and within the joint space to allow free movement without further rubbing from the Scapula. In some cases creating sufficient space for the joint to move as freely as it needs may involve a decompression procedure known as a Subacromial Decompression whereby the anterior edge of the Acromian on the Scapula is removed.

The procedure can be performed under general anaesthetic (you will be asleep) or under regional anaesthetic (you will be awake) and will take around an hour to perform dependant on the complexity of the condition.

It is increasingly common for this procedure to be performed arthroscopically (by 'keyhole' surgery) and further information can be obtained on this surgical method by consulting an alternative fact sheet entitled 'Shoulder Arthroscopy'.

How long do I have to be hospitalised?

Once a patient is fully recovered from the effects of anaesthetic they are normally quickly encouraged to be as active and mobile as possible to avoid joint stiffness and other complications such as Deep Vein Thrombosis (DVT) from developing. It is therefore normal for patients to be encouraged to take a short walk and perform gentle postoperative exercises with guidance from a physiotherapist on the day of surgery.
Following a progressive improvement of mobility and pain control patients are normally discharged from hospital 24 hours following surgery. By the time the required level of recovery is achieved for discharge, patients are normally fully mobile, wearing a light weight dressing and support sling on the effected shoulder, eating and drinking normally and taking only mild analgesia (pain killers).

Recuperation

Over the next 6 weeks patients will be expected to work on improving their new shoulder joints mobility and stability through a dedicated and progressive upper limb physiotherapy regime.
Your Consultant Surgeon will assess your joints stability and range of movement after 6 weeks and then again after three months. Patients should expect a continuous and full physical recovery to take around four to six months to achieve.

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