Subacromial Decompression

Subacromial decompression, also known as an acromioplasty, is a surgical procedure to alleviate shoulder pain and impingement. The acromion is a large bony projection on the outer part of the shoulder blade (scapula) that forms part of the shoulder joint. Ordinarily, a space exists between the top of the arm bone and the acromion. A bursa, or a small fluid-filled sac, sits in the area and allows the tendons of the rotator cuff to glide smoothly during overhead arm movement.

Irritation or swelling of the bursa can decrease that space, which can lead to shoulder impingement. In other cases, shoulder impingement can be caused by bony spurs developing on top of the shoulder blade due to osteoarthritis.

Shoulder impingement causes persistent pain when the tendons and bones of the shoulder rub together while raising the arm. The condition is sometimes referred to as swimmer’s shoulder or thrower’s shoulder, and it can worsen with repetitive pinching as the tendons become irritated and inflamed. If left untreated, shoulder impingement can lead to a rotator cuff tear.

For some patients, surgery isn’t necessary to correct shoulder impingement. There are conservative treatment options for shoulder impingement that revolve around reducing pain and inflammation as well as increasing strength and mobility. These options include:

• Rest and avoiding painful movement
• Physical therapy
• Nonsteroidal anti-inflammatory medications, such as ibuprofen or naproxen
• Steroid joint injections

Patients who fail to gain relief using the methods above may consider subacromial decompression surgery to improve the condition.

How is Subacromial Decompression Performed?

Subacromial decompression is typically performed under general anesthesia, but patients may also be given a local anesthetic into the nerves around the shoulder. This helps to reduce the amount of pain experienced after the surgery.

During the procedure, the orthopaedic surgeon makes small incisions in the shoulder to insert an arthroscope, which is a narrow, flexible, tube-like telescopic camera. The arthroscope allows the surgeon to look in the subacromial space and insert surgical instruments to reshape part of the shoulder blade and also repair any damaged tendons. Once the necessary repairs have been made, the surgeon stitches the site closed.

The Role of Physical Therapy in Subacromial Decompression Recovery

Subacromial decompression is just the first step patients take in recovering from shoulder impingement.  It is crucial for patients recovering from this surgery to adhere to the prescribed physical therapy regimen. The physical therapist will help the patient through a range of exercises to speed along the recovery. These exercises can help:

• Stretch the muscles around the shoulder
• Improve range of motion in the shoulder
• Enhance the strength of the shoulder muscles

The physical therapists at Ability Rehabilitation are trained and specialized in the most up-to-date procedures and protocols for post-surgical rehabilitation. Patients who are adherent to their exercise and stretching plans can expect to improve over the course of two to four months post-surgery.