Having relatively recently, undergone subacromial decompression surgery I thought that I should write about my experience to help ease any worries of other people who are anticipating a similar operation.
A shoulder impingement can come about for a variety of reasons and the treatment will vary depending on the cause of the injury.
Within the shoulder there is a narrow passage, known as the subacromial space, that runs between the head of the upper arm bone or humerus and a part of the shoulder blade known as the acromion.
Through this channel run the tendons of the supraspinatus muscle. The Supraspinatus is one of the four muscles that make up the rotator cuff which pull the arm into the shoulder joint, to stabilize the joint and help with rotational movement of the arm.
Normally the tendon can slide back and forth through the channel without difficulty. When you suffer from a shoulder impingement the channel narrows making it difficult for the tendon to move freely, resulting in pinching or an impingement of the tendon as we move our arm.
This could be due to an injury that makes the tendon become inflamed, it might be down to changes in posture caused by the aging process or it can be caused by bone spurs growing on the underside of the acromion, which can make the acromial space narrower.
However it is caused, it is a very painful condition that will simply get worse in time. The impingement causes friction, which in turn causes swelling, worsening the impingement. A vicious circle of inflammation and pain with your joint getting weaker and more painful with each passing day.
There are a number of non surgical treatments for shoulder impingement which can be tried before using surgery. Most shoulder impingements can be cured or at least improved significantly without surgical intervention.
Prior to surgery I had tried anti-inflammatory drugs and even a course of steroid injections without success, so my doctor suggested surgery.
My surgery day arrived and I went to the local hospital on a Friday morning. My surgeon explained that the surgery would last around about an hour. He would make two or three small cuts each side of my shoulder. He would then be able to insert an Arthroscope into the incisions to inspect the shoulder joint and confirm the diagnosis.
He would then shave away a small amount of bone from the bottom of the acromion to increase the subacromial space and release the impingement. While he was in there, he would inspect the shoulder joint and do any minor repairs at the same time. It all sounded very straight forward… and it was. All went well. Ninety minutes after going under the anaesthetic I woke up to find my wife seated at my bedside reading a newspaper, feigning indifference.
A while later the surgeon called in to say that he had made three incisions. Two were for the standard operation, and the third was in order to repair the labrum which was slightly frayed. Providing that I had recovered from the anaesthetic, I could go home later that day.
I wore a sling for the first couple of days but it was suggested that I needed to keep my arm as mobile as I could. I was also given some simple exercises to do after the weekend. I was booked in to see a physiotherapist a few days later
That first night at home was a little difficult because my shoulder was quite bruised and sore from the operation but I was prescribed some painkillers which dealt with the pain and allowed me to get a good night’s sleep.
Surprisingly, I was able to return to work the following Monday without any side effects and managing to use my arm reasonably well. My shoulder joint, which had hurt for months, was much better. The relief from the pain of the impingement was almost immediate. I started physical therapy exercises that week and within just six felt that my shoulder was almost as good as new.
I was lucky, my recuperation period was much quicker than average. Recovery from this operation usually takes anything from two to six months. How committed you are to your physiotherapy regime will have a large impact on how long it takes to get better. Exercises are normally aimed at strengthening the rotator cuff muscles. You will begin with gentle low resistance exercises to maintain mobility, and then gradually increase resistance to strengthen the muscles.
Rotator cuff decompression surgery is successful in improving shoulder movement and relieving pain in more than ninety percent of cases. If it’s offered to you as a treatment for a shoulder impingement, grab it with your one good arm.