Impingement

This is when the tip of the shoulder (tuberositas of humerus – part of shoulder) compresses the tendons (pinch or impinge) on the acromion (a bony protrusion on the shoulder blade), usually due to bony spurs that form underneath the acromion, an injury sustained to this part or due to “wear and tear” of the shoulder joint.

In the front or the back of the shoulder, or both. The joint is usually tender and a “painful arc of motion” will be experienced – pain will be experienced when the arms are lifted 60-120 degrees to the body. If left untreated, it may result in muscle atrophy (wasting away).

Usually only an experienced examiner can fully diagnose impingement. There are several physical tests. Thereafter the doctor will confirm the diagnosis with an x-ray. Depending on the severity of the condition, it can be treated with cortisone injections where up to three cortisone injections can be given into the shoulder joint. If the cortisone injections do not relieve the pain and discomfort the shoulder will have to be repaired by arthroscopic (key-hole) surgery.

The best way to do the repair is by arthroscopic (“key-hole”) surgery. This is called an acromioplasty – thus removing bone from the lower surface of the acromion (part of the shoulder bone, forming the highest point of the shoulder) to make space for the humeral head (ball of the shoulder) to move, as well as an AC- (Acromio Clavicular) joint excision to remove bone (smoothing out any irregularities) so that there will be no bone-on-bone friction in the shoulder.

You will be able to leave the hospital the next day. Your arm will be in a sling for a day or two after surgery, but you will be able to use the shoulder after surgery.

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The operation has a very high success rate and patients are usually pain-free. If there are any recurrences due to muscle imbalances, these can be corrected with physiotherapy.

The acute healing process is 6 weeks, but the full healing process can take from 6 months up to a year.