What is a Subacromial Decompression?
decompression is a specific type of shoulder arthroscopy. It is used to
treat sports injuries like impingement syndrome after conservative
treatment has failed. This procedure is considered a "minor" shoulder
surgery, however no surgery is minor when it is your shoulder under the
decompression is used to increase the subacromial space, the area
between the humerus and the acromion, and can relieve impingement
syndrome symptoms of pain, popping, and numbness and tingling.
surgery is the last resort for impingement syndrome
usually only performed after several weeks or months of conservative
The Subacromial Space
The subacromial space is the
area between the top of the humerus and the acromion. This area is also
the home of the rotator cuff tendons, the subacromial bursa, and the
With impingement syndrome, these
soft tissues become inflammed and can cause pain and shoulder problems.
This is extremely common with overhead athletes.
subacromial space can become cramped for many different reasons. You
may have a "hooked" acromion, where your bone extends down into the
space, impingeing on the soft tissues.
You may also
have inflammation in the area, causing the bursa and soft tissue to
form scar tissue and fibrosis, again reducing this free space.
Subacromial decompression is performed as an arthroscopic procedure
. This means
that you will have two or three small incisions on the front, back, and
side of your shoulder. Your surgeon will use a small camera and small
tools to decompress the subacromial space. They will also be able to
look inside of your shoulder to make sure that there is nothing else
Once your surgeon determines the nature of
your shoulder injury, they will remove the subacromial
. This fluid filled sac is often inflammed and
irritated. If you have had shoulder pain for a long time it may have
accumulated scar tissue or be stiff and fibrotic.
Once the bursa is removed,
they will shave down the underside of the acromion so that it is flat.
If you have a hooked acromion, this will help to increase the space for
the rotator cuff tendons.
The next step is to remove
part of the coracoacromial
. This ligament is also an area of inflammation
with impingement syndrome and may have scar tissue or fibrosis.
surgeon will also evaluate your rotator cuff tendons to make sure there
are no tears. You may have some fraying of these tendons or areas of
wear that can be cleaned up.
decompression is complete, they will close your incisions with sutures
or staples and you will be sent to recovery.
After surgery you will need some shoulder rehabilitation
your range of motion and strength. You may be given a sling to wear for
comfort, or you may just be instructed to rest your shoulder.
exercises and shoulder rolls are common exercises that you may be told
to do at home. As with any surgery, make sure you follow your surgeons
instructions for your rehabilitation.
your range of motion and strength are the number one goals after this
sugery. A full recovery usually takes 4-6 weeks, but varies for
everyone. Sports activities like throwing may take 2-3 months to get
back to normal.
decompression can be an effective treatment for impingement syndrome if
conservative treatment has failed. By removing the subacromial bursa
and flattening the acromion, this procedure can increase the space
between the humerus and the acromion, reducing impingement of the
rotator cuff tendons. A full recovery after surgery usually takes 4-6
weeks, with a return to sports in 2-3 months. Rehabilitation after
surgery to regain strength and range of motion is important for a full
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