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Shoulder Impingement

What is Shoulder Impingement?

When you have Shoulder Impingement, the bursa becomes inflamed and the rotator cuff sometimes swells and rubs on the bone. Shoulder pain is a common symptom. 

It is often painful and difficult to lift your arm, as the the bursa with the rotator cuff muscle becomes trapped and pinched. The acromion (bony arch) may then respond to this by forming a spur on its under-surface.


There are many different causes, which can include normal ‘wear and tear’ with age, an injury, or overuse of the joint from particular sports such as swimming or tennis. 

In order to diagnose Shoulder Impingement, your specialist will conduct a physical examination and likely request an imaging scan such as an x-ray or MRI.

Surgery is not always required to treat Shoulder Impingement. Depending on the severity of your condition, other treatments such as painkillers, joint injections, exercise and physiotherapy may be recommended first.

For people with persistent symptoms (the shoulder is painful and stiff) or when other treatment options have failed, surgery may be recommended. 

Arthroscopic Subacromial Decompression (ASAD) +/ Acromioclavicular Joint (ACJ) Excision

The aim of the Arthroscopic Subacromial Decompression (ASAD) is to provide pain relief by removing the inflamed bursa and shaving the bone that has developed on the under-surface of the acromion. This surgery may or may not include the removal of your acromioclavicular joint and/or calcification within the tendons.

Your arm will be resting in a sling for approximately 24-48 hours after surgery. It is important to continue to use your arm after your operation to prevent any stiffness or weakness developing. You can rest out of the sling and support the arm on a pillow when you are not moving around.

At two weeks following surgery you should aim to get your arm well above shoulder height, however it will still not be able to go straight upwards. You should regain the majority of your range of movement after three weeks.

Download our Patient Information Leaflet below:

Arthroscopic subacromial decompression and ACJ excision leaflet

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