The acromion is a bone located at the tip of the shoulder. When you experience subacromial decompression, it signals that part of the muscles or tendons in your rotator cuff are lodged beneath the acromion. If you experience subacromial decompression, you will have pain when lifting the arm, numbness and tingling in the hand or difficulty moving the shoulders forward or backward. Physical therapy exercises to correct the impingement can help to relieve pain.
Goals
Subacromial decompression that is not severe enough to completely restrict arm movement may require physical therapy. A physical therapist will evaluate the severity of your injury and recommend exercises. By encouraging movement, the exercises will help to return motion to the joint. Because the pain also can cause muscle tension, the stretches help to reduce pain associated with subacromial depression.
Shoulder Isotonic Exercises
When you initially experience a shoulder injury, your physical therapist may recommend isotonic shoulder exercises. These help to strengthen the shoulders, but do not require a significant amount of movement. Isotonic exercises can be made progressively more challenging. One example is holding a lightweight object such as a butter knife with the hand of your affected arm. Keep your arms straight and your palms facing toward the ground as you lift the arms to shoulder height, holding this position for 10 to 15 seconds, then lower back down. Repeat the exercise by lifting and lowering your arms eight times. As you increase in strength, hold heavier items like a tuna can, soup can or a 1- or 2-lb. hand weight.
Stretches
As your subacromial decompression injury begins to heal, your physical therapist may recommend stretching exercises to relieve muscle tension. Exercise examples include the scapular retraction. Start by holding your arms at your sides, bending your arms at the elbows, creating a 90-degree angle between your upper arm and lower arm. Focus on pulling your shoulder blades back behind you as you open the hands, opening your arms and pulling the top of your hands toward the wall behind you. Hold this position for five seconds, then release the stretch. Repeat the exercise eight times. As you increase in strength, you can hold lightweight dumbbells -- between 1 and 3 lbs.
Diagonal Movements
As your subacromial decompression begins to heal, your physical therapist may recommend a progression to diagonal exercises in which you move and lift your affected arm across your body. One example is the diagonal flexion/extension exercise, which simulates everyday activities, such as fastening your seat belt. Stand with your arms straight and your affected arm touching your opposite hip. Slowly lift your arm across the body into the air, lifting the arm to the side as if you are raising your hand in class. Lower the hand in a diagonal manner and repeat the exercise 10 times. Rest for 30 seconds, then repeat for one to two sets.
References
- Sports Medicine Institute University of Minnesota Orthopaedics: Arthroscopic Subacromial Depression
- eOrthopod: Physical Therapy Treatment for Subacromial Impingement Syndrome
- Orthopaedia: Disorders of the Rotator Cuff
- Manual Therapy and Exercises for Subacromial Impingement of the Shoulder; Mark Bookout, PT, MS, FAAOMPT; February 2006
- Orthopaedic Specialists of North Carolina; Scapular Stablization
