The shoulder is a complex joint that allows you to reach and turn your arm in multiple directions. The shoulder is also a location where many people complain of pain. The actual joint of the shoulder is made up of the upper bone of the arm, the collarbone and the shoulder blade. The rotator cuff covers the top of the arm bone as it rotates within the socket of the shoulder. A small sac of fluid called the bursa sits between the rotator cuff and the top of the arm, known as the acromion. Because of the number of different bones, muscles and tendons here, there are several types of injuries that can damage the shoulder, requiring surgery and rehabilitation.
Identification
The bursa sac normally provides lubrication between the rotator cuff and the acromion. Shoulder impingement occurs when the acromion rubs on the rotator cuff and the bursa. The condition commonly occurs among people who use their arms in repetitive motions, or with athletes in sports such as swimming or tennis. According to the American Academy of Orthopaedic Surgeons, shoulder impingement that is left untreated can lead to significant pain and diminished function of the affected arm. In some cases, surgery is indicated for repair of the site.
Surgery
The surgical process for shoulder impingement repair is performed either as an open procedure or arthroscopically. During the open process, the surgeon makes an incision on the front of the shoulder and then removes a portion of the acromion to prevent further rubbing against the tendons; part of the bursa sac may also be removed. This process is known as acromioplasty. When the procedure is performed through arthroscopy, the physician removes these tissues through several small holes in the shoulder. This type of procedure may result in a faster rate of healing and less scarring.
Rehabilitation
Rehabilitation following shoulder impingement surgery is aimed at gaining strength back and preventing stiffness in the affected arm. Your physical therapist may start slowly, depending on your doctor's orders. Rehabilitation typically involves range of motion exercises, which move the shoulder joint through its normal positions. After several weeks, you may move on to strengthening exercises, which involve weight lifting and strength training. If your surgery was arthroscopic, you may begin rehabilitation exercises at a faster rate than if you had an open repair.
Therapy
Your doctor may recommend that you keep your arm in a sling for a period of time following surgery. Additionally, you may be prohibited from reaching overhead or performing any repetitive movements with your affected arm for a period of time. Your physical therapist may also perform other types of therapy for your healing shoulder, such as ice or electrostimulation at the site, particularly if you are having pain. Rehabilitation following shoulder impingement surgery often takes several weeks, and it may be a few months before your shoulder has fully recovered.
