Four muscle-tendon units compose the rotator cuff within the shoulder joint. These units provide joint stability and shoulder rotation, as well as a connection between the humerus (upper arm bone) and the scapula (shoulder blade). The rotator cuff muscles travel underneath the acromion, a portion of the scapula, as they travel to the humerus. The bursal (tiny fluid-filled sac that functions as a gliding surface to reduce friction between bones, tendons, and muscles around a joint) tissue in this area may become inflamed, known as bursitis, or bone spurs may develop, and cause mechanical irritation and pinching of the tendon, known as impingement. Overuse of the shoulder joint and the natural aging process are responsible for many cases of impingement and bursitis. Patients suffering from either of these shoulder conditions may benefit from a shoulder impingement treatment called subacromial decompression, offered by Vail, Aspen and Denver, Colorado orthopedic shoulder specialist Dr. Matthew Provencher.
Dr. Provencher performs subacromial decompression under regional or general anesthesia on an out-patient basis in many cases. The arthroscopic procedure requires Dr. Provencher to create a tiny incision in the affected area so he can gain access to the joint, remove the inflamed bursa, and any other irritated soft tissue in the acromion.
Cases of impingement will also be treated with the same technique, but with Dr. Provencher additionally removing bone spurs, and any other bony abnormalities responsible for pinching. Patients suffering from advanced AC joint arthritis and pain may benefit from this shoulder impingement treatment. In these patients, Dr. Provencher will remove a small portion of the clavicle’s distal bone to alleviate pain and other troublesome symptoms.
After all areas of inflamed tissue and bone spurs are removed with subacromial decompression, Dr. Provencher will gently move the shoulder through a series of motions to confirm all areas causing pain and pinching are removed. He will then close the incision site with a simple suture, dress the repaired area, and place the arm in a sling or similar device to immobilize the joint and protect the repair.
Recovery and Rehabilitation Following Subacromial Decompression
Following surgical shoulder impingement treatment, patients will be prescribed a detailed physical therapy program that will begin fairly quickly to work on active movements and eliminate sling use. It is strongly suggested that patients work with the in-house physical therapists at Howard Head Sports Medicine to optimize their rehabilitation. If Dr. Provencher only performs subacromial decompression, range of motion exercises will begin immediately after the procedure. Most patients can expect a full recovery and return to normal activities pain-free within two months following surgery.
For more resources on subacromial decompression, or to determine if you are an ideal candidate for surgical shoulder impingement treatment, please contact the practice of Dr. Matthew Provencher, orthopedic shoulder specialist in the greater Vail, Aspen and Denver, Colorado communities.