Subacromial impingement of the shoulder, commonly known as impingement syndrome, occurs when the space between the humerus and the acromion narrows, causing irritation of the surrounding soft tissues.
This chronic inflammation causes pain and limits the shoulder's range of motion.
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Subacromial impingement generally presents as localized pain in the anterior and lateral aspect of the shoulder that increases with overhead motion. This pain may be accompanied by joint stiffness that limits range of motion and muscle weakness, especially during external arm rotation.
In addition, some patients report a creaking or grinding noise in the shoulder with certain movements.
Subacromial impingement is caused by a pinching of the rotator cuff tendons under the acromion.
This phenomenon is often related to a combination of anatomical factors (acromion shape, reduced subacromial space) and mechanical factors (repetitive movements, poor posture).
Repeated microtrauma leads to tissue inflammation and scarring, further reducing the available space and exacerbating the conflict.
Conservative treatment is the preferred first-line treatment for subacromial impingement of the shoulder. They include:
A personalized rehabilitation program is designed to:
Specific exercises adapted to each stage of rehabilitation help stretch tight muscles, strengthen weak ones, and restore optimal coordination.
The length of rehabilitation varies depending on the severity of symptoms and the individual's response to treatment. The acute phase may last several weeks, followed by a convalescent phase that may last several months.
Medical treatment for subacromial impingement includes:
Other techniques may help relieve subacromial shoulder impingement:
If conservative treatments do not provide lasting relief from shoulder pain caused by subacromial impingement, surgery may be considered. The main goal of this surgery is to decompress the space where the shoulder tendons slide in order to reduce the friction and inflammation that cause the pain.
The most common procedure is acromioplasty. This involves removing a small portion of the acromion bone that is compressing the tendons to create more space.
Depending on the exact source of the pain and the condition of the tendons, other surgical procedures may be performed in conjunction with acromioplasty:
Postoperative recovery from subacromial impingement surgery requires intensive rehabilitation tailored to each patient. The main goals of this rehabilitation are:
Rehabilitation can last from several months to a year.
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