Subacromial Impingement

Subacromial Impingement

Subacromial impingement occurs when the muscles responsible for lifting and rotating the shoulder get compressed and rubbed under the bony roof formed by the collarbone (clavicle) and the shoulder blade (acromion).

The individual’s specific anatomical structure of this bony roof can also play a role in the development of this condition. It is generally seen in middle-aged and older individuals who engage in repetitive overhead activities. Women are more often affected than men. Patients with subacromial impingement typically complain of severe pain when raising their affected arm upward or rotating it backward. Diagnosis is often made through physical examination and MRI imaging.

Diagnosis and Treatment

In the early stages, treatment options may include anti-inflammatory medications, activity modification, shoulder injections, and physical therapy. If these treatments do not provide relief, intractable cases may require arthroscopic procedures to relieve the impingement by shaving bone or widening the affected area. Untreated or delayed treatment of impingement can lead to muscle tears.

After surgery, patients are allowed to move shortly after a few days of immobilization with a shoulder arm sling, and they can use their arm for daily activities. Return to overhead and rotational activities is typically achieved after approximately three weeks of physical therapy.

To prevent impingement syndrome, especially in individuals over middle age who may have anatomical predispositions, it is essential to avoid repetitive overhead and rotational movements in activities.