Impingement Syndrome:

Rotator cuff tendinitis , often referred to as Impingement syndrome, is one of the most common indication for shoulder

arthroscopy.  Patients affected commonly do repetitive overhead work and place a lot of stress and strain on the shoulder

Signs and Symptoms:

Pain at nighttime, difficulty sleeping on the affected shoulder

Pain with activities of the shoulder: overhead motion, motion behind ones back

Pathology:

Impingement syndrome is encroachment of the acromion, coracoacromial ligament, or coracoid on the rotator cuff mechanism.  This can result in chronic inflammation to the rotator cuff. 

Treatment:

The vast majority of the time rotator cuff tendinitis responds well to a conservative management program including physical therapy and injections.  However, occasionally patients continue to experience continued pain with the shoulder.  When pain does not respond to conservative meansures, an arthroscopic shoulder decompression may be performed.

The procedure is performed on an out- patient basis with several small “poke holes” or portals about the size of a pencil around the shoulder.  The shoulder is inspected intraarticularly and then the arthroscope is placed in the subacromial space underneath the acromion.  Here the undersurface of the acromion and coracoacromial ligament is released to provide more room for the rotator cuff for range of motion.  The procedure takes approximately 45 minutes to perform.  Patients wear a dressing for two days and then place a band aid on the portals and can begin showers.  Range of motion to the shoulder is initiated as soon as the patient tolerates.  There are no specific restrictions to the shoulder.  Patients notice a significant improvement in their pain and range of motion usually by 6‑12 weeks.



Dr. Sonya M Clark

Shoulder Disorders