Subacromial Decompression

Performed arthroscopically through small incisions, the surgeon removes inflamed bursal tissue and any bony spurs on the underside of the acromion that are narrowing the space above the rotator cuff. The procedure typically takes thirty minutes to an hour and is usually day surgery.

Surgery is generally considered after a structured physiotherapy programme has not sufficiently relieved symptoms. Assessment includes examination and imaging, usually an ultrasound or MRI, to assess the rotator cuff and confirm the diagnosis. Standard preoperative preparation applies otherwise.

A sling is often worn briefly for comfort, though movement is generally encouraged fairly soon afterward since there is no tendon repair to protect. Physiotherapy typically begins within the first week or two, with most patients experiencing good improvement over the following months.

Rehabilitation focuses on restoring full shoulder movement and rebuilding rotator cuff and scapular strength, since impingement is often linked to underlying weakness or imbalance in these muscles. A consistent physiotherapy programme supports both symptom relief and reducing the chance of symptoms returning.

Risks include infection, persistent pain despite the procedure, and stiffness, along with the general risks of anaesthesia. Some patients continue to have symptoms if an underlying rotator cuff tear or other contributing factor was not fully addressed.

The aim is to relieve the pinching that causes impingement pain and allow the rotator cuff tendons to move freely. Most patients experience significant improvement in pain and function, particularly when symptoms have not responded to a genuine course of physiotherapy beforehand.

Subacromial decompression creates more space for the rotator cuff tendons to move without pinching, addressing persistent shoulder impingement that has not responded to physiotherapy. Most patients experience good relief of pain and improved shoulder function.