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Treatment

Subacromial Impingement

Dr. Pramod Bhor · Shoulder Impingement Specialist

Dr. Pramod Bhor

Expert Orthopaedic Surgeon

Dr. Pramod Bhor stands out as a renowned and reliable orthopedic and joint replacement surgeon based in Kharghar, Navi Mumbai. With a solid 15 years of experience under his belt, he has skillfully performed a variety of surgeries that include, but are not limited to, total knee replacements, total hip replacements, trauma-related surgeries, and arthroscopic knee procedures.

Moreover, as a distinguished orthopedic surgeon at Fortis Hiranandani Hospital in Vashi, Navi Mumbai, Dr. Bhor has built a stellar reputation for his excellent surgical abilities and dedication to patient care. With a remarkable tally of over 3000 surgeries, he has refined his skills across a broad spectrum of procedures including joint replacements, trauma surgeries, spine surgeries, arthroscopic interventions, and minimally invasive operations for fractures and trauma.

Causes of Subacromial Impingement

Vascular Factors

The tendons which make up the rotator cuff have sufficient vascularisation except the supraspinatus muscle tendon. Its blood supply relies on vessels from the anterior circumflex humeral artery and the sub- and suprascapular muscle arteries. The critical area-about 1 cm medial to the insertion-is relatively avascular, making the tissue more vulnerable as nutrients diminish with age.

Mechanical Factors

Neer proved that during shoulder adduction the rotator cuff chafes against the underside of the acromion. Aggressive acromion shapes (types II and III) or acromial osteophytes further narrow the space. An unfused acromion (os acromiale) and thickening of the subacromial bursa can also cause abnormal rubbing of the cuff tendons.

Degenerative Factors

Degenerative changes to the rotator cuff occur predominantly in individuals over 50 years of age. Friction against the acromion accelerates this degeneration, triggering progressive cuff weakness and pain.

Shoulder Impingement Overview

Expert explanation of why impingement occurs and how it affects shoulder function.

Symptoms of Subacromial Impingement

  • Insidious and progressive onset of pain
  • Gradual loss of shoulder strength
  • Dull, persistent shoulder pain with a sensation of tiredness, especially at night
  • Exacerbation of pain with excessive movement
  • Radiating pain to the elbow
  • Intensified pain when raising arms above the head or placing them behind the back

Procedure Highlights

A closer look at the precision required during subacromial decompression.

FAQs & Recovery Tips

What are the common causes?

Vascular limitations within the supraspinatus tendon, mechanical friction from aggressive acromion shapes, thickened bursae, and age-related degeneration collectively narrow the space.

How is it diagnosed?

A detailed clinical exam evaluating range of motion, provocative impingement tests, and imaging (X-ray, ultrasound, or MRI) helps confirm tendon irritation.

What treatment options are available?

Early care focuses on activity modification, anti-inflammatory support, and targeted physiotherapy. Persistent cases may need arthroscopic subacromial decompression.

Recovery Milestones

Essential exercises and tips for regaining full range of motion without pain.

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