Body > Common Shoulder Surgeries > Shoulder Subacromial Decompression

Shoulder Subacromial Decompression

This is keyhole surgery, usually performed under a combination of general anaesthetic and a nerve block. It may be performed as a day procedure, but some patients remain in hospital overnight to ensure they are comfortable.

The operation is performed through two small incisions (about 1cm).  The surgeon inserts an arthroscope through one incision and examines the shoulder joint to confirm the cause of the symptoms. The arthroscope is then used to view and guide the surgery performed through the second incision.

The surgeon can use a range of different tools, via the second incision, depending on what needs to be done.  A heat probe may be used to remove soft tissue, or a high speed burr to remove bone spurs. The bursa (a fluid filled sack in the shoulder) is usually removed to make more space. The biceps tendon or rotator cuff tendons may also be trimmed, to clear away any frayed tissue.

The incisions are sutured and dressed, and the arm is placed in a sling for comfort.Gentle exercises are started the day after your operation, guided by your physiotherapist. 

Photo by kali9/iStock / Getty Images
Photo by kali9/iStock / Getty Images

Exercises

  • Don’t lift your arm without assistance for the first few days otherwise the tissue may become more inflamed, and even tear
  • After your shoulder operation it is very important to perform exercises to regain your mobility, and later strength.
  • Only perform exercises taught to you by your physiotherapist or surgeon.
  • Exercises should be performed 3-5 times a day.  It may be helpful to take pain medication 30-40 minutes prior to exercise (as prescribed by your doctor).

Swelling

  • You may have considerable swelling around your shoulder after surgery.
  • Apply ice for a maximum of 20 minutes following exercises or as required.
  • Ice (crushed, cubes, frozen peas, gel pack etc.) should be wrapped in a towel and placed directly on the shoulder over the waterproof dressing.

Pain

  • Immediately after your surgery, pain at rest and with movement is expected.
  • Take your medication and use ice regularly to keep your pain mild-moderate (<4/10).
  • Many people develop pain around the neck, upper back and down the arm which is normal, but if you are concerned please call your physiotherapist.
  • If you develop worsening tingling or numbness, please call your physiotherapist.

Sling

  • The sling is just for comfort, and it is safe to stop using it when pain permits.
  • Ensure your elbow is in the corner of the sling, and hand supported inside the sling.
  • Wear the sling both day and night for 1-2 weeks (including sleeping) as required.
  • Your arm should rest comfortably in the sling, with the entire weight of the arm supported and with your hand at the level of your chest.

 Driving

  • No driving for 1-2 weeks to ensure that the surgical site heals well.
  • Await instructions from your surgeon or physiotherapist to commence driving