By Shaun Rodgers, Physiotherapist
Subacromial Decompression SHOULDER Surgery – Advice and Exercises
Shoulder pain can be a debilitating condition, affecting everything from simple daily activities to more vigorous physical pursuits.
For many, the source of this pain is often linked to impingement in the shoulder, where the rotator cuff tendons become irritated and inflamed as they pass through the subacromial space.
When conservative treatments like rest, medication, and physiotherapy don't provide sufficient relief, a surgical procedure known as subacromial decompression may be recommended.
This procedure aims to alleviate the pain by creating more space for the tendons, thus reducing the impingement.
In this blog, we will discuss what subacromial decompression entails, how it helps, and the importance of subacromial decompression physio for a successful recovery.
Additionally, we will cover key subacromial decompression exercises that can help you regain strength, mobility, and function post-surgery.
Understanding Subacromial Decompression
Subacromial decompression is a surgical procedure designed to relieve shoulder pain caused by impingement syndrome. The procedure is often performed arthroscopically, which is less invasive than traditional open surgery.
During arthroscopic subacromial decompression, the surgeon removes or shaves away parts of the acromion (a bone spur or part of the shoulder blade) to create more space in the subacromial area, thereby reducing pressure on the rotator cuff tendons.
This surgery is particularly beneficial for patients who have not responded to non-surgical treatments such as physiotherapy, anti-inflammatory medications, or corticosteroid injections.
The goal is to alleviate pain, improve shoulder function, and allow the patient to return to their normal activities.
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The Role of Physiotherapy in ARTHROSCOPIC Subacromial Decompression
Subacromial decompression physio is a critical component of the recovery process.
Physiotherapy begins shortly after surgery and continues for several months, focusing on gradually restoring shoulder strength, flexibility, and function.
Without a structured physiotherapy plan, patients risk developing stiffness, weakness, or even re-injury.
The physiotherapy process generally follows a staged approach:
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Early Post-Operative Phase (0-2 weeks):
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Goals: Protect the surgical site, reduce pain and swelling, and begin gentle mobility exercises.
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Physiotherapy Focus: The emphasis during this phase is on pain management, protecting the shoulder, and maintaining as much passive range of motion as possible.
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Intermediate Phase (2-6 weeks):
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Goals: Gradually restore range of motion and begin strengthening exercises.
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Physiotherapy Focus: This phase focuses on increasing shoulder mobility and starting light strengthening exercises to rebuild muscle support around the joint.
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Advanced Rehabilitation Phase (6+ weeks):
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Goals: Regain full strength and range of motion, and return to normal activities.
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Physiotherapy Focus: The final phase includes more intensive strengthening exercises and functional training to ensure the shoulder is capable of handling daily activities and physical demands.
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Key Subacromial Decompression Exercises
Engaging in the right subacromial decompression exercises is crucial to a successful recovery.
These exercises are designed to restore strength, flexibility, and function to the shoulder after surgery. Below are some of the most effective exercises recommended by physiotherapists:
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Pendulum Exercises:
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Purpose: Maintain gentle shoulder mobility without straining the joint.
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How to do it: Lean forward, supporting yourself with your non-operated arm on a table or chair. Let your operated arm hang down, and gently swing it in small circles. This exercise helps maintain shoulder movement without putting stress on the healing tissues.
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When to Start: This exercise is typically introduced in the early post-operative phase to prevent stiffness.
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Passive Shoulder Flexion:
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Purpose: Restore range of motion.
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How to do it: Lie on your back with your arms at your sides. Use your non-operated arm to gently lift the operated arm over your head. This passive motion helps improve shoulder flexibility.
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When to Start: This exercise can be started in the early weeks after surgery, under the guidance of your physiotherapist.
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External Rotation with a Band:
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Purpose: Strengthen the rotator cuff muscles.
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How to do it: Attach a resistance band to a stable object. Hold the band with your operated arm, keeping your elbow bent at 90 degrees. Gently rotate your forearm away from your body, then return to the starting position. Repeat for 10-15 repetitions.
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When to Start: Usually introduced in the intermediate phase of recovery, once your physiotherapist confirms it is safe to begin strengthening exercises.
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Isometric Shoulder Exercises:
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Purpose: Begin strengthening the shoulder muscles without moving the joint.
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How to do it: Stand facing a wall with your operated arm bent at 90 degrees. Press your hand against the wall without moving your shoulder, holding for 5 seconds. Repeat 10-15 times.
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When to Start: These exercises are typically safe to start in the early post-operative phase and help maintain muscle tone while protecting the joint.
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Scapular Stabilization Exercises:
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Purpose: Improve shoulder stability by strengthening the muscles around the shoulder blade.
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How to do it: Perform exercises such as shoulder blade squeezes (pinching the shoulder blades together) to enhance scapular control and support the shoulder joint during movement.
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When to Start: These exercises are usually integrated into the intermediate phase of rehabilitation.
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Wall Climbing:
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Purpose: Increase range of motion in the shoulder.
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How to do it: Stand facing a wall with your fingers touching it. Slowly "walk" your fingers up the wall as high as you can without pain, then slowly lower your hand back down. This exercise helps to safely increase shoulder mobility.
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When to Start: This can be done in the intermediate phase, depending on the individual’s progress.
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Advice for a Successful Recovery After Subacromial Decompression
Recovering from arthroscopic subacromial decompression requires a commitment to following your physiotherapy program and taking care of your shoulder as it heals. Here are some tips to enhance your recovery:
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Follow Your Physiotherapy Plan: Adhering to the subacromial decompression physio protocol is essential. Your physiotherapist will guide you through each phase, ensuring that you progress safely and effectively.
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Manage Pain and Swelling: Use ice packs, prescribed medications, and proper positioning to manage post-operative pain and swelling. This will help you stay comfortable and facilitate better participation in your exercises.
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Avoid Overdoing It: While it’s important to stay active and follow your exercise plan, be careful not to overexert yourself. Pushing too hard can lead to setbacks in your recovery.
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Listen to Your Body: Pay attention to how your shoulder feels during and after exercises. If you experience increased pain or discomfort, stop the activity and consult your physiotherapist.
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Gradually Resume Activities: As your strength and mobility improve, gradually reintroduce daily activities and, eventually, more strenuous tasks. Your physiotherapist will advise you on when it’s safe to do so.
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The Path to Recovery FOLLOWING SUB-ACROMIAL SURGERY
Subacromial decompression surgery can be a highly effective solution for alleviating chronic shoulder pain caused by impingement.
However, the success of this surgery is closely tied to the post-operative physiotherapy that follows.
By engaging in a well-structured subacromial decompression physio program and performing the right subacromial decompression exercises, you can significantly improve your recovery outcomes.
Remember, your recovery journey is unique, and the exercises and advice provided here should be tailored to your specific situation by a qualified physiotherapist, in conjunction with your specific surgical orders.
If you’re preparing for arthroscopic subacromial decompression or are in the early stages of recovery, reach out to your physiotherapist to develop a personalised plan that suits your needs.
Taking the right steps now can help ensure a smoother recovery and a return to your normal activities as quickly and safely as possible. Good luck!
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LEARN How OUR MELBOURNE SPORTS PHYSIO TEAM can help you?
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If your sports, fitness training or work has been wearing your body down, book in with one of our expert massage therapists so we can help you reduce your pain or stiffness.
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