If you’ve been told you have Shoulder Impingement that needs to be surgically repaired, you may have a lot of questions.
Surgery for shoulder impingement is often suggested when rest and PT fail to improve the situation. The belief is that the loss of range of motion and the resulting pain is caused by bones that have grown improperly. Shaving down bone is supposed to restore the what are believed to be the appropriate shapes and sizes.
But does surgery for shoulder impingement really work that well?
What are the success rates for shoulder impingement surgery?
It’s easy to find and hear very optimistic success rates for shoulder surgery. Early published studies and papers especially tended to show great results for surgery for shoulder impingement. However, recent studies show a very different picture that you should be aware of. Given the complexity of the medical system, it is possible that your physician may not even be aware of some of this literature, so it’s imperative you look at this information when deciding how you want to proceed with your shoulder issues.
You'll often find success rates of "between 77% and 90%” (Dopirak 2010) for subacromial decompression. But those numbers may be misleading. While the decompression is “widely held to be effective, pain may persist after the procedure” (Brouchard 2014).
What are the long term results of shoulder surgery?
Many times, short windows for follow up result in rosy results.
After 8-11 years, they found that 44.3% had pain during activity and 26.3% still had pain at rest.
This additional study took the same long term view of the results of surgery. After 8 - 11 years following surgery, 95 patients were assessed to see their satisfaction with their arthroscopic subacromial decompression for their stage II or early stage III impingement syndrome (Klintberg 2010).
They found that 50% still had pain during activity and 32% still had had pain at rest.
In both of these studies almost half of these surgical patients still had pain with activity, and about 1 in 3 or 4 had pain even at rest.
Pain, of course, not only limits your ability to move and function, it has a significant impact on your quality of life.
How does surgery compare to a well-structured exercise program for shoulder impingement?
When looking at these numbers, surgery doesn't seem like a strategy with great odds. It may be helpful for some people, but there are strong odds that undergoing a surgery for impingement will still leave lingering pain. The question then is whether or not it's possible to approach impingement using carefully selected exercises to solve the problem.
One study compared an exercise program and surgery directly. 140 patients were included, 70 into a group of exercise and the other 70 into the arthroscopic acromioplasty plus exercise. At 24 months, both groups had improvements of pain, but the cost of exercise plus surgery was considerably higher. The researchers concluded “Arthroscopic acromioplasty provides no clinically important effects over a structured and supervised exercise programme alone in terms of subjective outcome or cost-effectiveness when measured at 24 months. Structured exercise treatment should be the basis for treatment of shoulder impingement syndrome...” (Ketola 2009).
Unfortunately, one problem that ends up frustrating many people with shoulder impingement is that the exercise programs they're asked to do don't get them the results they want. Many exercises recommended for shoulder impingement are ineffective or are missing key pieces of the puzzle. That's why the Shoulder Fix was created. The Shoulder Fix is designed to help you build fundamental levels of coordination and strength so that your shoulders move well and feel good in the long run.