The Orthobullets Podcast Shoulder & Elbow | Subacromial Impingement
Aug 3, 2025
Dive into the intricate world of subacromial impingement, a common shoulder pain culprit. Discover its causes, anatomy, and how it's diagnosed. The discussion includes treatment options, from non-surgical to surgical, and the potential complications involved. Learn how workers' compensation claims impact patient satisfaction post-surgery and the differences in outcomes tied to bursal-sided versus joint-sided tears. The episode also considers the implications of biceps tenotomy in younger patients, making it a must-listen for anyone interested in shoulder health.
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Subacromial Impingement Overview
- Subacromial impingement causes shoulder pain from rotator cuff compression by AC joint, acromion, and CA ligament.
- Inflammation leads to bursitis, diagnosed by physical exam and MRI; treated first non-operatively.
Pathophysiology of Impingement
- Impingement results from extrinsic compression and intrinsic tendon degeneration.
- Compression is between humeral head and acromion complex; tendon attrition causes humeral migration and space narrowing.
Acromion Morphology Classification
- Bigliani classification divides acromion shape into flat, curved, and hooked types.
- This classification helps in assessing impingement risk but has poor inter-observer reliability.