Shoulder impingement occurs when there is a compression of muscle, tendon and bursa between the acromion or the roof of the shoulder and the outer part of the ball of the humerus, called the greater tuberosity. The condition can be very painful and can affect one’s ability to perform everyday activities and exercises. It is the most common shoulder complaint in my practice. Shoulder impingement can be treated by means of shoulder muscle rebalancing or in advanced longstanding cases with arthroscopic surgery, during which tiny surgical tools are inserted through small incisions in the shoulder. I will then remove damaged bone and soft tissue, along with parts of the acromion and bursal tissue in some cases.
Arthroscopy can also be performed in order to treat a rotator cuff tear, although the procedure will vary according to the nature of the tear. A partial tear can be repaired with a debridement procedure where damaged tissue is trimmed. In the case of a full tear the muscle is repaired back onto the bone with suture anchors.
Biceps tendinitis, which refers to inflammation in the upper biceps tendon, can be treated with activity modification and physiotherapy and occasionally would warrant surgical treatment. The surgery is performed arthroscopically, a minimally invasive technique, which allows me to either tenotomise the tendon (sever it from its attachment) or to perform a tenodesis where it is fixed back onto the bone.