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Subacromial Decompression

Arthroscopic Subacromial Decompression Overview

The rotator cuff consists of numerous muscles and tendons that play a critical role in the function of the shoulder, and connect the humerus (upper arm) to the scapula (shoulder blade). The tendons are responsible for providing shoulder stability and the muscles are responsible for allowing the shoulder to rotate. The muscles travel underneath a portion of the scapula, known as the acromion, as they travel to the humerus. In certain patients, the bursal tissue in this area can become inflamed and irritated, commonly referred to as bursitis. In addition, overgrowth of bone in this area (bone spurs) may cause mechanical irritation of the tendon (impingement). Patients who experience bursitis or impingement in this area may be an ideal candidate for arthroscopic subacromial decompression. Dr. Brian Waterman can help patients suffering from bursitis and impingement get back to the activities they love by the use of subacromial decompression.


Arthroscopic subacromial decompression is typically performed on an out-patient basis under regional or general anesthesia. Dr. Waterman will make a tiny incision in the shoulder to gain access to the affected area. Using a small camera and surgical instruments, he will remove the inflamed bursa from the acromium and remove any other irritated tissue that is causing pain. If impingement is present on the rotator cuff, any bone spurs and other structures responsible for the pinching will be removed. The shoulder will then be gently moved through a series of motions to confirm that all areas of bursitis and impingement have been removed. In some cases with advanced acromioclavicular joint arthrosis and pain, a small portion of the distal end of the clavicle is removed to alleviate pain from this area.

When subacromial decompression is completed, Dr.Waterman will close the incision with one suture. The affected area will then be dressed and a sling will be applied to keep the arm immobile.
Recovery and Rehabilitation after Subacromial Decompression

Patients are able to return to their normal, daily activities relatively quickly following an arthroscopic subacromial decompression. Many patients will only require mild pain medications to control the pain. The arm will remain in the sling for a fairly short amount of time determined by Dr. Waterman, typically one week.

A short course of physical therapy will begin after arthroscopic subacromial decompression to regain full shoulder function. Physical therapy is crucial to complete a full recovery, typically around 3 months.

At a Glance

Dr. Brian Waterman, MD

  • Chief & Fellowship Director, Sports Medicine, Wake Forest
  • Team Physician, Wake Forest University, Chicago White Sox
  • Military affiliation/Decorated military officer and surgeon
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