Special physiotherapy is used to promote the mobility of the shoulder. The shrunken capsule is stretched and the muscles are retrained.
In this way, the humeral head is re-centered in the shoulder area and the impingement is reduced or even eliminated.
We usually recommend physiotherapy twice a week for 6 weeks.
Especially in the case of tendon injuries or irritations, such as those caused by impingement syndrome, we have observed very good treatment successes with ACP therapy in our practice in Freiburg.
Patients report a significant reduction in pain and an improvement in mobility.
For degenerative changes in the tendon, we recommend 3-6 ACP injections, one week apart.
Themode of action of ACP
Many injuries to the human body heal themselves. Behind these complex healing processes are growth factors from the blood.
During treatment with ACP, blood is taken from the patient with a small special syringe, similar to the way you would have a small blood count at your GP.
This blood is then specially processed so that only the growth factors responsible for healing remain in a highly concentrated form.
The body's own active ingredient obtained in this way is then injected into the affected tendon. At the site of the injection, the body's healing mechanisms kick in and the inflammation and associated swelling recede. This creates more space under the acromion.
The muscles can then glide better again, the joint runs more smoothly and the tendon can recover. In professional sport in particular, the treatment of irritated tendons with ACP has now become standard practice - ACP can often even replace harmful cortisone treatments in the long term.
Medication is used to combat inflammatory changes in the bursa. If the inflamed bursa swells again in this way, more space is created under the acromion. The muscles can then glide better again, the joint runs more smoothly and the tendon can recover.
This can also be supported by a one-off cortisone infiltration directly into the bursa.
Cortisone infiltration is covered by all health insurance companies.
Acupuncture can be used very well as supportive pain therapy and to reduce the tendency to swell in osteoarthritis.
1x - 2x per week for 10 weeks
During the operation, the constriction in the shoulder and thus the pinching of the tendon is removed in a minimally invasive keyhole procedure. A small burr is inserted to correct any bony changes under the acromion.
The inflamed bursa in this area is also removed during the operation, but in most cases it re-grows after a short time without becoming inflamed again.
The space between the humeral head, muscles and acromion is widened so that the muscles can glide normally again.
We perform this operation exclusively arthroscopically (using the keyhole principle). Thanks to particularly gentle techniques, there is usually no major bleeding. The muscles are not injured, so there is very little swelling.
Nodrainage:
We can almost always dispense with the insertion and subsequent removal of a drain.
No long immobilization of the arm:
The patient can move their arm again on the first postoperative day.
Specialpain blockade:
Intraoperatively, patients receive an injection into the nerves of the arm to block pain, so that patients feel no pain for up to 24 hours immediately after the operation.
Nostitches necessary:
Theuse of self-dissolving cosmetic sutures means that our patients no longer need to remove stitches.
The operation usually takes 30 minutes and is performed under general anesthesia.
In most cases, we recommend that impingement syndrome surgery is performed on an inpatient basis, as a pain block (anesthesia of the nerves by injection) is used specifically in our procedure. As a result, the patient usually has no discomfort on the first postoperative day.
You will be able to move your arm again on the first postoperative day. A drain is not inserted and no bandage is required.
Depending on the work activity 1-3 weeks after the operation.
Sports that do not put a lot of strain on the shoulder, such as jogging, can be performed from the 3rd week onwards.
For sports that put strain on the shoulder, breaks of up to 6 to 12 weeks may be necessary. We will be happy to advise you on this and create an individual plan for you to build up the load.
In the long term, a bony constriction can lead to damage to the tendon. This can result in a complete rupture of the muscles and partial loss of arm function.
With today's special minimally invasive techniques, complications are extremely rare. The worst and extremely rare complication would be a joint infection.
As our arthroscopic surgery involves a great deal of fluid irrigation, infection practically never occurs. However, should this occur, an antibiotic would have to be administered. It may be necessary to irrigate the joint again.
There is normally no risk of major injury to the tendon, bone or nerves.
