Sloping acromiums and what to do

Jan 11th, 2014

Chris asked The Guru for the following Physiotherapy Advice:

Hi Guru,
I’ve got ‘anteroinferior slope of the acromion with impingement of the underlying cuff’ (copy and pasted from my MRI scan results!)
I’m 24 and due to years of shoulder injuries I consider myself retired from golf and boxing at this age! So the NHS want to fob me off with a cortisone injection but I don’t see this as a long term cure, so I’m looking into other options such as surgery, any experience curing this with physio?


Jan 11th, 2014

The Guru Responded:

Hi Chris
I agree – I’m not sure a jab will provide the cure, but will most likely help. This may well provide a pain free window of opportunity to get more control, and so less impingement.
What you’ve got is more common (bone growth under the acromium) in people over 55….well away from a 24 year!! However, some people are born with sloping acromiums, which may preclude them from lots of overhead activities. Some acromiums can slope due to the body responding to injury. The biggest question is this a purely structural issue or is it functional – and can be changed. Massive rhomboid activity or strength may indicate a functional issue, and more rectifiable.
If it’s what you’ve got then you’ll still need to work on your shoulder blade stability (not strength) to try to maximise the space between the underside of your acromium and cuff. This also involves thoracic spine mobility and cuff reeducation.
Surgery maybe an option if this is structural – make sure you’ve failed at good conservative intervention [like physio sport trement] before going under the knife and make sure you see a wo/man [sports physiotherapists] that can…..
Hope this helps

The Guru

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