The acromion differs in individuals normally (morphological variants). These were described by Bigliani as type I, type II or type III. Type I is flat, type II is curved and type III hooked. A person with a type II or type III acromion would be at a higher risk of impingement due to the narrowing of the acromiohumeral gap and bursal space.
In addition to the above, with advancing age people tend to develop a bone spur on the front and side of the acromion. This further reduces the subacromial space increasing the risk of impingement.
Therefore somebody with a rotator cuff injury who has a type III acromion and is their 50’s has a very high risk of developing significant impingement compared to a patient in their 20’s sustaining a supraspinatus strain who may have a type I acromion and no spurs.
The rotator cuff and acromion will then rub against one another, causing a painful condition known as impingement. Each time the arm is raised there is a bit of rubbing on the tendons and the bursa between the tendons and the acromion, which may cause pain and inflammation.
Impingement may become a serious problem for some people and disturb their normal activities. This is when treatment is needed.
Q. what does c4-5 mild central disk bulging impinging upon cervical cord without spinal stenosis or distortion of the cord . mild righ neural foraminal narrowing from uncovertebral joint hypertropy mean A. Well this basically means there is a very small narrowing of the cervical (your neck area) spinal canal (where the spinal cord is), however the narrowing does not cause any damage to the spinal cord, therefore probably does not cause any major symptoms involving the nerves. The c4-5 bulging part refers to the part in between the two cervical vertebras c4 and c5, in which the disc (a part in the spinal cord) is sliding a bit side-ways, but again, it does not seem to be causing any trouble.
Surgery may be used to treat a rotator cuff disorder if the injury is very bad or if nonsurgical treatment has failed to improve shoulder strength and movement sufficiently. Subacromial smoothing involves shaving bone or removing growths on the upper point of the shoulder blade ( acromion ). It removes damaged tendon and bursa from the joint . The surgeon may also remove small amounts of bone from the underside of the acromion and the acromioclavicular joint (acromioplasty). The goal is to take away roughness while keeping as much of the normal supporting structures as possible. This surgery creates more room in the subacromial space. With more space, the rotator cuff tendon is not pinched or irritated and can glide smoothly beneath the acromion.