[Chronic impingement syndrome of the shoulder]

The subacromial joint is an area which is particularly predisposed to chronic tendon deterioration. Rupture of the rotator cuff is usually the ultimate stage of a pathology that has been present for several decades. The so-called chronic impingement syndrome is generally part of a regional pathology of the shoulder, where it is associated with lesions of the biceps long head and of the acromioclavicular joint. Surgery is indicated only when a well-conducted conservative treatment has failed, in subjects with major functional handicap and after a thorough assessment of the lesions. Pre- and postoperative rehabilitation is of considerable importance as part of the overall management.