Hayley,

I recently (Nov '13) had surgery for impingement (subacromial decompression) and really wish I didn't. It created more issues for my TOS symptoms since it tightened the area up a bit and made it easy for TOS to enter the fray once again.

I think the big question is why do you have impingement?

Impingement is usually caused when the humeral head of the shoulder moves forward in the socket thus creating less room for the ligaments to move through. To correct this, you have to a) loosen up the pec minor muscle which pulls that shoulder forward (since it's attached to the ribs) and b) strengthen the posterior muscles of the rhomboids and lats that help pull the shoulder back and down.

But again, the question is why this is taking place?

Is it due to poor posture? That would mean forward rolled posture, tight pec muscles, and weak rhomboids/lats. This is fixable.

Where it gets tricky is when TOS is involved. If your posture is too forward, nerves can get compressed in the thoracic outlet making it impossible to strengthen those muscles since their not getting impulses correctly.

Anyways, I would not move quickly to surgery until you have found a very good physical therapist to explore the above.

KY