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Recently it was suggested that supervised physical therapy is comparable with SAD, which was contested by other studies claiming that SAD is clearly superior to nonoperative treatment. Before consideration for treatment, the diagnosis of impingement with an intact rotator cuff must be determined by clinical history, a detailed and structured clinical examination, and appropriate imaging. In favor of SAD are published long\u2010term studies with a minimum of 10\u00a0years outlining significant functional and clinical improvement. The main factor for failure reported was workers compensation, calcific tendinopathy, and high\u2010grade partial\u2010thickness tears. Studies nonsupportive of SAD suffer from bias, crossover from the nonoperative group to the operative group following failure of conservative treatment, and loss of follow\u2010up. Recently, lateral acromion resection has been suggested as a viable alternative, effectively reducing the critical shoulder angle. 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