Evidence shows that 65% of people experience shoulder pain at some point in their lives, and one common shoulder problem is bursitis. Shoulder bursitis (also known as subacrominal bursitis) is characterised by an inflamed bursa (a small fluid filled sac located beneath the bony prominence of the shoulder) which causes pain in the top outer aspect of the shoulder.
A bursa is a small sac filled with lubricating fluid which is designed to reduce friction between adjacent soft tissue structures and bony layers. During certain activities, such as arm elevation or rotating the shoulder, friction and compressive forces are placed on the subacromial bursa. The surrounding soft tissue structures such as muscles, ligaments, tendons and bursae are packed closely together, so their health is interdependent. If one structure becomes damaged, others are likely to follow. Therefore, it is common for shoulder bursitis to occur in association with other conditions of the shoulder.
What causes subacromial bursitis?
Bursitis can be caused by repeated minor trauma such as:
- Repetitive or prolonged overhead activities or lifting.
- Repetitive or prolonged use of the arm in front of the body.
- Excessive pushing or pulling activities .
In athletes, subacromial bursitis may be seen in throwing sports (such as cricket or baseball), or swimming and racquet sports. The condition can also be caused by a single more significant trauma such as:
- A direct blow to a point of the shoulder.
- Due to a fall onto the shoulder, elbow or outstretched hand
Signs and Symptoms:
- Ache or stiffness in shoulder.
- Tenderness at the top outer shoulder.
- Shoulder pain when raising arm above head.
- Shoulder pain during lifting, pushing or pulling.
- Shoulder pain may radiate down the arm as far as the elbow.
Physiotherapy can assist with restoring a range of motion and rotator cuff strength. Treatment may include:
- Postural correction and shoulder-blade stability.
- Activity modification: activities that increase pain should be avoided in the acute inflamed stage, and gradually re-introduced with correct technique.
- Manual techniques to lengthen muscles.
- Exercises may be prescribed to strengthen rotator cuff muscles.
Most patients with this condition heal well with appropriate Physiotherapy, and return to normal function in a number of weeks. However, rehabilitation can take significantly longer for those who have suffered this condition for a long period of time, or for those with other shoulder associated injuries. Early Physiotherapy treatment is vital to hasten recovery in all patients with subacromial bursitis.