Understanding Shoulder Bursitis
Bursas are small fluid-filled sacs which can be found around most major joints in the body. They act as a cushion between moving joints to reduce frictions among the bones, tendons and muscles. Shoulder bursitis occurs when the bursa in the shoulder becomes damaged, irritated or inflamed.
There are several bursae in the shoulder joint, the subacromial bursa is the most commonly inflamed bursa of the shoulder joint.
Cause of Shoulder Bursitis
- Repetitive overhead movements
- Poor shoulder mechanics
- Poor posture
- Imbalance of the shoulder muscles
- Trauma or injury (a fall or hit on the shoulder)
- Shoulder surgery
- Calcium deposits or bone spurs in the acromion bone
- Rheumatoid arthritis
Signs and Symptoms of Shoulder Bursitis
- Pain around or on the outer tip of the shoulder
- Tender to touch
- Reduced range of motion in the shoulder joint
- Swelling and redness around the shoulder
- Pain on overhead movements (Eg. Combing hair, reaching the upper shelf, wearing or removing a t-shirt
Physiotherapy Management of Shoulder Bursitis
The objective is to relieve symptoms while restoring the normal range and function to the shoulder joint. The role of a physiotherapist will include:
Relieving pain and swelling
Pain and swelling are usually the main complaints for this condition, pain can be present while attempting to lift the arm or sleeping on the side of the shoulder. Modalities such as ice, hot pack, ultrasound, transcutaneous electrical nerve stimulation (TENS) will be used during to help control the pain and swelling.
Regain flexibility and full range of motion
In order to improve the flexibility and range of the shoulder joint, passive techniques such as joint mobilization, passive stretch and soft tissue release (if required) will be done. These techniques help to relax the surrounding muscles and improve the range of the shoulder joint. Besides that, targeted self- stretching exercises of the upper body and passive shoulder activities such as pendulum exercise will also be taught to do independently.
Bad posture with rounded shoulders and head stooping forward contributes to the mechanism of injury. The use of verbal and tactile cues and kinesio-taping helps to improve the posture and relieving pain. A good posture helps to prevent future recurrence.
Improving strength and coordination (scapulo-humeral rhythm)
Poor muscle strength leads to poor coordination of the shoulder joint. It is only reasonable to strengthen the weak shoulder joint muscle (rotator cuff) and retrain the normal shoulder movement pattern (scapulo-humeral rhythm) for the recovery. A physiotherapist will gradually challenge the strength and control of the shoulder with the use of resistance bands and weights.
Returning to sport or work
Depending on individuals’ activity level, treatment programs set by the physiotherapist will be sport-specific or work-specific to ensure safe and injury-free when returning to their respective sport or job.