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Shoulder Bursitis And Impingement

Shoulder Bursitis And Impingement
Shoulder Bursitis And Impingement

What Is Shoulder Bursitis?

Shoulder bursitis is an inflamed shoulder bursa, a bursa is a fluid filled sac that helps to reduce friction in your shoulder spaces. The subacromial bursa is the most commonly inflamed bursa of the shoulder bursa and is termed subacromial bursitis. Bursitis in the shoulder is a common cause of pain. The cause of this shoulder pain related to subacromial bursitis is usually related to impingement of the bursa between your rotator cuff tendons and the acromion (part of your shoulder blade forming the roof to the shoulder joint).

Symptoms Of Shoulder Bursitis?

Shoulder bursitis and subacromial impingement commonly present with the following symptoms:

  • Although pain with shoulder bursitis can come on quickly following a fall or some other traumatic event, shoulder bursitis is more commonly of gradual onset with symptoms developing over weeks or months.
  • Pain is typically felt on the outside of your shoulder and may spread down your arm towards the elbow or wrist.
  • Pain is made worse when lying on your affected shoulder.
  • Pain is made worse when using your arm above your head. When your arm is by your side there is minimal pain (because when your arm is at your side the bursa protrudes laterally and is not normally impinged unless it is grossly inflamed) but there is shoulder pain with activities such as washing your hair or reaching up to get something off a high shelf (because when you elevate your arm further out to the side the bursa rolls beneath the bone causing impingement).
  • The presence of a “painful arc” of movement where shoulder pain is felt between 60 – 90° of arm moving up and outwards from your side. This occurs because when your arm is at your side the bursa protrudes laterally and is not normally impinged but when you elevate your arm further out to the side the bursa rolls beneath the bone causing impingement and then when you continue elevate your arm above shoulder height, the bursa rolls clears the impingement zone and your the pain eases. However, further impingement of the bursa and hence pain may return at the extreme of range when your arm is up next to your ear.

How Is Shoulder Bursitis Diagnosed?

Shoulder bursitis commonly co-exists with other shoulder pathology frequently associated with rotator cuff tendinopathy. Your physiotherapist will use special tests to help diagnose and differentiate if necessary shoulder bursitis from a rotator cuff injury or other possible causes of shoulder pain. The use of X rays, ultrasound imaging or an MRI are sometimes required to help confirm the diagnosis or better plan the treatment approach for shoulder bursitis.

What Is The Cause Of Shoulder Bursitis?

Shoulder bursitis can be caused by a significant trauma such as a fall or more commonly caused by repeated minor trauma such as overuse of the shoulder joint common in sports such as tennis or weight lifting but also common from simply repetitive day to day activities or occupations like painting, gardening or cleaning.

Can You Prevent Shoulder Bursitis?

Like with most conditions a pinch of prevention is worth a pound of cure so working to eliminate the causes of shoulder impingement and bursitis in the first instance is a better option than trying to fix shoulder bursitis once you already have the pain. Factors such as posture, soft tissue mobility of the shoulder and rotator cuff strength are things that can be addressed and optimized via the use of specific exercises and help prevent the onset of shoulder bursitis. A physiotherapist is trained in recognizing potential risk factors relevant to your individual situation and setting up a plan of action for you to address such factors.

What’s The Treatment For Shoulder Bursitis?

Shoulder bursitis is common and unfortunately it is often an injury that takes time to settle completely and can come back if you return to sport, work or aggravating activities too quickly.

  • Your rotator cuff is an important group muscles of the shoulder that work to maintain the shoulder ball centered over the small socket helping prevent injuries such as bursitis and impingement.
  • Your shoulder blade the “scapular” has a vital role as the main dynamically stable base plate that attaches your arm to your chest wall.

Correct action and movement of the rotator cuff and the shoulder blade are crucial to normal functioning of the shoulder. Treatment of shoulder bursitis will frequently focus on improvement of any issues noted with the rotator cuff or scapular. In persistent, severe or acute traumatic shoulder bursitis, a corticosteroid injection to help reduce inflammation may be required and is commonly used to good effect (however results can vary considerably). Physiotherapy is normally used in conjunction with a cortisone injection focusing on any of the predisposing factors recognized during assessment to reduce the likelihood of the complaint returning.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance regarding Shoulder Bursitis And Impingement should consult his or her orthopaedic surgeon, general practitioner, sports medicine specialist or physiotherapist.

Hayden Latimer is the founder of and principle physiotherapist at Sydney Physio Clinic. Since graduating from Otago University, Dunedin, New Zealand he’s gained wide experience practicing across the globe for over 15 years and is now extremely knowledgeable in helping people reduce discomfort and restore function and mobility.


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