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What is shoulder bursitis/impingement?

What is shoulder bursitis/impingement?

What is it?

Shoulder bursitis is an inflamed shoulder bursa. A bursa is a fluid filled sac that helps to reduce friction between soft tissues and bones in a joint. The bursa commonly injured in the shoulder is located in the subacromial space and is therefore termed subacromial bursitis. It presents as pain locally in the shoulder region and often refers down the arm to the mid humerus. The pain is usually related to the impingement of the bursa between the rotator cuff tendons and the acromion (anterior, superior bony prominence from shoulder blade forming the roof of the shoulder joint).

Causes of Shoulder (Subacromial) Bursitis?

  • Most common- Repeated minor trauma where the shoulder is “overused” especially in compromising positions (may be sport related but commonly simple daily activities or occupations like painting, cleaning, gardening, hanging washing).
  • Often there is underlying weakness or pathology to scapula stabilisers and/or rotator cuff that causes normally simple activities to become traumatic to the bursa and cause impingement.

Symptoms of Shoulder (Subacromial) Bursitis?

The most common symptoms are pain and restriction of movement

  • Gradual onset of pain progressively worsening in intensity over weeks or months following or during repetitive activity.
  • Pain may have rapid intense onset if bursitis caused by significant trauma such as fall.
  • Location of pain is typically on the outer aspect of the shoulder and often refers down the arm to the mid humerus and can spread down to elbow and wrist.
  • Patients often describe a tightening sensation around their upper arm.
  • Pain aggravated when lying directly on affected side but also can be when lying with affected arm hanging over the body when lying on unaffected side.
  • At rest shoulder often feels more comfortable to be held across the body as though wearing a sling or supported by arm of a chair.
  • Pain most intense by using arm for activities at or above shoulder height (Painful arc).
  • Feeling of inability to lift arm (and weights) away from body due to pain inhibiting the muscles and causing a sensation of weakness
  • Prolonged untreated bursitis can result in shoulder movements being restricted due to atrophy of muscles and stiffening of the joint.

Treatment of Shoulder (Subacromial Bursitis)

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As shoulder (subacromial) bursitis is often caused by repetitive minor activities involved in daily activities it can be an injury that takes a while to settle down or is easily re-aggravated, it is therefore important to avoid aggravating activities wherever possible until acute pain has settled and the patient is able to perform activities with correct posture and muscle activation.

If good awareness of general posture and specific shoulder positioning is achieved with effective rotator cuff and scapula strength and stability then recurrence of this injury will be prevented. If you would like to make an appointment to see one of our specialist shoulder Exercise Physiologists please do not hesitate to call us on (02) 4015 4446 or Book Online via our website www.hunterrehab.com.au

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