A Brief Overview By Emily Champion
WHAT IS A BURSA?
A Bursa, or Bursae are fluid filled sacs that are positioned between our bones, tendons and muscles. These small, slippery sacs facilitate gliding motions by providing a thin cushion, reducing friction between these surfaces.
FUN FACT: The human body has over 150 bursae!
WHAT IS “BURSITIS?”
“Burs”= Bursa – Fluid filled sac – “Itis” = Inflammation
Therefore, “Bursitis” literally means inflammation of the bursa.
WHAT CAUSES SHOULDER BURSITIS?
Within the Shoulder, there are various bursae that facilitate shoulder movement and function. The most common bursa that becomes inflamed in the shoulder is the “Subacromial Bursa”. This bursa sits within the joint that connects the end of your collarbone (acromion) and head of humerus (arm bone).
Shoulder Bursitis can be caused by:
1. Overuse and Repetitive movements.
This is one of the most common causes of shoulder bursitis. This type of bursitis occurs when the bursa is placed under increased stress, load or tension for extended periods of time. Activities like throwing, swinging a golf club, gardening, painting, lifting or stacking shelves can aggravate and inflame the bursa.
This can be a common cause in sports. A direct blow to the shoulder can cause the bursitis to become irritated and inflamed.
3. Muscle weakness, poor control and postural deficits
4. Infection or Autoimmune diseases such as rheumatoid arthritis, gout, psoriasis, or thyroid disease
WHAT ARE THE COMMON SYMPTOMS OF SHOULDER BURSITIS?
- Painful shoulder – localised to the shoulder however you may also experience referred pain into the arm, elbow or neck
- Increased pain with movements and lifting, particularity over head
- Reduced range of movement
- Swelling over the shoulder joint
- Tender to touch the shoulder
- Pain when lying on your shoulder or when pressure is applied
HOW CAN PHYSIOTHERAPY HELP WITH SHOULDER BURSITIS?
An inflamed bursa may take a long period of time to ease, particularity if your in an occupation that uses your upper limbs repetitively.
Your physiotherapist and doctor will initially suggest pain management strategies including ICE, gentle massage, rest and anti-inflammatories, however it is important to keep your shoulder moving to avoid decrease in range of motion.
Initially your physiotherapist will assess your shoulder to rule out any other pathologies that may be occurring within your shoulder. Once this is established, your physiotherapist may assist in improving your pain, range of movement and strength in your shoulder using techniques such as massage, dry needling and joint mobilisations. In addition to this, your physiotherapist would begin gentle strengthening program for the rotator cuff and surrounding areas, focussing on improving your deficits and working towards your goals. It is important to look at the body wholistically – taking into consideration other areas such as the neck, back or hips that may also be limiting movement and placing further stress on the shoulder.