Shoulder Bursitis - Tell me about it!?
Patients with persistent shoulder pain may be sent for an ultrasound scan revealing an inflamed bursae. Directed treatment at this structure (e.g cortisone injections) often results in temporary resolution, however pain and disability returns quickly. It is now well documented that bursitis may only be a symptom of an underlying condition; just the tip of the iceberg.
Bursitis rarely occurs in isolation except for in unique cases (e.g direct trauma, local infection). It is often attributed to shoulder impingement or more specifically subacromial impingement.
The cause of shoulder impingement can be divided into two broad categories; primary, secondary or both.
Primary shoulder impingement refers to structural changes (e.g bone spurs, tendon tears, osteoarthritis, and anatomical variations) which compromises the subacromial space. Sometimes surgery may be required to alleviate these issues, however it is recommended that secondary causes be addressed before going under the knife.
Secondary impingement refers to the subacromial space being compromised by non-structural changes. Such as aberrant movement patterns of the scapulae; shoulder capsule instability and muscle imbalances. Secondary impingement can be identified by a thorough history and physical examination. Most of these causes are often reversible under the correct physiotherapy management.
If you would like further guidance with your shoulder pain, our passionate physiotherapists at Bounce Health have post graduate training in shoulder management and will be more than happy to provide you with the most up-to-date evidence based advice and treatment in assisting you towards pain free shoulder function.
Picture sources
Upper cross syndrome:
https://lh3.googleusercontent.com/8ifrd84RBdlVYb6OjCqe5SMBnLfdYvJsPu5iRTpjSoR0GmCnzspWH9QX3xsHl9a4vQpH9kOMdD685-4zd3wcTWYnfdWoyZ50OQVOo6ABb2kpgZH2Sy0g3QBCYQ
RC Tear:
http://www.tidewatershoulder.com/#!rotator-cuff/c1lq0
Hooked acromion:
https://s-media-cache-ak0.pinimg.com/236x/f9/eb/95/f9eb951c1d03c4958b2c90beefc311bb.jpg
Shoulder anatomy:
http://www.fairview.org/fv/groups/public/documents/images/54513.jpg
Bibliography
de Witte, P. B., Nagels, J., van Arkel, E. R. A., Visser, C. P. J., Nelissen, R. G. H. H., & de Groot, J. H. (2011). Study protocol subacromial impingement syndrome: the identification of pathophysiologic mechanisms (SISTIM). BMC Musculoskeletal Disorders, 12, 282-282. doi: 10.1186/1471-2474-12-282
McClure, P., Tate, A. R., Kareha, S., Irwin, D., & Zlupko, E. (2009). A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train, 44(2), 160-164. doi: 10.4085/1062-6050-44.2.160