Subacromial Bursitis, Shoulder Bursitis or Shoulder Joint Inflammation?
So what is going on?
There is a gap between the very top of the shoulder blade and the tendons in the shoulder where there is 'bursa'. This bursa is a sac that is filled with fluid.
The job of the bursa is to allow smooth gliding of the tendons underneath the scapula.
It aims to reduce friction.
However, sometimes this doesn't always go to plan. Sometimes there are issues within the shoulder that can cause an 'impingement' or pinching. The more we move the arms over head the more we pinching.
So when the tendon rubs against the shoulder blade over and over again this can cause to become aggravated and inflamed. This is referred to as Bursitis.
(-itis means inflammation)
Shoulder pain can come on gradually over weeks or months and is often felt on the outside of the shoulder. Pain can also spread down the arm towards the elbow or wrist.
The pain is often made worse when lying on the affected shoulder or using the arm above your head. (Think washing hair, reaching up to a high shelf in the cupboard).
Quite often though the pain reduces a little when the arm is resting at side.
There are a number of reasons why this could come on. It could be due to the repetitive overhead movements, inflammation within the tendons that cause them to become swollen, shoulder instability, Biomechanical dysfunctions (think rounded shoulders) or an actual injury from a fall.
When I see a client with these issues my aim in those early stages is to increase their range of movement in the shoulder which may mean that I need to use massage techniques or other exercises to do just that. I look at getting them to maintain their cardio fitness although it may mean they need to swap overhead movements for something else for a little while. This doesn't mean stopping completely. It means adapting what they are doing.
I also looking at increasing their strength through isometric exercises or Muscle Energy Techniques.
And finally I address the causes of the issues such as their biomechanics and training loads (the amount of training they are doing).
If this all rings a bell with you (or someone you know), here's some advice to get you on the road to recovery.
Stop any activity that causes the bursa to flare up. Sounds obvious. But strapping it up and continuing to aggravate it is not going to help in the long run.
Try Manual Therapy, ice and anti-inflammatories. They may help to relieve pain in the short term but again you need to stop what's causing it to flare up (only initially!)
Please continue to exercise. Anything that does not aggravate the bursa further (such as running, walking, cycling or lower body weight training) is all good.
And finally you need to address the cause of the issue. Whether that's your Biomechanics or the amount of training you're doing (have you pushed too hard too soon?). If you keep doing the same thing your body will keep responding in the same way. Either that or it will start to compensate (which isn't good either).
So here are 2 exercises that I have found to help considerably. Please be aware that you need to use LIGHT pressure. Too much can aggravate more. There is a goldilocks zone!
These isometric exercises will help to reduce pain whilst strengthening the muscles in the shoulder. They will also help to reduce any tension within muscles that are tight around that area. That's the beauty of Muscle Energy Techniques!
1. Wall Press
2. External Rotation Hold
Image: Complete Anatomy