Injury Tip Sheet: Shoulder Bursitis Rotator Cuff Tendonitis (Impingement Syndrome)
Learn what you need to know to help treat and prevent this common shoulder injury
Kathy Weber, M.D., M.S. Daphne R. Scott, PT, Dsc Chicago, IL
- There are hundreds of bursae in the human body
- The function of a bursa is to decrease friction between two surfaces that move in different directions
- Bursitis is an inflammation of a bursa. Bursitis frequently occurs in the shoulder, knee, elbow, and hips.
- Shoulder bursitis and rotator cuff tendonitis refer to inflammation of a particular area of the shoulder that typically results in the same symptoms.
What you need to know
What are shoulder bursitis and rotator cuff tendonitis?
- Between the top of the humerus (arm bone) and the acromion (tip of the shoulder bone) lies the tendon of the rotator cuff and the bursa that protects the rotator cuff tendon
- When the shoulder bursa is inflamed it results in shoulder bursitis
- Bursitis, like tendinitis, is an inflammation and has many of the same symptoms
- Bursitis often occurs in conjunction with another injury such as tendinitis or a rotator cuff tear
- Shoulder bursitis is inflammation of the bursa resulting in pain especially with shoulder motion at or above chest level
Signs & symptoms
- Shoulder bursitis is typically localized pain, tenderness, and pain is elicited with motion of the shoulder in the affected area.
- Pain and tenderness when lifting the arm especially with overhead activities
- Pain while sleeping at night
- Pain over the outside of the shoulder/upper arm
- If stiffness and a limited range of motion in the shoulder joint is developing see a physician as soon as possible since these are signs of a developing frozen shoulder
When should I see a doctor or other professional?
- You should see a doctor if you are unable to move your shoulder
- Swelling is accompanied by a rash or fever
- Making the diagnosis of shoulder bursitis is usually accomplished through a physical exam.
- Radiographs may be obtained to assess the bony anatomy of the shoulder or to detect calcifications within the bursa of rotator cuff tendon. When deemed appropriate further imaging with an MRI may be considered to evaluate for a rotator cuff tear
- A bursa can become inflamed from an injury, infection (uncommon in the shoulder), or an underlying rheumatic condition.
- Improper mechanics at the shoulder resulting from weakness in the rotator cuff muscles or the scapular stabilizing muscles
- Repetitive overhead shoulder motion with associated weakness in the rotator cuff muscles or the scapular stabilizing muscles
- Sudden trauma, such as falling on the shoulder, falling an outstretched arm, or being tackled from the side
- Chronic conditions such as arthritis or another undiagnosed injury
- People who have suffered previous shoulder injuries or have received cortisone injections may have a weakened shoulder joint
- Sports that require repetitive overhead motions such as swimming or baseball place added stress on the bursa
- Improper mechanics or poor posture can decrease the amount of space in the shoulder and aggravate the bursa
What you can do
- Stretching will help prevent tightness and stiffness in the shoulder joint. Stretching is particularly important in colder weather.
- Make sure not to aggravate any minor shoulder pain or tenderness
- Wear protective gear if participating in contact sports
- Improve daily postural habits to decrease stress on the shoulder
Recommendations for treatment and rehab
- Immediately ice the shoulder joint for 48-72 hours after injury or trauma
- Bursitis that is not infection can be treated with ice, anti-inflammatory medications (in appropriate) and physical therapy
- Most bursa injuries can be treated at home over 1-2 weeks with rest, proper exercise, and medications
- If infection is of concern your physician may aspirate fluid from the bursa and send it to a laboratory for analysis.
- Noninfectious shoulder bursitis can be treated with an injection of cortisone medication into the bursa.
- Your doctor may also refer you to Physical Therapy to address strength and muscle imbalances that may be contributing to your shoulder injury
What can I do to stay active?
- Participate in activities that do no reproduce or increase pain
- Typically swimming will aggravate a shoulder injury so activities such as cycling, using the treadmill or the elliptical trainer without use of the arm movement can be performed while the shoulder is recovering
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