What is Shoulder Bursitis?

You’ve caught that high fly ball winging its way toward left field with a leap and a grab. As you throw it to third base for the out, you feel pain in your shoulder. Oh, no! Is this the beginning of the end of your career as an amateur outfielder? Will you have to give up a game you so enjoy?

Let’s hope not. What you may be experiencing is bursitis of the shoulder, also known as subacromial bursitis, because it occurs in the bursa beneath your acromion, the bone that forms the roof of your shoulder joint. Very well, you say, but whatever is a bursa?

A bursa (plural, bursae) is a fluid-filled sac that helps to reduce the friction between the bones in a joint and the soft tissues, such as tendons. The bursae lubricate and cushion the areas where these structures rub against each other. Inflammation to these sacs is called bursitis and it may occur in the shoulder, knees, elbows or wrists. Bursitis, while painful, isn’t life-threatening and usually responds well to treatment.

Common causes for shoulder bursitis are:

• Overuse and repetitive movement.
• Sudden injury, such as a blow to the area.
• Aging; formation of calcium deposits on collarbone that interfere with bursa.
• Sudden trauma, e.g., falling so that the shoulder absorbs the blow.
• Lifting items overhead.
• Underlying weakness of the rotator cuff or shoulder blade stabilizers that impinges upon the bursa.

Athletes who use an overhand throwing motion are susceptible to shoulder bursitis, such as swimmers, tennis players and volleyball players. Non-athletes who may experience shoulder bursitis include people involved in chores such as hanging the laundry or painting the house. Shoulder bursitis often occurs as the result of another injury, such as a torn rotator cuff, that begins to impact the bursa.

The main indicators of the onset of shoulder bursitis are pain and restricted movement:

• Tenderness or stiffness in the affected area.
• Gradual onset of pain that progressively worsens in intensity following or during repetitive activity.
• Rapid onset of pain if caused by trauma.
• Skin may swell and be warm to the touch.
• Pain located at the outside of the shoulder and it may radiate to the mid-arm; it can spread as far as the wrist.
• At rest, shoulder feels more comfortable when held across the body, as if in a sling.
• Pain increases when you lie on the injured side, but it can also hurt when lying on your unaffected side with your arm slung across the body.
• A tightening sensation in the upper arm.
• Pain intensifies when you use your arm for actions that require you to lift it above shoulder height, such as reaching for an object on a high shelf.
• Inability to lift arm away from body, because pain causes a feeling of weakness.

If you are experiencing shoulder pain that you think might be bursitis, a visit to your physician is indicated. Once he or she diagnoses it, a course of rest and home treatment will generally be successful, but physiotherapy may also help you by strengthening the muscles around your joints; it will certainly be useful in preventing a recurrence.
To heal properly:

• Rest is best. Avoid engaging in any activity that puts pressure on the shoulder or may cause pain.
• Freeze it. As soon as you feel muscle pain or pain near a joint, apply ice for 10 or 15 minutes, as often as twice an hour, if needed. Continue for 72 hours (three days).
• Dull the pain. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen help reduce inflammation and cut the pain.
• Move it. Gently move the affected joint through its full range of motion daily to avoid stiffness. Work with your physiotherapist to add exercises that strengthen the surrounding muscles.

If the swelling is severe, your physician may decide to remove some of the fluid using a needle. He or she might also suggest a pressure bandage for the affected area.

Keep your shoulder healthy by:

• Staying the course. Continue with your treatment and exercise regimen.
• Slow but steady. Slowly re-start the activity that aggravated your shoulder, warming up beforehand and stretching afterward. Do the activity for short periods of time to give your body a chance to adjust.
• Improve technique. If a certain activity has caused bursitis, make sure you are doing it with proper technique to avoid further injury. If equipment is necessary, check it to make sure it is doing its job in protecting you.
• Look for alternatives. If the activity that led to injury is a sport you play for fun, consider looking for an alternative that doesn’t require overhead motion.

Remember: shoulder bursitis may be painful, but it can be healed. Be patient and follow the advice of your healthcare professionals and you should soon be feeling fine.