Subacromial Bursitis


Bursitis is an inflammation or irritation of the bursa, which is a small sac located between a bone and muscle, skin, or a tendon. The bursa allows smooth gliding between these structures. The subacromial bursa helps the motion of the rotator cuff in activities such as overhead work.


Symptoms:


• Gradual onset of your shoulder symptoms over weeks or months.
• Pain on the outside of your shoulder.
• Pain may spread down your arm towards the elbow or wrist.
• Pain made worse when lying on your affected shoulder.
• Pain made worse when using your arm above your head.
• Painful arc of movement – shoulder pain felt between 60 - 90° of arm moving up and outwards.
• When your arm is by your side there is minimal pain and above 90° relief of pain.
• Shoulder pain with activities such as washing hair, reaching up to high shelf in the cupboard.

Investigation:


• MRI
• Ultrasound
Shoulder bursitis rarely requires surgical intervention and generally responds favorably to conservative treatment


Physiotherapy treatment


• Reduce inflammation
• Reduce pain
• Prevent weakness and atrophy of muscles as a result of disuse
• Increase the patient’s awareness of bursitis
• Prevent/reduce impingement and further tissue damage
• Improve muscle control
• Improve scapulohumeral rhythm
• Improve active and passive range of motion
• Restore strength of scapular and rotator cuff muscles


Treatment


• • Educate the patient about their condition and advise to avoid painful activities and the importance of relative rest of the shoulder.
• Educate the patient about the importance of correct posture
• Soft tissue massage
• Mobilizations
• Gentle pendulum range of motion exercises
• Scapular exercises
• Stretching of tight muscles
• Rotator cuff strengthening
• pnf
• Ice
• U.S