Shoulder Bursitis Physiotherapy | Move Physiotherapy Fremantle
Have you been diagnosed with a rotator cuff tendinopathy or shoulder bursitis? Are you experiencing pain at the tip of your shoulder and wondering about your potential diagnosis?
The following guide offers a detailed explanation of rotator cuff tendinopathies and bursitis, and key information you should know before exploring more invasive treatments such as cortisone injections or surgery.
Move Physiotherapy Fremantle are your experts in treating shoulder pain. We offer 60 minute initial consultations to comprehensively assess your shoulder pain, provide a detailed diagnosis and assess contributing factors that may be contributing to towards your shoulder pain.
WHAT CAUSES A SHOULDER TENDINOPATHY OR BURSITIS?
Shoulder tendinopathies – or perhaps you have been given a diagnosis of a tendinitis or tendinosis – are your overuse or ‘wear and tear’ injuries of the shoulder. These injuries often involve repetitive shoulder movement in conjunction with poor muscular control which place strain or compression onto your rotator cuff tendons. This results in pain, and if left untreated, a gradual wearing away of your rotator cuff tendons.
A number of factors can increase the likelihood of these pathologies. Most significantly, a rounded shoulder posture and rounded upper back posture can decrease the amount of sub-acromial space. This is the space between the tip of the shoulder and the underside of your collarbone, where your rotator cuff tendons and bursa pass.
Furthermore, weakness in your rotator cuff muscles can result in superior migration of your humeral head – a fancy way of saying that your arm bone moves higher in the shoulder socket as you are elevating your arm.
The result is that the structures in the sub-acromial space become compressed and irritated. These structures include the rotator cuff tendons and the sub-acromial bursa.
In the absence of trauma, it is highly uncommon for the bursa to become inflamed without an underlying tendinopathy. As such, as a part of your rehabilitation it is important to address this underlying cause to prevent your pain from recurring. Furthermore, if you are considering a cortisone injection for your shoulder pain, these injections are highly effective at treating the inflammation of the bursa, yet do not address the muscle strength or postural issues that may have been underlying this inflammation.
ROTATOR CUFF TENDINOPATHY OR BURSITIS SYMPTOMS
The symptoms of your rotator cuff tendinopathy include:
- Pain located at the tip of the shoulder. Depending on the severity of the condition, this may also be radiating onto the outer part of the arm.
- There is generally a painful arc of movement which occurs when lifting the arm between 60 and 120 degrees of movement.
- Weakness on the affected arm, especially when holding objects away from the body.
If your sub-acromial bursa has become inflammed, you will generally experience further symptoms such as:
- Intense aching or burning at the tip of the shoulder especially at night time.
- Inability to sleep on the affected arm.
TREATMENT OF SHOULDER TENDINOPATHY OR BURSITIS
Stage 1: De-Loading and Symptom Relief
The first goal of your rehabilitation will be to reduce your pain levels. This will firstly require a period of de-loading, where we have to reduce our exposure to heavy loaded activities. Furthermore, we will have to minimise movements that compress the tendon or bursa, such as overhead activities and stretching the arm across the body.
Your physiotherapist will begin to address postural elements that decrease the sub-acromial space, such as a rounded shoulder posture or rounded upper back posture. They may employ techniques such as massage, dry needling or joint manipulation.
Often, anti-inflammatory medication can assist in subsiding your pain at this stage.
Stage 2: Gradual Strengthening, Adhering to Shoulder Pain Levels
Once your pain levels have decreased – generally to a level below 4/10 – your physiotherapist can begin strengthening your rotator cuff musculature. This will initially involve positions that do not compress the rotator cuff tendons or bursa, such as with your arms by your side.
Prior to beginning rotator cuff strengthening, it is important to be able to activate your postural muscles such as your midback or thoracic spine extensor muscles.
Stage 3: Progression Into Overhead Activities
Once you have achieved good control with your arms by your side, your physiotherapist will gradually introduce strengthening in positions that gradually work you towards overhead activities.
Stage 4: Sport Specific Training
The final stage of your rehabilitation is returning you to the activities that you love doing – or, in situations such as hanging the washing on the line – the activities you have to be doing.
At Move Physiotherapy we will work with you to ensure that you are confident and ready to return your sport or activity without risk of re-injury!
FREQUENTLY ASKED QUESTIONS
Why Should I Get My Shoulder Pain Treated At Move Physiotherapy?
At Move Physiotherapy Fremantle, we consider ourselves to be experts in Shoulder Pain Physiotherapy.
We spend longer with you during your first appointment (60 minutes compared to 30 or 40 minutes at competing clinics) in order to comprehensively assess not only the source of your shoulder pain but also the contributing factors underlying your injury.
We also take the time to understand how your injury is impacting you, and work with you to formulate a plan to get you from pain and injury back to performing at your peak.
Our first appointment always includes treatment, whether this be joint mobilisation, massage, dry needling or simply advice.