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What is Bursitis Shoulder? Injury Overview

by Jaydee Vykoukal, PT, DPT December 13, 2017 0 Comments

Shoulder pain

Shoulder bursitis is a painful and troublesome condition that can seriously impede your ability to use your arm and shoulder. While it can affect anyone, bursitis of the shoulder is particularly prevalent in older people and athletes. In this article, we will walk you through the key causes and symptoms of this shoulder pain, along with effective treatments to help to relieve bursitis pain, tenderness, and swelling.

What is Bursitis of the Shoulder?

Shoulder bursitis is caused by inflammation of one of the bursa in the shoulder, which is a fluid-filled sac in your shoulder joint. Bursitis in shoulder joints causes tenderness and pain and reduces your ability to move your shoulder.

About the Bursa

When we think of joints, we tend to focus on the articulation of two bones. What we don’t always consider is the tendons, muscles, and ligaments that allow our joints to function properly; providing a balance of strength, stability, and mobility.

A bursa is a tiny sac filled with fluid, which acts as a cushion between the joints’ tissues. They are most commonly found in areas of high friction between a bone and tendons to provide extra support and lubrication. Altogether, there are 160 bursae in the human body. They are found in key joints, including the shoulders, knees, and hips.

In the shoulder,  there are 6 bursae. The subacromial bursa is most likely to become inflamed (known as subacromial bursitis). This is the bursa that sits between the coracoacromial ligament and the supraspinatus muscle (underneath the acromion process), the small muscle that runs along the top of the shoulder from the shoulder blade. Also present in the tissues of the shoulder joint is the subdeltoid bursa, subscapular bursa, scapulothoracic bursa, though they are less commonly affected.

As there are bursae in other joints in your body, it is also possible to develop bursitis of the knee, hip, or elbow.

Difference Between Tendonitis and Bursitis in Shoulder

Both tendinitis of the rotator cuff tendons and bursitis refer to inflammation of certain soft tissues in the shoulder. Both can cause significant pain but affect slightly different areas in the shoulder. It is possible, and actually quite common, to have both an inflamed tendon and bursa in shoulder joints. As the symptoms can be similar, you’ll likely need a professional diagnosis.

What Causes Bursitis in the Shoulder?

Bursitis of the shoulder is often caused by repeated microtrauma to the shoulder. This is particularly common among athletes, especially those participating in sports that involve overarm reaching and throwing.

Shoulder injuries can also cause bursitis. A direct impact to the shoulder or a fall in which you land largely on your shoulder can lead to inflammation of the shoulder bursa.

The most common shoulder bursitis causes are:

  • Repeated microtrauma to the shoulder joint
  • Overuse of the shoulder, particularly during sports or manual labour
  • Falls
  • Sudden and direct impacts and injuries
  • Underlying rheumatic conditions, such as rheumatoid arthritis
  • Infections (septic bursitis)
  • Shoulder impingement syndrome

Risk Factors for Shoulder Bursitis

Certain people are at greater risk of experiencing bursitis of the shoulder due to their lifestyle or work.

  • Athletes

    Athletes who frequently participate in javelin, swimming, shot put, tennis, basketball, or baseball are at a higher risk. Sports that involve sharp and forceful movements of the shoulder make shoulder bursitis a stronger possibility. Frequent participation in such sports can lead to overuse and microtrauma, among the most common causes of shoulder bursitis.

    Inexperienced or amateur athletes may also be at a higher risk. People who rush to get fit often perform exercises improperly and without proper balance, increasing the likelihood of sustaining an injury. Avoid poor technique and overuse by starting slow, attending a group class, or even taking one-to-one lessons. Also, don’t attempt to lift too much weight before you’ve developed a solid foundation of strength and proper form.

  • Manual Laborers

    Manual laborers, such as construction workers, painters, or decorators, are also more likely to develop shoulder bursitis. Heavy lifting and frequent overarm work, such as painting ceilings, can cause strain and pressure on your shoulder. It is also worth noting that “weekend warriors” that try to get a lot of their own home projects done are also at a higher risk.

  • Seniors

    Older people are at greater risk of falling and developing injuries due to repetitive microtrauma over the years, which are both a common cause of shoulder bursitis. Falling often results in direct impact to the shoulder or places the arm in an awkward and painful position. Such an injury can lead to bursitis, as well as shoulder tendonitis.

    Since the majority of falls happen in the bathroom, practicing good bathroom safety is crucial to preventing injury.

    Seniors are also at risk of an injury because of weak muscles and joints. To remedy this, begin a safe, low-impact exercise program, such as chair exercise.

  • Those with Prior Injuries

    Shoulder impingement syndrome can cause or exacerbate damage to the tendons and bursa. Shoulder impingement syndrome is a condition in which the tendons in the rotator cuff become trapped and inflamed. If you are suffering from chronic shoulder pain or problems, speak to your doctor for further advice and a professional diagnosis.

Bursitis Shoulder Symptoms

Bursitis shoulder pain can be frustrating and debilitating. Shoulder bursitis symptoms often come on gradually, particularly when caused by overuse. If you are suffering from one or more of the symptoms below, consult your doctor for a formal diagnosis and treatment plan.

  • Swelling
  • Tenderness
  • Pain on the outside or top of your shoulder
  • Pain that spreads down the arm
  • Significant pain when lying or sleeping on your shoulder
  • Pain or difficulty moving your arm upwards and outwards
  • Difficulty using your arm and shoulder

Bursitis Shoulder Diagnosis

In order to diagnose shoulder bursitis or other conditions, your doctor will perform a physical examination. He or she will ask questions about the pain, swelling, and other symptoms.

Most often, a manual examination can identify bursitis by assessing strength, the location of tenderness in the affected area, and joint range of motion. If more information is needed, your doctor will order other tests, such as an ultrasound or MRI to get a clear view of tissue damage.

Less commonly, X-rays are used to detect calcification of the bursa or bone spurs. Plus, it can help rule out fracture if there was a fall. Your doctor may consider this necessary if you report chronic symptoms.

Shoulder Bursitis Recovery Time

Will shoulder bursitis go away? Yes! With proper treatment, most make a complete recovery and learn to manage their shoulder function to prevent future issues and symptoms. Even better, the shoulder bursitis recovery usually only takes weeks or months.

Mild or moderate bursitis, without the need for surgery, may take a couple weeks to heal. Pain modalities like ice packs, anti-inflammatory medications (NSAIDs), aspiration or corticosteroid injections can help you make a full recovery, but such procedures may increase your recovery time by a few weeks.

Most importantly, expect to follow your physical therapy rehabilitation program for at least six weeks. In that time, you will gradually build your strength and mobility to restore proper shoulder mechanics. Always follow your orthopedic doctor’s and physical therapist’s advice and find the proper balance between rest and exercise.

Although it’s tempting to rush back to sports or exercise, doing so can damage your shoulder further and prolong your recovery time.

Getting Over Bursitis Shoulder

The road to recovery from shoulder bursitis doesn’t need to be long if you address it properly and quickly. Give your shoulder rest, and reintroduce exercises gently. Use the information in this guide to identify and treat your bursitis of the shoulder. But remember to consult a medical professional for a proper diagnosis and treatment plan.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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