Definition:
Subacromial Bursitis is the inflammation of the subacromial bursa, a fluid–filled sac located between the rotator cuff tendons and the acromion(part of the shoulder blade). This bursa acts as a cushion, reducing friction during arm movements.
Cause:
The primary cause is often repetitive overhead activities, leading to overuse and irritation of the bursa. Other contributing factors include:
- Trauma: Direct injury to the shoulder.
- Improper Biomechanics: Poor posture or movement patterns.
- Bone spurs: Acromial spurs can impinge on the bursa.
- Underlying Conditions: Rheumatoid arthritis or gout.
Clinical Features:
Patients typically experience:
- Gradual onset of shoulder pain.
- Pain worsens with arm elevation, especially overhead.
- Night pain, particularly when lying on the affected side.
- Limited range of motion due to pain.
Signs & Symptoms:
Key indicators include:
- Localized Tenderness: Pain when pressing on the top of the shoulder.
- Painful Arc: Pain between 60 and 120 degrees of arm abduction.
- Weakness: Perceived weakness due to pain, not true muscle weakness.
- Clicking/Grinding: Less common, but can occur with severe inflammation.
Physiotherapy Management:
Physiotherapy is crucial for recovery. Management often includes:
- Pain Management: Ice application, modalities like ultrasound.
- Rest and Activity Modification: Avoiding aggravating activities.
- Stretching: Gentle exercise to restore range of motion.
- Strengthening: Progressive exercise for the rotator cuff and periscapular muscles.
- Postural correction: Addressing poor posture that contributes to impingement.
- Education: guidance on proper body mechanics and activity modification.
complications:
Chronic Shoulder Pain: Persistent inflammation can lead to long-term irritation.
Reduced Range of Motion: Ongoing swelling may limit shoulder mobility.
Rotator Cuff Tendinopathy: Increased friction can irritate or damage the rotator cuff tendons.
Rotator Cuff Tear: Severe or long-standing bursitis may increase the risk of partial or full-thickness tears.
Shoulder Impingement Syndrome: Ongoing irritation can worsen impingement under the acromion.
Muscle Weakness: Due to pain inhibition, leading to reduced functional use of the arm.
Calcific Bursitis: Chronic inflammation may cause calcium deposits within the bursa.
Adhesive Capsulitis: Prolonged pain and limited movement can contribute to stiffness and capsular tightening.
Conclusion:
Subacromial Bursitis can be debilitating, but with appropriate rest, activity modification, and a structured physiotherapy program, most individuals experience significant improvement and return to their normal activities. Early intervention is key for optimal outcomes.
What is Subacromial Bursitis?
Answer: It is the inflammation of the subacromial bursa, a fluid-filled sac that reduces friction between the rotator cuff tendons and the acromion.
What are the common causes of Subacromial Bursitis?
Answer: Repetitive overhead activities, trauma, improper posture, bone spurs, and conditions like rheumatoid arthritis or gout.
How is Subacromial Bursitis managed in physiotherapy?
Answer: Treatment includes pain control, rest, stretching, strengthening exercises, postural correction, and guidance on proper body mechanics.
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