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Injury/Pain

The Simple Guide to Shoulder Bursitis

Overview

Bursae (the plural of bursa) are fluid-filled sacs or cavities positioned in joints throughout the body, including the shoulder. Their purpose is to make shoulder movement easy and to reduce friction in the joint. The definition of shoulder bursitis is an inflamed, swollen bursa.

Bursae are not likely to become inflamed or swollen independently, but are probably a side effect of rotator cuff damage (to the muscles and tendons that connect the upper arm to the shoulder blade) or an injury that accompanies shoulder impingement (a shoulder muscle, tendon, or bursa rubbing against the shoulder blade, or scapula). The greater the swelling and thickening of the structures caused by inflammation, the less space there is for easy movement in the shoulder joint.

How It Happens

In athletes, bursitis can develop as a result of a direct blow in a contact sport, repeated, long-term friction that occurs in throwing sports, falling so that the shoulder absorbs the force, either directly or indirectly, or lifting, as in lifting weights to an overhead position.

In middle-aged and older athletes, bursitis could develop because calcium deposits form on the collar bone (clavicle) and irritate or even intrude into the bursa sac.

Who’s At Risk

Athletes who take blows to the shoulder (football players, for example) as well as those who overuse the shoulder joints (baseball pitchers, tennis players, volleyball players, throwing athletes, and swimmers) are particularly vulnerable. The risk increases for athletes who have a history of the condition, for those who have not trained properly to build shoulder strength, muscle endurance, and easy range of motion, and possibly for those who do not warm up properly, though the latter is hard to document. Athletes over the age of 40 are more likely to develop bursitis than younger adults.

Symptoms

  • Gradually developing symptoms that usually require a physician for an accurate diagnosis
  • Pain in the shoulder or upper arm
  • Shoulder pain when the arm is extended, then raised or lowered
  • Shoulder stiffness
  • Possible redness of the skin near the inflamed bursa

Initial Treatment

  • Rest the affected shoulder until symptoms subside.
  • Use ice packs for 15-20 minutes, 3-4 times a day for the first 48-72 hours after the onset of symptoms.
  • Use moist heat after the first 48-72 hours if it makes the shoulder joint more comfortable.
  • Aspirin, acetaminophen, ibuprofen, and naproxen may relieve pain. Aspirin, ibuprofen, and naproxen may relieve pain and reduce inflammation.
  • Get medical attention if the symptoms get worse or don’t subside within one to two weeks.

Comeback Strategy

  • Two or three weeks should be enough to recover from mild or moderate shoulder bursitis.
  • Six to eight weeks of rehabilitation is needed following surgery to address the condition.
  • Execute the overhead movements without pain in the movements required in your sport.
  • Cross-train in sports (walking, running, jogging, swimming, cycling) that do not require overhead movements.

Prehab

Incorporate these exercises into your prehab routine:

  1. Standing shoulder external and internal rotation (two sets until fatigue)
  2. Floor Y's & T's (10 repetitions, two sets each)

How to Avoid This Condition

There are no sure ways to prevent shoulder bursitis, but these measures might lessen the risk:

  • Take frequent breaks in sports that require repetitive overhead movements.
  • Wear warm upper-body clothing in cold weather.
  • Allow more warm-up time in cold weather.
  • Wear sport-specific protective equipment to protect the shoulder against blunt forces.
  • Gradually increase exercise intensity, duration and frequency — no more than 10 percent a week.

Movement Prep

Incorporate these exercises into your warm-up routine:

  1. Floor posture slides (10 repetitions, two sets)
  2. Floor Y (10 repetitions, two sets)
  3. Handwalks

Jim Brown, Ph.D. has written 14 books on health, medicine, and sports. His articles have appeared in the Washington Post, New York Post, Sports Illustrated for Women and Better Homes & Gardens. He also writes for the Duke School of Medicine, UCLA School of Medicine, Cleveland Clinic and Steadman-Hawkins Research Foundation.


Tags: Shoulder Pain, Injury, Shoulder, Injury Prevention

References

  1. Ramin Modabber, MD, Santa Monica Orthopedic and Sports Medicine Group, Santa Monica, California
  2. Anna J. Hartman, MS, ATC, CSCS, Manager, Performance Physical Therapy Services, Athletes’ Performance, Phoenix, Arizona
  3. American Academy of Orthopaedic Surgeons
  4. Cedars-Sinai Medical Center
  5. MayoClinic.com
  6. National Institutes of Health (Medline Plus)

 

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