Understanding Shoulder Bursitis: How Exercise Physiology Supports Rehabilitation

Shoulder bursitis is a painful condition that affects many individuals, often limiting their ability to perform daily activities and participate in physical exercise. For those suffering from this condition, effective rehabilitation is crucial to restoring function, reducing pain, and preventing future flare-ups.

Causes of Shoulder Bursitis

Shoulder bursitis can be triggered by various factors, including:

• Overuse or repetitive motion: Repeated movements, especially those that involve lifting the arms above shoulder level, can irritate the bursa. Athletes, manual labourers, and individuals who frequently perform overhead activities are at higher risk.
• Trauma or injury: A direct blow to the shoulder or a fall onto the joint can cause inflammation of the bursa.
• Poor posture: Slouching or rounded shoulders place extra pressure on the shoulder structures, leading to irritation of the bursa.
• Age-related wear and tear: As we age, the tissues in our joints become less resilient, making bursitis more common in older adults.
• Underlying conditions: Arthritis, gout, or infections can also cause bursitis in the shoulder joint.

Symptoms of Shoulder Bursitis

The symptoms of shoulder bursitis can vary in severity but often include:

• Pain: A sharp or dull ache, typically on the outside or top of the shoulder. The pain may worsen when lifting the arm or lying on the affected shoulder.
• Limited range of motion: Difficulty lifting the arm above shoulder height or moving the shoulder in various directions.
• Tenderness: The area around the shoulder may feel tender to the touch.
• Swelling: In some cases, there may be visible swelling around the shoulder joint.
• Weakness: A feeling of weakness in the shoulder, particularly when lifting or reaching overhead.

Diagnosing Shoulder Bursitis

If you suspect you have shoulder bursitis, it is important to consult with a healthcare professional. A thorough evaluation, including a physical exam and imaging studies (such as an X-ray or MRI), may be needed to confirm the diagnosis and rule out other shoulder conditions like rotator cuff tears or tendonitis.

How Exercise Physiology Helps in Shoulder Bursitis Rehabilitation

Exercise Physiology plays a crucial role in the rehabilitation process for shoulder bursitis. Through targeted exercises, postural corrections, and strengthening routines, Exercise Physiologists can help reduce inflammation, improve shoulder function, and prevent future episodes of bursitis.

Comprehensive Assessment and Personalised Treatment Plans

Rehabilitation for shoulder bursitis begins with a comprehensive assessment. Exercise Physiologists assess several factors, including posture, range of motion, muscle strength, and movement patterns, to understand the root cause of bursitis. This information allows them to create a personalised treatment plan that addresses the specific needs of the individual.

Key components of this assessment include:

• Postural analysis: Poor posture, particularly rounded shoulders, can exacerbate bursitis by increasing pressure on the shoulder bursa.
• Range of motion (ROM) assessment: Limited shoulder mobility is common in bursitis, and evaluating ROM helps determine the severity of the condition.
• Muscle strength testing: Identifying weaknesses in the muscles surrounding the shoulder, particularly the rotator cuff and scapular stabilizers, allows for targeted strengthening exercises.

Pain Management and Reducing Inflammation

In the early stages of shoulder bursitis, pain and inflammation are the primary concerns. While exercise is important, it’s essential to manage pain before introducing an exercise program. An Exercise Physiologist may collaborate with other healthcare providers, such as physical therapists or doctors, to recommend appropriate pain management techniques like:

• Rest and activity modification: Temporarily avoiding activities that aggravate the shoulder, especially overhead movements, can help reduce inflammation.
• Ice therapy: Applying ice to the shoulder for 15-20 minutes several times a day can help alleviate pain and reduce swelling.
• Gentle stretches: Passive stretching exercises can help maintain shoulder mobility without putting too much strain on the inflamed bursa.

Stretching and Flexibility Exercises

Stretching exercises play a vital role in reducing muscle tension around the shoulder and improving flexibility. Tight muscles, particularly in the chest and shoulders, can contribute to poor posture and increase pressure on the bursa. Stretching exercises are designed to gently relieve tension, restore range of motion, and prevent further strain on the shoulder joint.

Common stretching exercises for shoulder bursitis include:

• Cross-body shoulder stretch: Gently pulling one arm across the body to stretch the muscles at the back of the shoulder.
• Chest stretch: Standing in a doorway and pressing your hands against the doorframe to stretch the pectoral muscles, which can help open up the chest and improve posture.
• Pendulum stretch: Leaning forward and gently swinging the affected arm in a circular motion to improve range of motion without causing pain.

Strengthening Exercises for Shoulder Stability

Once pain is managed and flexibility has been restored, the focus shifts to strengthening the muscles surrounding the shoulder joint. Strong muscles help stabilize the shoulder and reduce strain on the bursa, preventing future flare-ups of bursitis. Strengthening exercises for shoulder bursitis should target the rotator cuff, scapular stabilizers, and upper back muscles.

Key strengthening exercises include:

• External rotations with resistance bands: Strengthening the rotator cuff muscles to improve shoulder stability.
• Scapular retractions: Strengthening the muscles that support the shoulder blades, promoting better posture and reducing strain on the bursa.
• Wall push-ups: A gentle way to strengthen the chest and shoulders while minimizing stress on the shoulder joint.

These exercises should be performed with proper form and technique to avoid aggravating the shoulder. An Exercise Physiologist will guide you through each exercise, ensuring that movements are safe and effective.

Postural Corrections and Ergonomic Adjustments

Correcting poor posture is an essential part of managing shoulder bursitis. Rounded shoulders, forward head posture, and slouching can place excessive pressure on the shoulder joint and increase the risk of bursitis. Exercise Physiologists focus on postural retraining exercises to help individuals maintain proper alignment and reduce strain on the shoulder.

In addition to postural exercises, ergonomic adjustments in the workplace or home environment may be necessary to prevent future episodes of bursitis. For example, ensuring that a desk chair provides adequate support for the back and shoulders, or adjusting the height of a computer screen to prevent hunching, can make a significant difference.

Gradual Return to Activity and Preventing Recurrence

As shoulder strength and flexibility improve, the goal is to gradually return to regular activities, including sports or exercise, without risking re-injury. Exercise Physiologists will design a progressive plan that increases the intensity and duration of activities while monitoring symptoms.

To prevent future recurrence of shoulder bursitis, it’s essential to continue regular stretching and strengthening exercises. Consistent engagement in an exercise program that promotes shoulder stability and flexibility is the key to maintaining shoulder health in the long term.

Shoulder bursitis can be a painful and limiting condition, but with the right approach, it is possible to achieve long-term recovery and prevent recurrence. Exercise Physiology offers a comprehensive, evidence-based approach to rehabilitation that includes pain management, targeted exercises, postural corrections, and lifestyle adjustments.

By working with an Exercise Physiologist, individuals with shoulder bursitis can restore shoulder function, reduce pain, and return to their regular activities with confidence. If you’re experiencing shoulder pain or have been diagnosed with bursitis, reach out to us today to start your personalised rehabilitation journey.