Shoulder Bursitis

Author: Jerry Song

Shoulder bursitis is characterised by the inflammation of the bursae, small fluid-filled sacs that cushion and reduce friction between tissues in the shoulder joint. The condition commonly affects the subacromial bursa, which lies between the acromion and the rotator cuff tendons. Shoulder bursitis can cause significant discomfort and limit the range of motion, impacting daily activities and quality of life. While conservative treatments are often effective, manual therapy, including dry needling and myofascial cupping, can play a crucial role in symptom management and functional restoration.

Shoulder bursitis can arise from various factors, often classified into two main categories: acute and chronic causes.

1. Acute Causes:
   • Trauma: Direct impact or injury to the shoulder can cause inflammation of the bursae.
   • Overuse: Repetitive overhead movements or heavy lifting can irritate the bursae, leading to acute inflammation.
   • Infection: In rare cases, bacterial infections can cause septic bursitis, resulting in significant inflammation and pain.
2. Chronic Causes:
   • Degenerative Changes: Ageing and wear-and-tear can lead to degenerative changes in the shoulder, contributing to chronic bursitis.
   • Postural Imbalances: Poor posture, such as forward head posture or rounded shoulders, can increase the risk of bursitis by altering shoulder mechanics.
   • Systemic Conditions: Conditions such as rheumatoid arthritis and gout can cause recurrent bursitis due to systemic inflammation.

 

Shoulder bursitis affects a wide demographic, with certain groups being more susceptible:

1. Age: The risk of developing shoulder bursitis increases with age, particularly due to degenerative changes in the shoulder joint.
2. Occupation and Activities: Individuals engaged in occupations or activities involving repetitive shoulder movements, such as painters, athletes, and manual labourers, are at higher risk.
3. Gender: While both genders are affected, certain studies suggest a slightly higher prevalence in females, possibly due to differences in shoulder anatomy and biomechanics.
4. Posture and Biomechanics: Poor posture, muscle imbalances, and improper biomechanics can predispose individuals to shoulder bursitis by increasing stress on the shoulder joint and bursae.

 

Manual therapy offers a range of non-invasive techniques to manage shoulder bursitis, alleviating pain, improving mobility, and promoting healing. Key manual therapy interventions include:

1. Dry Needling

Dry needling involves the insertion of fine needles into specific trigger points or areas of muscle tightness to promote pain relief and muscle relaxation. Benefits of dry needling for shoulder bursitis include:

• Reduction of Muscle Tightness: Targeting trigger points in the shoulder and surrounding muscles can alleviate tightness, improving range of motion and reducing stress on the bursae.
• Pain Relief: By disrupting pain signals and promoting local blood flow, dry needling can effectively reduce pain and inflammation associated with bursitis.
• Improved Muscle Function: Enhancing muscle function around the shoulder joint can stabilise the area, reducing abnormal movement patterns that exacerbate bursitis.

2. Myofascial Cupping

Myofascial cupping involves the use of suction cups to create negative pressure on the skin, lifting and separating the underlying tissues. This technique can:

• Enhance Blood Circulation: Increased blood flow aids in nutrient delivery and waste removal, promoting healing and reducing inflammation.
• Release Myofascial Restrictions: Loosening tight fascia and muscle adhesions can restore normal tissue mobility, reducing pressure on the bursae and alleviating pain.
• Reduce Muscle Spasms: The negative pressure from cupping can relax muscle spasms, improving muscle tone and function in the shoulder region.

3. Soft Tissue Mobilisation

Soft tissue mobilisation includes techniques such as massage and myofascial release to manipulate the soft tissues around the shoulder:

• Massage Therapy: Techniques like deep tissue massage can reduce muscle tension, improve circulation, and decrease pain, facilitating recovery of muscle function and flexibility.
• Myofascial Release: Applying sustained pressure to myofascial restrictions can eliminate pain and restore motion, addressing tightness in the shoulder muscles and fascia.

4. Joint Mobilisation

Joint mobilisation involves applying controlled forces to improve the range of motion and alleviate pain in the shoulder joint:

• Glenohumeral Joint Mobilisation: Techniques to mobilise the glenohumeral joint can enhance joint mobility, reduce stiffness, and correct abnormal mechanics contributing to bursitis.
• Scapulothoracic Mobilisation: Addressing scapular movement can improve overall shoulder mechanics, reducing compensatory stresses on the bursae.

5. Manual Stretching

Manual stretching techniques aim to improve flexibility and reduce tension in the muscles around the shoulder:

• Pectoral and Rotator Cuff Stretching: Stretching the pectoral and rotator cuff muscles can relieve tension and improve range of motion in the shoulder.
• Upper Back and Neck Stretching: Addressing tightness in the upper back and neck can reduce stress on the shoulder and improve posture.

Listed below are some details of a client dealing with shoulder bursitis who is seeking treatment here at HBM, which may also serve as a case study:

Age: 50+

Gender: M

Symptoms: Right shoulder pain

Medical history: Non pertinent

Lifestyle: Frequently goes cycling long distances, and seated for work mainly

The client has received fortnightly treatments here at HBM over the period of 3 months to manage his symptoms, and even after the first treatment has had great improvement in mobility and pain. Educating him on the importance of compliance to treatment due to his active schedule has made a big difference on his quality of life, and after educating him on the possible cause (after numerous questioning and orthopaedic testing) and with some take home exercises and stretches, he’s been able to get back to his daily activities with much improvements on symptoms.

If you or someone you know are dealing with shoulder bursitis, musculoskeletal pain, or even myofascial trigger points, book in an appointment to see Jerry now for an initial consultation so we can assess your condition and come up with an appropriate and tailored treatment plan to manage your pain.  Simply click this booking link for the myotherapy initial consultation with our experienced myotherapists.