A Bursa is a small fluid filled sac present is our joints with the primary function of reducing friction and providing cushioning to the muscles, tendons, and bones near a joint. Bursitis is simply the term used for an inflamed bursa that usually gets injured through repetitive movements.

There are certain symptoms that you may experience which would point to a possibility of bursitis. Certain shoulder movements, especially forward flexion and lifting the shoulder to the side (abduction) are the most painful.

Common Symptoms of Bursitis:

Shoulder pain related to an inflammed bursa is very common in the general population. You may be experiencing bursitis related pain if you have the following symptoms:

• Shoulder pain and discomfort when lying on your affected shoulder.

• Tenderness and redness on the top edge of the shoulder

• Pain that gets worse when you lift your arm to the side or forward

• Shoulder pain at night that can disturb your sleep

• Pain that can also spread down the arm towards the elbow.

Who should you see?

Physiotherapists are healthcare professionals best suited to assess and treat shoulder pain and bursitis. Their training and clinical expertise allows them to accurately diagnose the injury and identify the primary factors that cause it. Following the assessment, a tailored plan for treatment and long-term recovery will be developed in collaboration with you, keeping your future goals in mind.

While a GP would be able to help and prescribe you with pain killers for short term relief, your symptoms will very likely return within the week. At our Richmond clinic, our shoulder specialist physios work closely with our network of GP’s and can refer you to one if required.

When should you see a physiotherapist?

Shoulder pain can be very limiting and can restrict a majority of basic daily functions. If left undiagnosed and untreated, shoulder injuries tend to become worse over time and further limit your functioning. Therefore, in order to prevent long term pain and dysfunction, it is advised that you see your physiotherapist immediately if you feel any of the following symptoms:

• Inability to sleep on affected side.

• Disabling joint pain.

• Sudden inability to move a joint

• Excessive swelling, redness, bruising or a rash in the affected area

• Sharp or shooting pain, especially when you exercise or exert yourself

• A fever

Recovery Timeline for Shoulder Bursitis:

Majority of our patients coming to see us with bursitis related shoulder pain have usually been experiencing symptoms over the course of weeks or even months. With timely treatment, a realistic recovery timeline for recovery from buristis can range from 6 weeks to 6 months. Your specialist shoulder physiotherapist will be able to provide a more accurate timeline after a physical assessment of your symptoms.

Our Treatment Program for Shoulder Bursitis:

After a detailed physical assessment, the physiotherapist will decide the best course of treatment. Our comprehensive treatment approach is progressed over three stages:

Stage 1: Pain Management & Regaining Functional Range of Motion

Soft Tissue Therapy:

Stretching and soft tissue techniques used by shoulder physiotherapists help to mobilize the muscles around the shoulder and make it more flexible in its different movements. These treatments are very beneficial in improving function and reducing shoulder pain.

Load Management:

In some cases, especially with higher levels of pain, it is best to initially treat the shoulder by reducing load and minimizing movements. In those cases, the physiotherapist will prescribe a shoulder sling which will help to unload the shoulder and allow the initial inflammation to settle.

Exercise Therapy:

After the shoulder physiotherapist conducts a detailed assessment, a tailored exercise plan is developed as per the patients’ specific goals and physical demands. Exercises for treating bursitis include stretching and strength training. Stronger and more flexible muscles improve the shoulders biomechanical efficiency and help in preventing re-occurrence in the long term.

Shockwave Therapy:

Shock wave therapy is application of the sound waves to treat musculoskeletal conditions and has had promising results with treatment of shoulder conditions. Shockwave therapy is used to treat the initial pain and more importantly to promote protein synthesis to stimulate collagen synthesis and tissue remodelling.

Dry Needling:

Muscle imbalances in the shoulder play a major role shoulder dysfunction as it disrupts the normal biomechanics of the shoulder. This can result in painful areas called trigger points (knots) within the muscles. Although dry needling will not have a direct effect on the bursitis itself, it is very beneficial in treating the pain caused by these painful knots in the muscles

Stage 2: Muscle Activation and Retraining the Shoulder

Once the pain in under control, the physiotherapist will guide you on initiating an exercise program to improve shoulder function and prevent reinjury in the future. The exercise approach in based on:

• Rotator Cuff Strengthening

• Scapular Muscle Stability

• Stretching & Flexibility

Common Exercises for Bursitis (Download)

Stage 3: Prevention of Re-injury

The last phase of the treatment is a targeted exercise program set by the physiotherapist for you to do at home or in the gym. The training program is put in place to keep the muscles around the shoulder strong and mobile to prevent recurrence of your symptoms.

Frequently Asked Questions

What causes bursitis?

Overuse and repetitive motion are usually the commonest cause of bursitis. In general, however, bursal irritation can be roughly divided into three groups.

Chronic Bursitis: This type is the most common type of bursitis and develops over time due to repetitive irritation of the bursa and most people who experience symptoms may start to feel pain over time for no apparent reason.

Infected Bursitis: In this type, the bursa becomes infected with bacteria and is considered a serious condition that requires immediate medical attention. Your physiotherapist and GP will be able to assess and diagnose the type of bursitis.

Traumatic Bursitis: The last type, typically seen in athletes and active individuals. Although not the most common type of bursitis, it occurs due repetitive rubbing of an extremity again a hard surface, such as protective padding.

How is Shoulder Bursitis Diagnosed?

Physiotherapists can often diagnose bursitis based on a medical history and detailed shoulder assessment. Scans and imaging is done to confirm a clinical diagnosis. Common imaging includes ultrasound scan or MRI to view the soft tissues in the shoulder including the bursa.

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