Rotator Cuff Therapy Exercises

Rotator Cuff Bursitis

Rotator cuff bursitis is a specific condition that affects the bursa in the shoulder.

Bursitis has similarities to tendonitis of the rotator cuff in its causes, symptoms and treatment.

Because of these similarities rotator cuff bursitis is often difficult to diagnose.

That is not so great a problem as you would imagine because any rotator cuff therapy or rotator cuff rehab exercises are likely to improve the symptoms.

What is a bursa?

A bursa is a lubricated fluid-filled sac. Major bursae are located adjacent to the tendons and near the large joints, such as the shoulders, elbows, hips, and knees. They function as a gliding surface to help reduce friction between moving tissues of the body.


Bursa located in the shoulder joint

What is Bursitis?

Bursitis is an inflammation or irritation of the bursa, in this case, in the shoulder area. Bursitis can occur anywhere in the body near the joint areas.

The most common tendon areas that become inflamed are the elbow, shoulder, hip, knee, ankle, and heel. Of course, bursitis can and will vary with each person, as it strikes the areas you use and irritate the most.

What causes rotator cuff bursitis

A bursa is what cushions the tendons and helps to prevent friction between the tendons of the rotator cuff and the bones of the shoulder.

Unfortunately, constant rubbing of the tendon over the bone because of repetitive arm and shoulder movement can lead to friction. It is this repeated friction of the bursa that can lead to inflammation and irritation of the bursa itself. An obvious example would be repeatedly throwing a ball.

Another common cause is compression or squashing of the bursa. If this happens on a regular basis, especially if it is then made worse by movement, it can lead to the same irritation and inflammation.

For example, a person who sleeps on their shoulder and regularly compresses the bursa and who then moves in their sleep can bring on bursitis. This is why if surgery is required then an important part of that is rotator cuff decompression, to increase the available space.

shoulder impingement Shoulder impingement is a common cause of bursitis.

It is also possible for a bursa to become inflamed and irritated due to infection.

It is the least likely cause of bursitis as infection is particularly uncommon in the bursa of the shoulder.

Symptoms of rotator cuff bursitis

The symptoms of bursitis range from an ache in the shoulder to an excruciating pain on movement of the arm or shoulder. Generally the pain is felt in the upper shoulder or upper third of the arm and may radiate as far as the elbow.

This is often accompanied by a burning sensation around the whole joint. There is often an increase in pain directly related to how much the shoulder is used. There can also be stiffness in the area of the shoulder joint.

Treatment of rotator cuff bursitis

Treatment of bursitis is very similar to the treatment used for tendonitis of the rotator cuff.

In the specific case of rotator cuff bursitis however rotator cuff therapy is governed by the presence of any infection.

As stated above it is unusual for bursitis to be caused by an infection, this is normally caused by injury.

Bursitis that is not caused by infection can be treated in a very similar way to tendonitis of the rotator cuff.
  • 1. Stop what you are doing! If it hurts don't do it.

  • 2. R.I.C.E - Rest, Ice, Compression and Elevation

  • 3. Painkillers and anti inflammatory medication

  • 4. Take action to strengthen your rotator cuff and shoulder muscles.

  • 5. Slowly ease back into action.

Generally symptoms of rotator cuff bursitis should begin to lessen after three weeks or so with proper care.

Healing actually continues after this time for a total of at least six weeks.

If after 6 months the condition has not responded to treatment it is considered to be chronic and is much more difficult to treat.

Occasionally rotator cuff bursitis requires further invasive treatments, such as aspiration of the bursa fluid.

This involves the removal of the fluid with a syringe under sterile conditions and can often be performed in the doctor's office. Sometimes the fluid is sent to the laboratory for further analysis.

Bursitis can also be treated with an injection of cortisone medication into the swollen bursa. This is sometimes done at the same time as the aspiration procedure.

The cortisone is designed to reduce inflammation of the bursa and hence to reduce the associated pain.

Infectious or septic rotator cuff bursitis, which again is uncommon in the shoulder, requires a lot more evaluation and aggressive treatment.

The bursal fluid can be extracted and examined in a laboratory to identify the specific microbes causing the infection. Septic bursitis requires antibiotic therapy, sometimes intravenously, that is by way of a drip.

Repeated aspiration, see above, of the inflamed fluid may be required.

If this fails to cure the problem then the only other alternative is surgery. Surgical drainage and removal of the infected bursa sac, a process known as a bursectomy, may be necessary.

Generally, the shoulder joint functions normally after the surgical wound heals.

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