1. This shows the anatomy of the shoulder, including the subacromial bursa. The subacromial bursa cushion and reduce friction between the acromion of the scapula and the tendons of the rotator cuff.
2. This is an X-Ray showing bursitis of the shoulder.
Bursa are fluid filled sacs that reduce friction and cushion the tissues within a joint. The bursa in the glenohumeral joint (shoulder) lies underneath the acromion of the scapula and has the potential to become inflamed (bursitis).
Types of Bursitis
There are three types of bursitis: chronic, infected, and traumatic. Chronic is the most common, and is caused by repetitive overhead movements that increase friction between tissues, that can in turn irritate and inflame the bursa. Infected bursitis is caused by bacterial infection, and traumatic bursitis is caused by acute trauma, which often occurs in sports.
Some common symptoms of bursitis are pain with movement, stiffness, and swelling. Chronic bursitis is characterized by swelling, while infected bursitis involves more severe symptoms like pain, inflammation, tenderness, fever and swelling spreading throughout the body. Traumatic bursitis can be characterized by the immediate onset of swelling and tenderness.
All types of bursitis can be treated with rest, ice, immobilization and over the counter pain medication for the pain and inflammation. Antibiotics can help with infected bursitis, and compression and padding can help with traumatic bursitis. If the bursitis is severe, steroids, joint aspiration, or arthroscopy may be helpful.
Most bursitis can be treated non surgically, as it is mostly a chronic issue that flares up occasionally. Finding out what aggravates the pain and avoiding or modifying those activities can help prevent further pain an injury.
Risk Factors and Prevention
Risk factors for subacromial bursitis include repetitive overhead activity such as throwing, swimming, and weight lifting. Additionally, chronic diseases such as diabetes, rheumatoid arthritis, kidney disease, and thyroid diseases are also associated with increased risk for bursitis. Studies also show a relationship between increasing age and increased risk for subacromial bursitis.
To prevent subacromial bursitis, avoid or modify behaviors that put pressure on the shoulders. Ensure proper biomechanics while lifting heavy loads and allow for adequate breaks with any repetitive overhead activity.
It is important to incorporate a warm up and stretching program, as well as exercises to strengthen the structures of the glenohumeral joint to prevent irritation of the subacromial bursa and prevent injury.
Attribution for Images
1. OpenStax College. “Shoulder Joint”. Wikimedia Commons, 19 May 2013, https://commons.wikimedia.org/wiki/File:914_Shoulder_Joint.jpg.
2. Lengerke. “Phs-calc”. Wikimedia Commons, 29 June 2010, https://commons.wikimedia.org/wiki/File:Phs-calc.jpg.
3. Oleg Bkhambri. "Kazan 2015 - Katie Ledecky swims to 1500m gold.JPG". Wikimedia Commons, August 4, 2015, https://commons.wikimedia.org/wiki/File:Kazan_2015_-_Katie_Ledecky_swims_to_1500m_gold.JPG.
4. Sandro Halank. “2018-10-11 Snatch (Weightlifting Girls' 58kg) at 2018 Summer Youth Olympics by Sandro Halank”. Wikimedia Commons, 11 October 2018, https://commons.wikimedia.org/wiki/File:2018-10-11_Snatch_(Weightlifting_Girls%27_58kg)_at_2018_Summer_Youth_Olympics_by_Sandro_Halank%E2%80%93118.jpg.