[gap height=”30″]Shoulder Bursitis

Causes and Best Treatment Options For This Common Cause of Shoulder Pain


Shoulder bursitis is a common cause of shoulder pain characterized by pain on the top of the shoulder that is often exacerbated by lifting and reaching with the arm.  In many cases shoulder bursitis can also be painful at night and interfere with sleep.
While almost everyone has heard of shoulder bursitis very few people really understand what it is or what to do to best treat this common cause of shoulder pain. So in this article I will provide a brief review of shoulder bursitis, including….

  1. Where the shoulder bursa is and what it does
  2. How does shoulder bursitis develop
  3. The best shoulder bursitis treatment options


Basic Anatomy of the Shoulder and Shoulder Bursa

To understand shoulder bursitis we need to first look at the basic anatomy of the shoulder joint, which is classified as a standard ball-and-socket joint. It consists of the the round surface of the upper arm fitting into the concave surface of the shoulder blade. Located directly above the shoulder joint is the acromial arch, which acts as a bony roof for the shoulder joint to protect it during a fall or trauma.

However, unlike the hip joint (the other ball-and-socket joint of the body) the concave surface of the shoulder blade is not very deep.  As a result the round head of the upper arm will have a tendency to slide within the socket as the arm moves.  This sliding can damage the shoulder so to prevent this from happening the body relies of a specialized set of muscles known as the rotator cuff to hold the upper arm centered within the socket.


rotator cuff problems - line of action

The rotator cuff is responsible for holding the round surface of the upper arm tight against the socket of the shoulder blade.

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The shoulder bursa is a small, fluid-filled sack located between the rotator cuff tendons and the overhanging acromial arch. This bursa acts like a cushion and helps the rotator cuff muscles to freely move and slide under the acromial arch as the arm moves.



The shoulder bursa is a small fluid filled sac located on the top of the shoulder between the rotator cuff muscles and acromial arch formed between the acromion and clavicle.

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Shoulder Bursitis Pain and  Injury

The problem is that these rotator cuff muscles are relatively small and have to work hard to control and stabilize the shoulder with even basic activities that involve lifting, pushing, pulling, or reaching with the arm.

The demand on these muscles is even greater with physically demanding jobs or athletic activities such as swimming, weight lifting, or throwing sports.

Over time , particularly with more physically demanding jobs or athletic activities these rotator cuff muscles can become strained, which over time  can develop into small scale tissue damage known as micro-trauma.

This repetitive strain injury cycle can continue and build up into more painful rotator cuff problems such as muscles strains, tears, or tendinitis.

When this occurs not only can the rotator cuff muscles become tight and painful (this is why shoulder bursitis usually begins as tightness or a mild ache in the shoulder) but it can begin to damage the shoulder bursa as well.

This damage can occur in two ways….

First, as the rotator cuff becomes inflamed it can also cause inflammation in the bursa due to the fact that that they are in close contact with each other.  The inflammatory exudate will basically spread into the bura and this inflammation in the bursa will sensitize pain receptors in the bursa.

Second, as the rotator cuff becomes damaged it cannot keep the head of the upper arm centered properly within the shoulder socket. When this happens the upper arm to slide up towards the acromial arch movements.  Since the shoulder bursa is located above the rotator cuff it becomes pinched between the upper arm and acromial arch.  When this happens repeatedly the bursa becomes inflamed and painful.


shoulder impingement

If the upper arm is not held tightly against the shoulder blade the arm will slide within the socket causing the shoulder bursa to become pinched.

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Best treatment Options for Shoulder Bursitis

We have found the best way to treat these conditions is with a combination of Active Release Techniques (or ART for short), along with specific home exercises to improve the health and strength of the rotator cuff muscles with specific home exercises.

I have discussed Active Release Techniques in depth in other articles and other areas of our website, but for the sake of being inclusive I will provide a brief description here as well.


What is ART


Active Release is a hands-on treatment method to address problems in the soft tissues of the body, including the muscles of the shoulder (remember, shoulder is almost always associated with problems in the rotator cuff).

What makes ART different from other treatments is that it is specifically designed to identify and treat scar tissue adhesions that build up and compromise muscle strength and flexibility.

These scar tissue adhesions represent new connective tissue that forms in and around the rotator cuff muscles after damage and microtrauma. It is the bodies attempt to heal and stabilize the damaged muscle fibers.  However, these adhesions will also make the muscles tight and weak.

As a result they need to be released to get the rotator cuff muscles healthy again.  We have found over and over again that this works better, and faster than other methods of stretching or muscle release therapy. (You can learn more about how ART can help shoulder pain here).

In fact, with ART treatment we are able to develop a very acute sense of touch and feel.  This not only helps us to know exactly which muscles or ligaments are the problem but also helps improve treatment results by allowing us to be very specific with treatment.

This is something that cannot be done with other treatment methods or with stretching or exercises which target the shoulder muscles in a more generalized fashion. As the adhesions are released with ART treatment specialize shoulder pain exercises can then be used to strengthen the rotator cuff muscles and stabilize the shoulder joint.

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How Long Does It Take to Resolve Shoulder Bursitis?

One of the best things about ART is how quickly results are felt. In our experience the majority of shoulder bursitis cases respond very well to ART treatment, especially when combined with the appropriate home exercises.

Although each case is unique and there are several factors that will determine the length of time it will require to fully resolve a condition, we usually find a significant improvement can be gained in just a few treatment.


Get Relief From Shoulder Bursitis

To learn more, or to book an initial appointment to see if ART may be able to help with your shoulder bursitis simply call our office at (905) 685-7227.

For general questions call our office or send us an email at info@graychiropractic.ca – one of our ART certified doctors will be happy to answer any questions you may have.

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