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The shoulder is a very complex joint and one that if injured can take months and months of long imperative rehabilitation.

There are numerous injuries that can take place in the shoulder such as a ligament sprain, subluxation, dislocation, fractures, cartilage tears, muscular tears and bursitis. One of the most common issues that clients present with is shoulder impingement or bursitis (inflammation of the bursa).

Subacromial bursitis is a condition caused by inflammation or swelling of the bursa. A bursa is very small fluid-filled sac. There are many bursas around the body and there role is to act as a cushion between bones and tendons and/or muscles around a joint. There designed to help reduce friction between the bones and allows freer movement. The subacromial bursa separates the upper surface of the supraspinatus tendon (one of the four tendons of the rotator cuff) from the acromial arch as seen in the above picture. The subacromial bursa helps the motion of the supraspinatus tendon of the rotator cuff in activities such as overhead work and if inflamed makes using the arm above shoulder height very difficult and very painful.

Inflammatory bursitis is usually the result of repetitive injury to the bursa, trauma to the supraspinatus tendon and possibly general injuries to the shoulder/ scapula region. Also, should the biomechanics fail in the shoulder movement, the gap in the acromial arch could be reduced and therefore the bursa could become irritated resulting in an inflamed bursa.

Subacromial bursitis is typically identified by pain when you move your shoulder or raise your arm over your head, swelling, tenderness, night pain especially when lying on the affected shoulder and possible an aching pain at rest.

Some common causes of shoulder bursitis are an injury of the shoulder or falling on your outstretched arm, older age group, infection and overuse of the shoulder in sports such as tennis, swimming and baseball, especially pitching and throwing. Overuse can also happen by doing activities that cause you to raise your arms over your head a lot. These activities include hanging wallpaper and painting the ceiling or pruning the garden.

The most important part of treating bursitis is to contact your local physiotherapist as soon as you can. The physiotherapist can diagnose the condition should it be bursitis and provide a range of treatment options for you to help reduce the shoulder pain as well as rehabilitate your shoulder so that it reduces the chances of it happening again.

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