One of the most common things I hear as a physiotherapist working with shoulders is that my patients have previously been told that they have bursitis - an inflammation of the bursa between their acromion (the tip of the shoulder) and the humerus (the upper arm bone). Often these patients come equipped with a scan on their initial appointment and have previously tried EVERYTHING - they've had cortisone injections (which help for a little while before the SAME PAIN returns some time later), they've had massage, physio, chiro or a blend of all of these where often they have received soft tissue work around the shoulder aimed at easing their pain but nothing has succeeded long term and they are resigned to a life of shoulder pain and limited activities!
Sound familiar? Then this 5 minutes of reading will be an INVALUABLE INVESTMENT in yourself!
BUT, and trust me when I say this, you don't have to accept defeat and put up with shoulder pain whilst giving up doing what you LOVE!
Your shoulder pain can definitely be fixed! Likely you are still unsure whether to believe this or not, so let's start by discussing the anatomy of the shoulder and, from there, how effective, deliberate and individualised treatment can be your saving grace...
ANATOMY OF THE SHOULDER
As you can see in the diagram above, the only attachment of your arm to your body directly is via your shoulder blade! AND there isn't much room between the upper arm bone and the acromion, when you take into account a whole lot of tendons passing through that space as well. What this means for the bursa in your shoulder is that, at the best of times, there's not a whole lot of space for it! And to add to this when you raise your arm you decrease this space even more!
So to combat this and prevent your bursa from being continuously caught between these two bones your shoulder blade will rotate upwardly, creating more space and thus allowing you to have the incredible shoulder range you do!
It's impossible to discuss the shoulder without mentioning the rotator cuff, which is made up of 4 small muscles wrapping around your shoulder to form the shoulder joint capsule, but all you need to know for now is that their job is, ironically, not to rotate at all but rather to centralise the upper arm bone in the shoulder socket throughout all ranges of movement.
SO WHAT DOES THIS MEAN FOR YOU?
What this means for you is that the SOLUTION to your shoulder pain lies in the function of your shoulder blade! To overly simplify this, if you can improve the upward rotation of your shoulder blade throughout shoulder movements then you will increase the space for your bursa to move freely and, because the bursa is no longer being constantly jammed between the two bones, it will settle down and become pain free! And if you continue the rehabilitation work to improve the upward rotation of your shoulder, your bursa symptoms will be gone for the long haul!
This is why we say bursitis is a symptom and NOT a condition!
As you now understand, your bursa is inflamed as a result of being constantly squished between your arm bone and your acromion BECAUSE your shoulder blade is failing to complete its role correctly, which we aptly name scapular dsykinesis; now there's a real diagnosis!
If you haven't guessed by now, the reason most treatments you've tried have failed is because they are purely aimed at your bursa and thus provide only short term relief because, no matter what you do to calm down the bursa, if you then go and continually aggravate it by jamming it between those two bones it will eventually come back! Often sooner rather than later too!
It makes sense doesn't it?
We'd love to hear your thoughts in the comments below and if you'd like to find the long term solution to your shoulder pain then contact us on (08) 7226 9901 or book online!
We love to help people just like you to return to doing what you love, PAIN FREE!