Rehabilitation of Subacromial Bursitis

Subacromial Bursitis Rehabilitation

The following guidelines are for information purposes only. We recommend seeking professional advice before attempting any rehabilitation.

Aims of rehabilitation:

• Reduce initial pain and inflammation.
• Improve and maintain normal shoulder mobility and biomechanical function.
• Improve and maintain shoulder strength.
• Return to full fitness.

Before beginning a rehabilitation programme it is important to be aware that the athletes chance of the injury recurring are increased by any of the following:

• If they have an unstable shoulder joint. An unstable shoulder joint means that there is a lot of movement and weakness in the joint. If not sure, see a sports injury professional. Failure to recognize this may mean the injury is likely to recur.
• Poor technique or bad training habits. Overuse or training too hard is just as likely to cause injury as poor technique. If not sure, find a good coach.
• Weakness in the rotator cuff muscles.

Stage 1: To reduce the pain and inflammation.

• Apply cold therapy or ice to the shoulder. This will help reduce pain and inflammation. Apply ice for up to 15 minutes every hour, gradually reducing the frequency of applications as the shoulder improves.
• Rest the shoulder. Do not do anything that causes pain. Every time the athlete causes pain, they may be making the injury worse. If necessary, use a sling to restrict movement then do so but only for a few days.
• NSAID or anti-inflammatory medication (e.g. ibuprofen) may help in the early stages. Always check with your Doctor before taking medication if you are not sure.
• Apply sports massage therapy. Simply applying pressure to the tendon initially may be all that is needed. As pain reduces, cross friction techniques may be applied.

Stage 2: To re-establish range of motion and strength

(usually 5 to 7 days after injury)

• Range of motion is done through mobility exercises, gradually increasing the range of motion the joint will go through pain free and specific stretching exercises to stretch all muscles around the shoulder joint.
• Sports massage techniques can help to improve greatly the condition of the rotator cuff muscles, so allowing more joint flexibility and better response to strengthening exercises.
• Strengthening exercises concentrate more specifically on the external rotator muscles (the ones that rotate the arm out) and the scapular stabilizers (muscles that support the shoulder blade). It is also important to strengthen the whole joint.
• Strengthening exercises must be done pain free and in conjunction with stretching exercises.

Stage 3: To return the athlete to competition or specific training

• These exercises need to be specifically tailored to the athletes sport. For example throwers would start throwing a tennis ball against a wall. Five sets of 20 throws gradually increasing the number of sets and number of repetitions assuming no pain during, after or the next day.

How long will it take to heal?

• Obviously every injury is different, however the athlete is usually able to resume sports specific training after between 1 and 3 weeks.
• If the injury is neglected it can become chronic and be very difficult to treat resulting a cycle of rotator cuff injury and impingement of the shoulder joint.