Shoulder pain due to rotator cuff tendonitis or bursitis is a relatively common problem, but fortunately one that can respond well to treatment. Firstly, a quick anatomy lesson. The rotator cuff is actually made up of four muscles which hold the head of the humerus (upper arm bone) in place and lift the arm. The supraspinatus muscle is the one most commonly inflamed or torn. The subacromial bursa is a small fluid-filled sac that reduces the rubbing of the tendons beneath a structure called the coracoacromial arch. Tendonitis occurs when the rotator cuff tendons become inflamed, and bursitis occurs when the bursa becomes inflamed due to compression inside the coracoacromial arch. So whilst the two conditions are different, given the close proximity of the bursa to the rotator cuff tendons, they will often become inflamed simultaneously.
Causes of inflammation of the rotator cuff tendons and bursa include overuse (particularly overhead activities e.g. throwing, swimming, painting ceilings), weak muscles, improper throwing/swimming technique, strenuous training e.g. one hard throw or weight lift, previous shoulder injuries, and direct trauma e.g. fall onto the shoulder.
Treatment for both conditions is the same, and aimed at reducing the inflammation and swelling. Ice is important especially in the first 48 hours after injury and after any activities which have caused the pain to flare up. Rest is crucial, avoiding activities which make the pain worse. Your GP may prescribe anti-inflammatory medication to help reduce the pain. Osteopathic treatment may also help with this by reducing muscle spasm and improving lymphatic drainage of the area. We can also advise you on exercises to do to keep the shoulder moving, address any muscle imbalances which may be contributing to the problem, and help restrengthen the shoulder.