Tendons, ligaments, muscles and skin need to be able to glide smoothly over bones during movement. In order to prevent friction and irritation on these structures, we have small, slippery fluid sacks in our body called bursa. There are 150 bursae in the body, and six in the shoulder. The sub-acromial bursa is the one most commonly affected in shoulder bursitis.

Bursitis (meaning inflammation of the bursa) is characterised by swelling, thickening and of course inflammation of the bursa. In the shoulder this is often caused by a sudden increase in overhead workload, long-term repetitive overhead work, or infection.

Bursitis of the shoulder often presents with pain down the side of the arm or at the front of the shoulder. Pain can be worse at night and with reaching forward or to the side. The bursa can swell and cause a bump in the side of the arm, as well as redness and heat.

What is important to know is that often bursitis is a symptom of an underlying issue in your shoulder, such as instability, rotator cuff pathology, or other pathology. A common story we hear is that o people having a steroid injection in their shoulder that settles their pain temporarily, but manages to return after a few days or weeks. This is because the injection has only treated the symptom and not the cause of their bursitis.

It is really important that your therapist is able to identify the source of your pain or instability, and the complexities associated with diagnosing shoulder pain.