Swimmer’s Shoulder Bursitis
Rotator Cuff Bursitis
The shoulder is a complex joint where several bones, muscles, and ligaments connect the upper extremity to the chest. The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint providing movement and stability to the shoulder. Inflammation of the rotator cuff tendons is called rotator cuff tendonitis or shoulder impingement and inflammation of the bursa that surrounds these tendons is called rotator cuff bursitis or shoulder bursitis. The inflammation leads to thickening of the tendons and bursa causing space reduction that may squeeze or compress the rotator cuff muscle between the acromion process of the shoulder blade and the humeral head of the arm. This compression results in pain, tenderness, swelling, warmth and redness in the shoulder. The combined condition of tendonitis and bursitis is called impingement syndrome and is more intense and severe than shoulder impingement.
Three bones, namely the upper arm bone (humerus), the shoulder blade (scapula) and the collar bone (clavicle) join together to make the shoulder joint.
The acromion is a protuberance of the shoulder bone or scapula. Ligaments are the thick strands of fibres that connect bone to bone. Ligaments connect the collar bone to the shoulder blade at the acromion process.
Bursa is a sac between the acromion process and the rotator cuff. It contains a lubricating fluid which prevents friction between the moving rotator cuff and the acromion.
Causes of Swimmer’s Shoulder Bursitis
Swimmer’s shoulder bursitis may be caused by repeated minor trauma such as overuse of the shoulder joint and muscles during swimming.
Diagnosis of Swimmer’s Shoulder Bursitis
Diagnosis involves physical examination by the doctor. X-rays are ordered to nullify other causes of the pain such as arthritis or to check if shoulder impingement is due to a bone spur. Soft tissues such as muscle and tendons cannot be seen by X-ray so an ultrasound or MRI scan may be ordered to see if shoulder bursitis or shoulder tendinitis is involved.
Your doctor may give an injection of an anaesthetic drug in the space below the acromion to see if it provides relief for the pain. If it does, it confirms that the pain was due to rotator cuff tendinitis or shoulder impingement.
Treatment of Swimmer’s Shoulder Bursitis
Inflammation of the shoulder bursa or tendons can lead to compression of the rotator cuff muscles resulting in pain and stiffness in the shoulder. The condition generally improves with conservative treatment of oral medications and muscle strengthening exercises. In some cases, a corticosteroid injection is administered in the shoulder. Rarely, surgery is required when conventional treatment doesn’t help to improve the condition.