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Rotator Cuff Tendinitis and Subacromial Bursitis

Rotator Cuff Tendinitis and Subacromial Bursitis

 

Understanding Your Shoulder Pain

Rotator cuff tendinitis and subacromial bursitis are common causes of shoulder pain. They often occur together and lead to discomfort during lifting, reaching, or sleeping on the affected side.

What Is the Rotator Cuff?

The rotator cuff is a group of four muscles and their tendons that help:

  • Lift and rotate the arm
  • Stabilize the shoulder joint

These tendons pass through a small space under a bony area called the acromion.

What Is Rotator Cuff Tendinitis?

Rotator cuff tendinitis occurs when one or more of the rotator cuff tendons become irritated and inflamed.

This is often caused by:

  • Repetitive overhead activity (reaching, sports, lifting)
  • Poor posture
  • Weakness in shoulder stabilizing muscles
  • Age-related changes

Symptoms may include:

  • Pain when lifting or reaching
  • Pain lying on the affected shoulder
  • Difficulty with overhead movements

What Is Subacromial Bursitis?

A bursa is a fluid-filled sac that cushions and reduces friction between tissues.
The subacromial bursa sits between the rotator cuff tendon and the bone above it.

If this space becomes irritated, the bursa can swell, causing:

  • Pain with overhead movement
  • Painful arc of motion
  • Tenderness at the top or outside of the shoulder

Often, bursitis and rotator cuff tendinitis happen at the same time.

First-Line Non-Operative Treatments

Most patients improve without surgery. Common treatments include:

1. Ice or Heat

  • Ice: reduces inflammation (10–15 minutes, 1–2x/day during flare-ups)
  • Heat: relaxes muscles before exercise (10–15 minutes)

2. Activity Modification

Temporarily avoid:

  • Repetitive overhead lifting
  • Heavy pushing or pulling
  • Exercises that cause sharp pain

You can stay active, just adjust painful movements.

3. Anti-Inflammatory Medications

NSAIDs (e.g., ibuprofen) may help reduce pain and swelling unless your doctor has advised otherwise.

4. Physical Therapy or Guided Exercise

Rehab focuses on:

  • Improving posture
  • Strengthening the rotator cuff
  • Improving shoulder blade control
  • Increasing flexibility in the shoulder

5. Corticosteroid Injection

If pain is severe or not improving, your doctor may recommend a subacromial steroid injection for short-term relief. This is typically a one-time injection to facilitate therapy and rehab, not a long-term solution.

Home Exercise Program

These exercises are designed to be done daily unless otherwise noted. Mild stretching discomfort and muscle soreness after exercise is normal. You will NOT damage your shoulder with good form, slow, and controlled exercises and stretches.

Warm-Up (Optional)

  • Apply heat for 10 minutes
  • Perform gentle pendulum swings

Stretches (2x/day)

1. Posterior Shoulder Stretch

  • Bring your affected arm across your body
  • Use the opposite hand to gently pull it closer
  • Hold30 seconds, repeat 3 times

2. Sleeper Stretch

  • Lie on your affected side
  • Bend your elbow 90° and rotate your forearm toward the floor using your other hand
  • Apply gentle downward pressure
  • Hold30 seconds, repeat 3 times

3. Doorway Chest Stretch

  • Place your forearms or hands on a doorway
  • Step forward gently until you feel a stretch across the chest
  • Hold30 seconds, repeat 3 times

Strengthening Exercises

(Do daily, unless soreness lasts more than 24 hours)

1. Scapular Squeezes

  • Sit or stand tall
  • Pinch shoulder blades together
  • Hold5–10 seconds, repeat 15–20 reps

2. Isometric External Rotation

  • Stand sideways to a wall
  • Keep elbow against side, bent 90°
  • Gently push the back of your hand outward into the wall
  • Hold5 seconds, repeat 10–15 reps

3. Isometric Internal Rotation

  • Stand at a wall corner in the same position as above
  • Push the palm inward against the wall / edge of the doorway
  • Hold5 seconds, repeat 10–15 reps

4. Wall Slides

  • Stand with back pressed against a wall
  • Bring back of hands and elbows into contact with the wall
  • Slide arms upward as high as comfortable while maintaining contact between hands and the wall
  • Focus on smooth motion and avoid shrugging shoulders (i.e. using the trapezius muscle)
  • Repeat10–15 reps

 

 

Recovery Outlook

Most patients improve over 6–12 weeks with consistent stretching, strengthening, and activity modification.
If symptoms persist despite therapy, additional testing or treatment may be recommended. Please never hesitate to schedule a consultation if you feel you are failing to improve.