Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Subacromial Bursitis

One large bursa in the shoulder is located between the supraspinatus muscle and the deltoid muscle and acromion process of the scapula. In its inflamed state the bursa is about the size of a golf ball. Inflammation
of the bursa (subacromial bursitis) commonly occurs.

Causes

– A fall or blow to the shoulder or a supraspinatus tendon rupture can cause bleeding into the bursa resulting in inflammation.
– Repetitive movements can cause bursitis which, in turn, causes accumulation of fluid in the bursa. The effusion causes tension in the tissues and pain in the anterior (front) and upper part of the shoulder and a thickening of the bursa.
– Inflammation in an adjacent tendon can easily spread to include the bursa.

Symptoms and diagnosis

– Pain occurs in the anterior, upper part of the shoulder.
– Impingement testing is positive.
– Tenderness is found on palpation.
– Sometimes the bursa feels ‘spongy’ on palpation.
– Examination using an arthroscope and/or bursography can confirm the diagnosis.
– Aspiration of the bursa can also be diagnostic.

Treatment

The athlete should:
– rest until the pain has resolved, and avoid pain-causing situations;
– apply local heat and use a heat retainer after the acute phase.

The doctor may:
– aspirate the bursa when bleeding or effusion is accompanied by pain;
– prescribe analgesic and anti-inflammatory medication;
– advise mobility exercises;
– administer a steroid injection and advise short-term rest in cases of chronic inflammation;
– use arthroscopic surgery to remove the bursa in chronic cases.

Healing

When bursitis is treated promptly, symptoms usually resolve in 2–3 weeks, after which sporting activities can be resumed.

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