By Hoba Pain and Motion Blog June 3, 2021

What is a Bursa?

Bursa is a small fluid-filled sac that cushions the bones, tendons, or muscles. It is a slippery sac that reduces friction between the surfaces of a bone and soft tissue. Bursa helps bones’ tendons, muscles, and skin glide over bone during joint movement.

What is a Bursitis?

When a bursa is not irritated or inflamed, joints move smoothly and pain-free. If a bursa becomes inflamed or irritated, it’s called Bursitis and the joints movements become painful. The most common areas for bursitis are the shoulder, hip, and elbow.

Where is the Acromion process?

The clavicle (collar bone) has 2 joints a medial (to sternum) and lateral end (to the acromion of the scapula-shoulder). The acromion (from Greek: akros, “highest”, ōmos, “shoulder”, plural: acromia) is a bony process on the shoulder blade. Together with the coracoid process, it extends laterally over the shoulder joint. The acromion is a continuation of the scapular spine and hooks over anteriorly.

Subacromial bursa - Acromion process anatomy — Subacromial bursa – Acromion process anatomy

Etiology of Subacromial bursitis:

Trauma and accident
Inflamed joint: i.e. arthritis, gout.
Overload: the repetition of a specific movement or motion too often can lead to the inflammation of the bursa because of the friction between the bursa on the one hand and another structure on the other hand.

Chronic irritation
Upper extremity muscle weakness
Overuse of the adjacent shoulder
Degeneration of muscle tendons
Calcium deposition
Adjacent inflammation of the Supraspinatus tendon
Glenohumeral instability (excessive movement of the joint)
Degeneration of the acromioclavicular (AC) joint
Tears of the surrounding rotator cuff
Impingement by the coraco-acromial ligament
Coracoid impingement
Impingement on the posterosuperior aspect of the glenoid

Bursitis could also be related to some professional activities (e.g. painter, …), although, this is not always the case in shoulder bursitis.
Bursitis often develops secondary to injury, impingement, overuse of the muscle, or calcium deposits.

Symptoms of Subacromial Bursitis:

Feel achy or stiff
limitations in the range of motion
Hurt more when you move it or press on it
Might look swollen and red

The Subacromial bursitis pattern of symptoms may occur in relation to rotator cuff tears, an impingement syndrome, frozen shoulder, or a systemic inflammatory disorder such as polymyalgia rheumatica (PMR) or rheumatoid arthritis (RA).
Scapulothoracic Bursitis results from the mechanical pressure and friction between the superior-medial angle of the scapula and the adjacent ribs. Pain and a “popping” sensation are typical complaints. Aggravating activities include repetitive movements such as working overhead, reaching up and forward, or doing pushups. Local tenderness and palpable crepitus are characteristic. An effusion or hemorrhage into the area may be seen on MRI.[Source: Physio-pedia.com]

What should I do?

Consult your doctor if you have the symptoms

Osteopathy for Subacromial Bursitis

Osteopathy is a gentle hands-on practice and applies a variety of techniques like shoulder joint mobilization, soft tissue therapy for shoulder and scapula, deep stretches, and myofascial releases. Osteopathy can reduce pain and inflammation in the bursa, increase the Range of motion, and increase blood flow. Osteopathy is a slow process and it usually takes a few sessions to see the results.