Like anything that has its own terminology shoulder pain is confusing until someone can break it down. The interesting thing is that almost all of those above can be caused from similar issues. Let me explain.
Bursitis is inflammation of the bursa. Yes you can get a steroid shot to put out the inflammation and the pain. But, you did not figure out the cause of the friction or correct the cause – so it could come back again. The shot is helpful to put the fire out, but be mindful if the bursitis was caused from tight muscles or a tight joint creating the friction and irritation of the bursa it can return. In fact, bursitis can be from several reasons: tightness in certain areas (usually chest, shoulders, and thoracic spine) AND from the rotator cuff not doing its fair share of the work load. We have to teach the rotator cuff and shoulder blade muscles to work together again. And many times without meaning to, people will use their neck muscles to compensate for the rotator cuff. Sometimes during exercises they found on YouTube or Google. This will usually lead to more shoulder pain. Don’t get me wrong I use YouTube all the time for do it yourself projects but sometimes consulting a professional is worth it.
Remember Last Week?
If you read last week’s write up about Bill you will recall that he had tightness in his chest, shoulders, and upper back. These changed the position of the shoulder and limited space in the shoulder joint causing “pinching” on the rotator cuff. This tendon friction is called “impingement syndrome.” So you can see bursitis and impingement can often have similar causes. The point is we have to evaluate each “medical diagnosis” separately to find YOUR causes. They are often slightly different from the next person walking in with “impingement.” And your posture, flexibility, strength, coordination and anatomy are all variables that we need to account for to develop a successful plan. This may surprise you but you can even get impingement in the shoulder due to the shoulder being unstable. Remember the shoulder is like a ball and socket type joint. The ball part of your shoulder may be too sloppy – moving around too much instead of it staying in the center of your shoulder joint. When the ball part moves around too much it can pinch on tissues with certain arm motions.
What About Tendonitis?
So we covered impingement and bursitis… how about tendonitis in the shoulder? Tendonitis is inflammation of the tendon. This can happen from overusing the shoulder or a sudden new activity on the tendon. The tendon attaches the muscle to the bone. For example, if you suddenly exert more force lifting an object a few times you could irritate the tendon causing tendonitis. I would say many patients are surprised that tendonitis can come on with only one day of an activity like weed wacking or moving heavy rocks etc. I recently had a bout of tendonitis from using a rope swing at my parent’s lake home. It was fun and it was only about 6x on 3 different days but my left elbow starting hurting. The left elbow was not “conditioned” to suddenly handle my body weight in an extended (weak position). Tendonitis can also come on from repetitive motions in a poor posture or position. Many times shoulder pain from tendonitis is due to overuse at shoulder height or above. However, most people don’t feel like they did too much. They will acknowledge it was an activity that was out of their routine and likely not strong enough for.
And Of Course, Arthritis
And of course let’s briefly talk about arthritis in the shoulder. Arthritis in the shoulder often produces bone spurs in the shoulder. Can you picture a piece of bone sticking into the shoulder joint (the bone spur)? Can you see how a bone spur might cause “pinching” in the shoulder? Or create friction and rubbing of the bursa and even start to cause micro tears in the rotator cuff tendon? Arthritis in the shoulder joint can cause aches and stiffness that needs CORRECT daily stretching and range of motion.
I hope that gives you some clarity on shoulder pain from bursitis, tendonitis, & arthritis and that each medical diagnosis needs to account for YOUR specific posture, flexibility, strength, anatomy, recent activities and postures/positions to solve the root cause of your medical diagnosis. We are happy to help! Call us at (360)-456-1444 or email us at email@example.com with any questions or to see if therapy is right for you!
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