Therapeutic exercise for shoulder bursitis
Bursitis is a painful condition named after inflammation of the small fluid-filled sacs (synovial bursae) that provide cushioning for the bones, tendons and muscles around the joints. It occurs most commonly in the shoulder, hip and elbow.
Causes of shoulder bursitis
Shoulder bursitis can be caused by a variety of factors, including:
Overuse or overuse of the shoulder: repetition of certain shoulder movements, such as lifting heavy objects or playing throwing sports, can cause irritation and damage to the bursa.
Shoulder injuries: Traumatic injuries, such as falls or direct impacts to the shoulder, can damage the bursa and cause inflammation.
Rheumatic diseases: Diseases such as rheumatoid arthritis or gout can increase the risk of developing shoulder bursitis.
Infections: Bacterial or viral infections in the shoulder can cause inflammation of the bursa.
Previous shoulder surgery: Shoulder surgery can irritate the bursa and cause bursitis.
Improper posture: Improper posture while working or sleeping can put pressure and stress on the shoulder, which can contribute to bursitis.
Pain management
Patients should work with their doctors and physiotherapists to develop a personalised and effective treatment plan for their specific situation. Pain management for patients with shoulder bursitis may include a variety of strategies, from medications to physical therapy to lifestyle changes.
Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as ibuprofen and naproxen can help reduce inflammation and pain in patients with shoulder bursitis. However, these drugs can have side effects, such as stomach upset, so it is important that patients talk to their doctor before taking them.
Heat or cold therapy: Heat or cold can provide temporary pain relief for patients with shoulder bursitis. Heat therapy, such as hot baths or hot packs, can help increase blood flow and reduce shoulder stiffness. Cold therapy, involving the use of cold packs or ice, can reduce inflammation and pain.
Corticosteroid injections: In some cases, doctors may recommend a corticosteroid injection into the inflamed bursa. Corticosteroids can reduce inflammation and pain in the shoulder, but the relief may be temporary and there may be risks associated with prolonged use of corticosteroids.
Lifestyle changes: Patients with shoulder bursitis may need to make lifestyle changes to reduce pain and prevent inflammation. This may include making adjustments in the way they lift heavy objects, changing their sitting or desk posture, or avoiding activities that exacerbate pain.
Physical therapy: Strengthening and stretching exercises can help improve shoulder mobility and reduce pain. In addition, physical therapists can provide massage techniques and manual therapy to reduce inflammation and pain.
Therapeutic exercise based on the evidence
Several studies suggest that therapeutic exercise can be an effective strategy for improving shoulder pain, mobility and strength in people with shoulder bursitis.
For example, a study published in the journal *BMC Musculoskeletal Disorders in 2010 found that therapeutic exercise was effective in reducing pain and improving function in patients with chronic shoulder bursitis.
In addition, a meta-analysis published in the journal Clinical Rehabilitation in 2017 that analysed the results of several studies on the use of therapeutic exercise in people with shoulder pain found that therapeutic exercise was effective in improving shoulder pain and function compared to other interventions or no treatment.
Exercise protocols for shoulder bursitis
Therapeutic exercises can be an important part of shoulder bursitis treatment, but it is important to work with a physiotherapist to develop a safe, personalised exercise programme. Here are some examples of therapeutic exercises for shoulder bursitis, backed by evidence:
Stretching exercises: Stretching exercises can help relieve tension in the shoulder muscles and reduce pain. A study published in the Journal of Shoulder and Elbow Surgery found that stretching exercises significantly improve shoulder function and reduce pain in patients with shoulder bursitis. Some effective stretching exercises include:
Wall Stretch: To do this exercise, place the affected hand on the wall at shoulder level and turn your body slightly to the other side. Hold the position for 15-30 seconds and repeat several times.
Butterfly stretch: To do this exercise, raise the affected arm and bend your elbow to place your hand behind your head. Then use the opposite hand to pull the elbow back and hold the position for 15-30 seconds.
Strengthening exercises: Strengthening exercises can help improve shoulder stability and range of motion. A study published in the Journal of Orthopaedic & Sports Physical Therapy found that rotator cuff strengthening exercises significantly improve shoulder function and reduce pain in patients with shoulder bursitis. Some effective strengthening exercises include:
Lateral raises: To do this exercise, hold a dumbbell in each hand and raise your arms out to the sides until they are parallel to the floor. Hold the position for a few seconds and then slowly lower your arms. Repeat several times.
External rotation with resistance band: To do this exercise, attach a resistance band to a door or stationary object and hold the end of the band in the affected hand. Then rotate the arm outward, keeping the elbow against the side of the body. Repeat several times.
Monitored therapeutic exercise between sessions What does it involve?
Patients are often encouraged to perform independent therapeutic exercise between face-to-face physiotherapy sessions as it can be important for recovery from shoulder bursitis. Regular therapeutic exercise can help maintain shoulder strength and flexibility, improve circulation and reduce pain and inflammation.
Until now, it was not possible to know for sure if the patient was performing the exercises between sessions or if they were being performed correctly. However, thanks to monitoring platforms such as ReHub, the patient can perform the exercises at home or at work and receive real-time corrections for correct execution, which can help advance the recovery process. In turn, this allows the physiotherapist to receive a detailed report of the execution of the therapy remotely through the same platform. ReHub goes further in monitoring and allows other parameters to be measured that allow the therapist to have a 360º control of what the patient is doing remotely, such as:
– Adherence to treatment, so that the professional can know if the patient is following the therapy/recommendations assigned to him/her.
– Sending approved questionnaires, which include parameters such as perceived mobility, pain or discomfort, mental state, in order to provide information both at a general level of quality of life and at a specific level of the area that is subject to treatment.
– Pain monitoring, important as it helps the professional to determine the adequacy of the rehabilitation programme.
– Range of Motion and Range of Strength
– Patient satisfaction, which is determinant and conditions their motivation and performance.
More than 2900 cases of shoulder bursitis treated with ReHub
On the ReHub telerehabilitation platform, the practitioner has pre-designed exercise protocols for shoulder bursitis, and can also create his or her own exercises and protocols.
Here are some recommended exercises for shoulder bursitis with ReHub.
What do patients say?
A few months ago, Alicia suffered a shoulder injury. Shortly after starting her face-to-face rehabilitation sessions through her DKV insurance, she was offered to do exercises at home with ReHub between sessions. Alicia told us that the experience was very positive. With ReHub, she was able to continue her rehabilitation treatment outside the clinic, felt comfortable and safe, and has been able to significantly improve the recovery of her shoulder.
In addition, therapeutic exercise can be an effective way to manage pain. Therapeutic exercise can help release endorphins, which are natural chemicals that the body produces to relieve pain and improve mood.
the body produces to relieve pain and improve mood.
It is important to work with a physiotherapist to develop a therapeutic exercise programme that is appropriate and safe for your individual situation. The physiotherapist can help adjust the exercise programme as recovery progresses and can provide guidance on how to perform the exercises correctly to avoid further injury.
