Sub Acromial Impingement & Bursitis - Fact Sheet
What is Sub Acromial Impingement & Bursitis ?
Sub-acromial impingement is the mechanical irritation of either the supraspinatus tendon or subacromial bursa, resulting in pain and inflammation. These structures lie in the subacromial space (pictured) and are sensitive to friction and compression.
What causes it?
There are several factors which may contribute to this condition. These include:
• Tightness around the capsule which surrounds the shoulder joints
• Instability and excessive movements of the shoulder joint
• Weakness and/or damage to the muscles which control the shoulder blade, or the shoulder joint itself
• Other changes such as acute injury or labral tears (less common).
All these issues can lead to irritation of the structures in the subacromial space. These problems may be present for a while before pain starts to be felt. Repetitive movements, awkward positioning or strenuous work may cause these problems to be challenged, therefore causing irritation and pain in the shoulder.
Signs and Symptoms of Sub Acromial Impingement & Bursitis?
• Slow onset of pain, over a few weeks
• Pain at the front or top of the shoulder, which can refer down the muscles of the shoulder.
• Pain with overhead movement/activity
• Night pain can indicate inflammation of the subacromial bursa (bursitis)
Treatment of Sub Acromial Impingement & Bursitis ?
Activity modification: Identifying and modifying any activities involving the shoulder that puts it at risk of impingement. A rehabilitation program will aim to gradually get you back to these activities.
Strengthening Exercises: the KEY to rehabilitating sub-acromial impingement. Working on the strength and control of the shoulder blade muscles, and the strength of the rotator cuff will help improve the position of the shoulder girdle, increasing the subacromial space and reducing the chances of impingement.
Other interventions: some structures such as inflamed bursae or bone spurs can also reduce the subacromial space. If your clinical exercise program is not effective in reducing your shoulder pain after 7weeks or so, referral for imaging and/or corticosteroid injection may be considered.