Patient Education
Shoulder Bursitis
(Shoulder Impingement, tendinitis)
What is it?  
Rubbing of the rotator cuff and the top part of the shoulder blade causes shoulder impingement syndrome, which can begin with participation in activities that require excessive overhead motion.

Shoulder impingement involves one or a combination of problems including inflammation of the lubricating sac (bursa) located just over the rotator cuff, a condition called bursitis; inflammation of the cuff itself, called tendinitis; and calcium deposits in tendons caused by wear and tear or injury.

A torn rotator cuff is a potential outcome of shoulder inmpingement, which may be caused by contnuing overhead activitiy despite bursitis or tendinitis, or by falling on or twisting the arm.
   
Who gets it?  
Athletes, industrial workers, home maintenance buffs and zealous gardeners are especially prone to shoulder impingement syndrome. Bursitis: Frequent extension of the arm at high speed under high load (like pitching a baseball) can cause bursitis. Nonsports activities ( i.e., painting, hanging wallpaper or drapes or washing windows) also can cause it. Medical research shows that the older you get, the more likely you are to deveolp bursitis.

Tendinitis: This develops over time and is likely to occur when a person whose muscles are not in good condition starts an overly aggressive training program. In younger athletes, the causees of tendinitis are similar to those of bursitis. Tendinitis can be harder to pinpoint in older individuals

Torn Rotator Cuff: Professional athletes can suffer torn rotator cuffs, but the injury is most common in members of the genearl public over age 40. 		 
   
What are the signs and symptoms?  
Many people live with rotator cuff tears and have no symptoms. Others have severe pain and weakness with small or even partial-thickness tears. Tears do often progress and get bigger if not treated. Rotator cuff arthropathy is a condition that is basically bad shoulder arthritis that can result from neglected rotator cuff tears. Also, the muscles of the rotator cuff can turn into fat or scar after long-standing rotator cuff tears. These are good reasons to have your doctor evaluate and treat shoulder pain or weakness earlier rather than later.  
   
What is the treatment?  

Therapy is effective for this condition. Medicines like aspirin, Tylenol, Motrin and other anti-inflammatories may help with the symptoms. An injection given in the shoulder by your doctor can often resolve this problem. Sometimes 2 or even 3 injections might be necessary. Surgery is very effective, as the pinching bones are smoothed out and the rotator cuff is repaired.

 

 

  
Do I need surgery?
Many patients do not need surgery for this, as they often respond well to therapy, medicines and injections.
 
What type of surgery are we talking about?  
If injections, therapy, and medicines don't work, surgery may be recommended. It is usually an outpatient surgery, meaning you go home the same day as surgery. It takes about an hour, and is done through 2 to 4 very short incisions which are often barely visible after they are healed. After the surgeon incises the skin, the bones are smoothed and the tear is repaired or reconstructed. The surgery is usually done with an arthroscope, which is a small pencil-sized camera that can look into the joint and be used with other small instruments to minimize the incisions used for surgery.

A high percentage of patients have resolution of the problem after surgery, and there are very few complications, making this a very safe and effective procedure. You will wear a sling for 3-6 weeks, and do therapy for 2-3 months to regain motion, strength, coordination, and endurance of the whole arm.



arthroscopic views inside the shoulder
 
Is surgery safe?
Your surgeon will discuss the risks with you, but it is a very safe and effective procedure.
 
How long would I be out of my job after surgery?  
You will be sent home with a sling. We use several methods of post-operative pain relief that are very effective. You should move your wrist, hand, and fingers the day of surgery, as this helps prevent and reduce swelling and stiffness. The stitches are removed in the office in less than 1 week. Jobs with clerical or light-type of work can be resumed within 1-2 weeks, heavier duty-type jobs such as manual labor can be done after 2-3 months in most cases. Many people have returned to their jobs the day after surgery - it really depends on the job type more than anything.