Shoulder Bursitis: A Complete Treatment Guide
What is Shoulder Bursitis?
Shoulder bursitis is a painful and often limiting condition caused by inflammation of the bursa — a small, fluid-filled sac that cushions and reduces friction between tissues of the shoulder. It most commonly affects the subacromial bursa located just beneath the acromion, the topmost bony part of the shoulder blade.
When irritated, the bursa can swell and press against the rotator cuff tendons or the acromion itself, causing impingement, inflammation, and a condition often termed subacromial pain syndrome. This pain is commonly triggered during overhead movements or pressure applied to the outer part of the shoulder.
Understanding bursitis is key to avoiding chronic discomfort, and early diagnosis and intervention are essential for successful management.
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Types of Shoulder Bursitis
Acute traumatic bursitis: Usually results from a direct blow or fall onto the shoulder
Chronic repetitive bursitis: Typically caused by overuse, especially in overhead activities
Infectious (septic) bursitis: Caused by bacterial infection and requires urgent medical attention
Our clinics in Richmond and South Yarra frequently manage chronic cases that develop silently over time due to poor posture and weak shoulder mechanics.
Common Symptoms of Shoulder Bursitis
Pain on the outer shoulder, especially when raising the arm
Pain worsening at night, particularly when lying on the affected side
Painful arc of motion (between 60° and 120° abduction)
Shoulder stiffness or weakness during lifting
A dull ache at rest, sharp pain during activity
Swelling or warmth over the top or side of the shoulder
Clicking, catching, or grinding sensations with certain movements
Symptoms can mimic other shoulder conditions, and accurate diagnosis is critical to effective treatment.
Is It Really Bursitis or Something Else?
Shoulder bursitis symptoms often overlap with other common conditions such as:
Rotator cuff tendinopathy or partial tears
Subacromial impingement syndrome
Adhesive capsulitis (frozen shoulder)
Labral tears (especially in athletes)
Acromioclavicular (AC) joint arthritis
At our clinics, we perform a detailed physical and functional assessment including:
Range of motion analysis (active vs passive)
Strength testing with resisted external rotation and abduction
Palpation of the subacromial space
Special tests like Neer’s, Hawkins-Kennedy, Empty Can, and Speed’s test
We also assess posture, scapular dyskinesis, and thoracic extension—all of which impact shoulder function.
In chronic cases or if no progress is made after 6–8 weeks, we may refer for imaging (e.g. ultrasound or MRI) to confirm the diagnosis and rule out more complex issues.
What Causes Shoulder Bursitis?
Repetitive overhead activity (e.g. swimming, painting, serving in tennis)
Office posture and prolonged sitting with poor ergonomics
Weak rotator cuff and scapular muscles
Poor thoracic mobility
Direct trauma or falls
Cervical spine dysfunctions contributing to altered shoulder mechanics
Previous injuries or surgeries that compromise joint stability
At our clinics, we often see bursitis in office workers, gym-goers, tradies, and weekend warriors alike. Education and movement correction form a critical part of your recovery journey.
Our Approach: Physiotherapy Treatment for Shoulder Bursitis
We combine the best available evidence with years of clinical experience to provide a tailored, multimodal treatment plan:
1. Manual Therapy
We utilise:
Maitland mobilisations to reduce stiffness and improve capsular mobility
Mulligan’s Mobilisation with Movement (MWM) for immediate pain-free movement gains
Soft tissue release to reduce tension in overactive muscles such as the deltoid and upper trapezius
Thoracic spine mobilisation to optimise shoulder mechanics
Manual therapy also helps modulate pain via neural input and improves joint proprioception.
2. Individualised Exercise Therapy
Progressive exercise rehabilitation is foundational. We tailor programs across four progressive phases:
Phase 1: Pain Management & Muscle Activation
Isometric exercises
Scapular setting drills
Thoracic mobility work
Phase 2: Strength Building
Rotator cuff strengthening (banded ER/IR, scaption lifts)
Closed-chain shoulder stability drills
Phase 3: Functional Reconditioning
Plyometric and proprioceptive tasks
Sport-specific or occupational exercises
Phase 4: Prevention & Maintenance
Ergonomic correction
Home exercise continuation
Lifestyle movement strategies
3. Shockwave Therapy
For stubborn, chronic cases or calcific bursitis, shockwave therapy can offer:
Non-invasive pain relief
Calcium deposit fragmentation
Enhanced local blood flow
Sessions are brief (10–15 minutes), with improvements often seen after 3–5 treatments.
4. Dry Needling
Dry needling offers rapid relief in cases where muscle trigger points contribute to pain. Common sites we treat include:
Infraspinatus
Deltoid
Levator scapulae
Upper trapezius
Needling is often used as an adjunct to therapy and may improve local blood flow, reduce neural sensitivity, and promote relaxation.
5. Taping & Support
We apply kinesiology tape or rigid scapular control tape to:
Offload inflamed bursal tissue
Improve proprioception
Reinforce postural cues
While temporary, it enhances comfort during early rehab and allows movement with less aggravation.
Ergonomic Advice & Lifestyle Changes
We provide education and workplace modifications including:
Chair and desk height optimisation
Mouse and monitor positioning
Advice on regular movement breaks
Postural cues and reminders
This is especially critical for those whose bursitis developed from cumulative strain, such as office-based clients and students.
Adjuncts to Care
Heat or ice therapy (depending on stage)
Ultrasound therapy for inflammation
Education around load modification, rest vs activity
Referral to GPs or sports physicians for corticosteroid injections in refractory cases (rarely required)
What to Expect During Your Physiotherapy Journey
Your treatment at our Richmond or South Yarra clinic will include:
Initial Consultation (45 mins):
Full movement, strength and postural assessment
Functional testing and diagnosis
Education and short-term plan
Treatment Sessions:
Hands-on therapy
Tailored exercises
Modalities like shockwave or dry needling if needed
Home Program & Monitoring:
Clear video-guided home exercises
Weekly or fortnightly reviews
Discharge Planning:
Final reassessment
Long-term prevention strategies
Our goal is to restore full pain-free function while teaching you to stay on top of your condition long term.
Recovery Timeframes & Outcomes
While recovery varies by individual, typical timeframes are:
Mild cases: 2–4 weeks
Moderate/chronic: 6–12 weeks
Severe or recurrent: 12–16 weeks
Key to successful outcomes:
Early physiotherapy intervention
Exercise consistency
Workplace and lifestyle adaptation
Avoiding re-aggravation
Our team continuously monitors progress and adjusts care accordingly. In >90% of cases, patients avoid injections or surgery.
Frequently Asked Questions
Q: How can I prevent shoulder bursitis from recurring?
Focus on posture, strengthen the rotator cuff and scapular muscles, and avoid repetitive overhead strain. A maintenance program post-recovery can help.
Q: Can I keep training at the gym with bursitis?
In many cases, yes — with guidance. You may need to modify certain movements like overhead presses or bench press temporarily.
Q: What’s the difference between bursitis and frozen shoulder?
Frozen shoulder involves the capsule tightening and severely limits motion. Bursitis usually allows reasonable passive movement and is more painful with activity.
Q: Will I need a cortisone injection?
Not usually. Most people respond well to conservative care. In persistent cases, we may refer you for imaging or injection as a last resort.
Q: What sports or jobs put people most at risk?
Swimming, tennis, construction, painting, and desk work with poor posture all increase risk due to repetitive overhead or static loading.