Shoulder Tendinitis & Bursitis Physical Therapy Treatment

How Physical Therapy Helps Shoulder Tendinitis and Bursitis

Tendons connect your shoulder muscles to bone. Tendinitis in shoulder tendons, most often the rotator cuff, happens when one of them gets irritated from doing too much too often. A bursa is a small, fluid-filled cushion that sits between those tendons and the bone above them. When it gets irritated and swollen, that’s shoulder bursitis.

The two frequently show up together, and both usually build over time. A new job with a lot of overhead lifting, a sudden jump in how often you’re at the gym, or a weekend spent painting a ceiling can be enough to tip a busy shoulder into pain. Because they’re so closely linked, treatment of bursitis of the shoulder overlaps a lot with tendinitis care, though the starting point can be different.

Physical therapy works on what’s putting extra stress on those tissues, like weak rotator cuff muscles, a stiff joint, or the way your shoulder blade moves when you lift. As your shoulder gets stronger, it can usually handle more before it starts to complain. If your pain mostly shows up when you raise your arm overhead, our Shoulder Impingement Syndrome page may also help.

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Shoulder Tendinitis Symptoms

Pain from tendinitis of shoulder tendons usually creeps in. It might start as a dull ache after work or a workout and slowly turn into pain you feel while you’re using your arm.

You may notice:

• An ache at the front or top of the shoulder
• Pain when you raise your arm or reach behind your back
• Weakness when lifting or carrying
• Pain that eases with rest and comes back when you get busy again

If you suddenly can’t lift your arm after a fall or injury, see a doctor first so a tendon tear can be ruled out.

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Shoulder Bursitis Symptoms

Bursitis shoulder pain is usually felt on the outside of the shoulder, and it may spread partway down the outside of your upper arm. It often hurts most when you lift your arm out to the side, or when you lie on that shoulder at night.

You may notice:

• Tenderness when you press on the outside of the shoulder
• Pain partway through lifting your arm that eases as it goes higher
• Trouble sleeping on the affected side
• An ache that lingers after you’ve been using the arm

Shoulder bursitis symptoms can look a lot like tendinitis, and shoulder pain can come from other problems too, so an evaluation helps sort out what’s going on. If your shoulder is red, hot, and swollen, or you have a fever, see a doctor right away, since that can be a sign of infection.

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Shoulder Tendonitis Treatment

Shoulder tendonitis physical therapy treatment is built around what’s flaring your shoulder up and how irritated it is right now. Early on, we’ll look at scaling back a few specific things, like how much you lift overhead or how long you go between breaks, without shutting your arm down completely.

From there, strengthening becomes the main focus. Tendons tend to respond well to being loaded gradually, so we’ll start with exercises your shoulder can handle without a big flare-up and build from there, working on the rotator cuff and the muscles around your shoulder blade.

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Shoulder Bursitis Treatment

Physical therapy for bursitis of the shoulder usually starts with calming the irritated bursa. That can mean changing how you reach or lift for a while and using gentle movement to keep the shoulder from getting stiff while it settles. If your doctor has recommended an injection, physical therapy can still be part of the plan.

Once the pain eases, the work shifts to strengthening the rotator cuff and shoulder blade muscles. A stronger shoulder that moves well may help take pressure off the bursa when you lift your arm, so the same activities are less likely to set it off again.

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Other Treatments That May Be Part of Your Plan

Shockwave Therapy (EPAT)

For tendon pain that’s been hanging around for months, shockwave therapy may be an option. Your therapist can tell you whether it makes sense for your shoulder, and it’s used alongside your exercise program.

Manual Therapy

If tight muscles or a stiff joint are making it harder to reach or lift, hands-on techniques may help loosen things up so your exercises feel more comfortable.

Orthopedic Joint Mobilization and Manipulation

When the shoulder joint itself isn’t moving well, controlled joint techniques may be used to improve its motion. That can take some of the strain off irritated tissues when you raise your arm.

Functional Dry Needling

Overworked muscles around the shoulder blade and upper arm can stay tight and tender. Functional dry needling may be used on those spots when your therapist feels it’s appropriate.

Graston IASTM

This instrument-assisted technique may be used on areas of soft tissue that feel restricted, usually right before your mobility or strengthening exercises.

Kinesiology Taping

Tape can give you feedback on how you’re holding and moving your shoulder during exercises and daily tasks.

E-Stim

If certain shoulder muscles are having trouble kicking in, electrical stimulation may be paired with your exercises to help get them working.

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Why Shoulder Pain Keeps Coming Back

One of the most frustrating parts of this problem is the cycle. You rest, the shoulder feels better, and then a few days back at your normal routine bring the pain right back. Rest and ice can quiet tendinitis shoulder pain for a while, but they don’t make the shoulder any stronger, so the irritation tends to return when the shoulder is asked to do more than it can currently handle.

Breaking that cycle usually means building up what your shoulder can tolerate a little at a time, until reaching at work, lifting around the house, or getting back to your sport stops setting it off.

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