6 Easy Home Exercises for Bursitis in the Shoulder

Pain on the tip of the shoulder when doing overhead activity could be due to bursitis shoulder. Pain feels like a throbbing kind that increases with any shoulder movement. Doing overhead activities like changing clothes and combing the hair becomes almost impossible.

Shoulder bursitis physical therapy exercises can immensely benefit this kind of pain. Bursitis of the shoulder is curable; many treatment options can completely cure it. I have treated many shoulder bursitis cases in our clinical settings. Having said this, let us first try to understand bursitis of the shoulder and its causes and symptoms.

What is bursitis shoulder?

Inflammation of the shoulder bursa is known as shoulder bursitis. Now, you might be wondering what this bursa is. The bursa is a sac or a cavity filled with lubricating fluid near joints between bone, muscle, and tendons to reduce friction and irritation during joint movement. The bursa is present around almost all major movable joints of our body, and in fact, we term swelling of any bursa as bursitis.

It is situated around the tip of the shoulder just below the acromion process. This is why the exact term for shoulder bursa is subacromial bursitis, and the disease is called “subacromial bursitis”. This image clearly shows the location of subacromial bursitis.

Exercise for bursitis in the shoulder

Exercise in shoulder bursitis is to help reduce pain and stiffness, improve range of motion, and prevent further injury. Exercises for shoulder bursitis typically focus on stretching and strengthening the muscles around the shoulder joint.

Stretching exercises help to improve flexibility and relieve tension in the affected area while strengthening exercises can help to build up the muscles that support the joint and improve stability. So, let us start with the posterior capsule stretch.

#1 Posterior capsule stretch

So, if you’re experiencing pain in your right shoulder, I have a simple exercise you can do, either sitting or standing. This will help stretch the muscles behind your shoulders and hopefully ease the pain. All you need to do is:

1. Raise your right elbow to chest level and put your left hand on your right elbow.
2. Then, use your left hand to gently pull your right arm towards your chest until you feel a nice stretch in the back of your shoulder.
3. Hold that position for 30 seconds, and then release.
4. Remember, this is a stretching exercise, so it’s best to do it three times in a session and not more than that.

#2 Door stretch for bursa shoulder

The door stretch for shoulders is a simple but effective exercise that can help improve shoulder mobility and flexibility. To perform this exercise, you’ll need a door frame and a little bit of space. Here are the steps to follow:

1. Stand facing a door frame with your feet shoulder-width apart.
2. Raise your arms to the sides so they are parallel to the floor, with your elbows bent at 90-degree angles and your palms facing forward.
3. Place your forearms on either side of the door frame, with your elbows at shoulder height and your palms facing inward.
4. Slowly lean forward, allowing your chest to move through the door frame while keeping your forearms in place.
5. Hold this position for 15-30 seconds, then slowly release and return to the starting position.
6. Repeat the stretch 2-3 times.

Remember to start slowly and gradually increase the intensity of the stretch as your flexibility improves. And, of course, if you experience any pain or discomfort during the exercise, stop immediately and consult a medical professional.

#3 Static shoulder flexor strengthening

This exercise is aimed at strengthening the shoulder flexor group of muscles. They are present on the front of the shoulder, and whose action brings shoulder flexion movement. Exercise is simple: stand in front of the wall with your elbow bent at a 90-degree angle. Now, press your fist on the wall as if trying to push the wall. Hold the position for a minimum of 5 seconds and then release it. Repeat the process a minimum of 20 times in a single session.

#4 Static shoulder extensor strengthening exercise

This is to strengthen the shoulder extensor group of muscles. These muscles are present at the back of the shoulder.

For this exercise, stand with your back facing the wall. Keep your arm in contact with the wall and try to push the wall with an optimum effort. Hold this position for 5 seconds and then release it. Repeat this for a minimum of 20 repetitions in a single session.

#5 Static shoulder abductor strengthening exercise

On the outer side of the shoulder, there is a group of muscles whose action results in the shoulder abduction movement. This group of muscles is known as abductor muscles.

For this exercise, your starting position should be standing with the side of your body facing the wall. By placing the outer side of the arm on the wall, try to press the wall with optimum strength. Hold this position for 5 seconds and then release it. Repeat it for a minimum of 20 repetitions in a single session.

#6 Shoulder flexion using a cane

This exercise is performed in the standing position. For this, we need a cane, stick or broomstick that may be available in your home.

1. Hold the cane with your hand, and remember that the backside of the forearm should be facing forward.
2. Then, slowly elevate your shoulder, holding the cane, and take it to the point where you feel slight stiffness or pain.
3. After that, lower down slowly.
4. Repeat the process at least 20 to 30 times in a single session.

#7 Shoulder pendulum exercise

The shoulder pendulum exercise is a gentle stretching and mobilization exercise that helps to loosen up the shoulder joint and surrounding muscles. To perform this exercise:

1. Start by standing with your feet shoulder-width apart and leaning forward slightly, resting your non-injured hand on a table or other stable surface to support your upper body.
2. Next, let your injured arm hang straight down towards the floor, with your hand relaxed and fingers pointing towards the ground.
3. Begin to gently swing your arm back and forth in a pendulum-like motion, gradually increasing the size of the circles you are making.
4. As you swing your arm, try to relax your shoulder as much as possible, allowing the weight of your arm to create the movement.
5. You can also try swinging your arm in different directions, such as side to side or in a circular motion, to target other areas of the shoulder joint.

Remember to keep your movements slow and controlled, and stop if you experience any pain or discomfort. This exercise is great for improving the range of motion and flexibility in the shoulder joint and can be especially helpful for those recovering from a shoulder injury or surgery.

What are the symptoms of shoulder bursitis

Shoulder pain is the main symptom of bursitis shoulder. However, one should not get confused with “frozen shoulder pain”, which is perhaps the more common cause of shoulder pain. To make things easier, remember that the subacromial bursitis pain location is on the tip of the shoulder. Other than this, it commonly presents with the following symptoms:

• Pain has a history of gradual onset that increases over weeks or months.
• The location of pain is on the outside of your shoulder and, to be specific, on the tip of the shoulder.
• As the symptoms increase, pain may spread down your arm towards the elbow or wrist.
• Subacromial bursitis sufferer usually complains of worse pain when lying on the affected shoulder. It also increases by doing the overhead activity.
• The shoulder becomes swollen and warm to the touch.
• Your pain becomes so unbearable that to get the slightest of relief, you need to hold the hand across the chest.
• Painful arc of movement – shoulder pain felt between 60 – 90° of the arm moving up and outwards.
• When your arm is by your side, there is minimal pain and above 90° relief of pain.

Causes of subacromial bursitis

Any repetitive friction/ trauma or direct impact on the tip of the shoulder causes an impact in the subacromial bursa, which results in subacromial bursitis. The following figure simplifies it.

Contributing factors to the development of subacromial bursitis

• The stiffness of the shoulder complex joint.
• Occur secondary to calcific tendinitis of the supraspinatus tendon.
• Instability of the shoulder joint.
• The tightness of muscles around the shoulder
• Poor posture 
• Inadequate recovery from training or activity
• The weakness of muscles around the shoulder.
• Inadequate rehabilitation following a previous shoulder injury or surgery. 
• Sports injuries occur during tennis, swimming, and badminton. Etc.

How can your physiotherapist help you?

When you go to your physiotherapist, he will take your history of pain and all your previous treatments. He will thoroughly observe and inspect the shoulder for swelling and tender/painful spots. 

Physiotherapist will examine

1.  Active movement: Active movement is the movement of the shoulder, which the patient does without help. Active movement is found to be affected in all directions.
2. Passive movement: It is done with the support of the physiotherapist. Passive movement is affected due to pain, but if done cautiously, it is full and free.
3. Resisted movement: Here, the therapist opposes the movement done by the patient, and the patient has to apply more force. Usually, the patient is hesitant to do this, but if done carefully, except abduction of the shoulder, all the other movement is STRONG and PAINLESS. (see figure)

Physiotherapy treatment for subacromial bursitis

During the acute stage, shoulder pain is the main concern, so the aim of the treatment would be the resolution of acute pain and swelling and prevent further damage. This we can achieve by the following means:

1. Rest to the shoulder by using a shoulder sling and avoid any movement on the particular shoulder joint.
2. Icing for 20 min and five times/day using ice or shoulder cold pack.

Resolution of the acute stage is characterized by the absence of rest pain, and abduction movement becomes pain-free up to 90 degrees of angle. Now you can start simple exercises such as the pendulum—exercise using weight not more than 3 kg of weight. The following figure shows the pendulum exercise. However, you can use weight such as a bottle filled with water or a sandbag (slat packet).

Sunit. S. Ekka

Dr Sunit Sanjay Ekka is a physiotherapist in practice for the last 15 years. He has done his BPT from one of the premium Central Government physiotherapy colleges, ie, SVNIRTAR. The patient is his best teacher and whatever he gets to learn he loves to share it on his Youtube channel and blog.