Subacromial bursitis is a condition where the bursa, a small fluid-filled sac that cushions the space between the shoulder blade (acromion) and the rotator cuff tendons, becomes inflamed. This inflammation causes pain, swelling, and difficulty moving the shoulder, especially during overhead or reaching movements. It’s one of the most common causes of shoulder pain.

An analogy…

Think of the bursa like a small water balloon that helps your tendons glide smoothly under the roof of your shoulder. If that balloon becomes overfilled or irritated, it gets squashed, making every movement feel tight, sore, and restricted.

What causes subacromial bursitis?

The subacromial bursa sits in a tight space under the acromion and above the rotator cuff tendons. If that space becomes narrowed, due to repetitive overhead activity, poor posture, shoulder impingement, or rotator cuff weakness, the bursa can get compressed and irritated. Over time, this leads to inflammation, pain, and loss of smooth shoulder motion.

What are the signs and symptoms of subacromial bursitis?

• Pain at the front or side of the shoulder, especially with overhead movements
• Pain at rest, often worse when lying on the affected shoulder
• The shoulder may feel achy, stiff, or weak
• Certain movements may cause a sharp or catching pain
• Unlike a tendon tear, bursitis often causes a generalised ache rather than a specific weakness

What tests are used to diagnose subacromial bursitis?

Neer’s Test: The practitioner lifts the patient’s straight arm up in front of the body. If this causes pain in the front or top of the shoulder, it suggests that the inflamed bursa is being compressed under the acromion, indicating possible subacromial bursitis.

Hawkins-Kennedy Test: The patient’s arm is raised to shoulder height and bent at the elbow. The practitioner then rotates the arm inward. If this movement causes sharp pain, it may mean the bursa is being pinched, which is common in subacromial bursitis.

How long does subacromial bursitis take to heal?

Recovery depends on how early the condition is treated. In most cases, symptoms improve within 2 to 6 weeks with proper management. If the bursitis is more chronic or linked to other shoulder problems like rotator cuff irritation, recovery may take up to 3 months or longer. Addressing the root cause, not just the inflammation, is key to long-term recovery.

How does subacromial bursitis happen?

• Repetitive overhead movements
• Poor posture, especially rounded shoulders and forward head position
• Muscle imbalances, such as weak rotator cuff or scapular muscles
• Shoulder impingement, leading to irritation of the bursa
• Tight chest or upper back muscles, which can reduce space in the shoulder joint
• Direct impact or fall on the shoulder, causing inflammation

What treatment can help subacromial bursitis?

• Follow the R.I.C.E. regime (Rest, Ice, Compression, Elevation) in the first 72 hours
• Rest from aggravating activities and apply regular ice
• Anti-inflammatory medication may help reduce pain and swelling
• Use manual therapy (massage, dry needling, joint mobilisation) to improve flexibility and healing
• Begin a graduated exercise program focused on posture, scapular control, and rotator cuff strength

What exercises or stretches can I do for subacromial bursitis?

• Shoulder Blade Squeezes
• Pendular Exercises
• Pendular Circles

What products can help with subacromial bursitis?

• Trigger Ball
• KT Pilates Band Pack