Subacromial bursitis refers to irritation or inflammation of the bursa located beneath the acromion—a bony part of the shoulder blade—and above the rotator cuff tendons. This bursa acts as a cushion to reduce friction during shoulder movements, especially overhead activities. Traditionally, bursitis has been viewed as a pathological condition requiring intervention, but emerging evidence challenges this narrative, as we’ll explain here.
Subacromial bursitis may often represent a normal, adaptive response to increased or altered load—like how skin forms a callous with repeated friction if that friction is applied slowly over a long period of time. Rather than being inherently harmful, this response may reflect the body’s attempt to protect and adapt to mechanical stress. Pain in this region is frequently multifactorial and not always linked to structural damage, making accurate diagnosis and thoughtful management essential by the experienced OHL Physio team.
Differential diagnoses include rotator cuff tendinopathy, adhesive capsulitis, and acromioclavicular joint pathology. A thorough assessment by your OHL physiotherapist will help clarify the source of symptoms and guides appropriate treatment.
Recent evidence suggests that surgical interventions like subacromial decompression (removing the bursa or shaving bone) offer no significant benefit over placebo procedures. Instead, physiotherapy and education are central to effective management. Treatment focuses on reassurance, load management, and progressive strengthening—particularly of the rotator cuff and scapular stabilisers. Exercises are tailored to the individual, after thorough clinical testing and appropriate strength capacity testing, and may include resistance training, mobility work, and functional reconditioning. Passive treatments like manual therapy or taping also play their role in rehab journey, but we’re aiming to give clients an evidence-based dose of care with a combination of therapies within the OHL treatment room!
If you're experiencing shoulder pain during overhead activity or rest, it's important to seek a comprehensive assessment. Our OHL physiotherapists will help you understand your condition, guide you through evidence-based rehab, and support your return to full function. Call 9431 5955 or book online via the Client Portal to get started.
