WHAT CAUSES IT?
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Poor control of shoulder and scapula
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Repetitive overhead activities
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Overuse (increased volume of training)
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Shoulder instability
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Trigger points and tightness within rotator cuff muscles
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Training technical faults
WHAT IS IT? BURSITIS OF THE KNEE
The knee has 14 bursae. A bursa is a small sac that prevents friction from occurring between tendon, muscle, bone and skin. If the bursa becomes irritated it fills with fluid and becomes inflamed resulting in ‘bursitis’. The pre-patellar bursa is the most commonly affected bursa of the knee. This is referred to as ‘housemaid’s knee’.
Signs and symptoms
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Pain (overhead activities – throwing, swimming, weights)
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Catching feeling
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Impingement with combined abduction and internal rotation
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Swelling
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Weakness
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Tenderness on palpation of the rotator cuff tendon
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Painful arc on movement (between 70 and 120 degrees of abduction)
HOW TO SELF MANAGE
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R.I.C.E. protocol
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Avoid overhead aggravating activities
PROGNOSIS
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It is important that the factors contributing to the tendinopathy are addressed. If instability and poor biomechanics are not addressed then the condition will likely worsen or reoccur at a later date. Diligence with a prescribed exercise program is the key to long term successful management of the condition.
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A corticosteroid injection may be helpful to reduce pain allowing progress with rehabilitation exercises
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MRI is the optimal investigation for a suspected tendinosis or tear affecting the rotator cuff.
HOW PHYSIO HELPS?
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Assessment of the shoulder complex
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Review and modification of sporting or work activities aggravating shoulder
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Assess rotator cuff and other stabilising muscles for weakness and/or imbalance
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Biomechanical review of shoulder and scapular function and stability
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Prescribe an individualised program to improve stability and strength
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Soft tissue massage and trigger point release
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Acupuncture and dry needling
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Liaising with coach RE sporting technique if required
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