I know you’ve seen me write about the numbers of patients I see each day with the various disorders. If you add them up, they might come out to more than the number of patients I see each day. But remember that some patients come with several complaints! I just had to qualify that so I can now tell you that EVERY day in my clinic I see at least five patients with shoulder bursitis and its related disorders; rotator cuff impingement, tendonitis, rotator cuff tears and problems with the biceps tendon.
First a little anatomy and physiology. We just got done talking about hip bursitis. Many people think all forms of bursitis are related to each other and if they have more than one of these disorders, then they have some kind of bursitis disease. Not true. These conditions are only related in that they pertain to the little sacks of fluid which we have all over our bodies. They’re there to protect various structures in our musculoskeletal system from rubbing against each other. Sometimes they get inflamed and certain bursas, because of where they are, are more likely than others to get that way; shoulder, hip, the bursa in front of your knee cap and behind your elbow, to name a few. And you could have every one of them inflamed at the same time and still not consider yourself to have a disease of the bursas. These are just very common areas which can be repeatedly irritated, mostly because of the way our bodies are put together, and because of the things we do on a regular basis to wear them out. And I’ll refer you back to the very beginning of my blog; the “Caveman” blogs, to understand all that a little better.
About 95% of the people I see with rotator cuff problems have a shape of the bone called the acromion which essentially rubs the rotator cuff the wrong way. You might just be born with a predisposition to developing problems with the rotator cuff. In those people, the front of the bone is pointed down in a way that makes it look like a spur. It’s not the kind of spur you have with arthritis. It’s just the way the bone is shaped. Sometimes that spur is made larger by a lifetime of traction on it by the ligament or muscle attached to it. This can give it a large deformity which can almost act like a blade against the rotator cuff sitting directly under it. The only thing between the rotator cuff and the blade is…your sub-acromial bursa!
95% of the people I see with rotator cuff problems are over 40. So what does that tell you? That this is just another one of those adult repetitive strain disorders we get as we age and serves as a reminder that we are still alive and kickin’!