Diagnosis Explanation:

Shoulder bursitis occurs when the bursa (fluid-filled sac that cushions the shoulder joint) becomes inflamed, leading to pain, swelling, and stiffness. It is often caused by repetitive overhead movements, prolonged pressure on the shoulder, poor posture, or trauma.

Symptoms:

• Pain at the top and front of the shoulder, especially with movement.
• Stiffness and swelling, making overhead motions difficult.
• Pain when lying on the affected shoulder.
• Clicking or catching sensation with movement.

Specific Work Modifications:

• If your job requires standing or walking: Avoid repetitive overhead reaching and take frequent breaks to stretch the shoulder.
• If your job involves lifting: Avoid lifting heavy objects above shoulder height, and use both hands whenever possible.
• If your job is desk-based: Keep shoulders relaxed, ensure proper arm support, and take breaks every 30 minutes to prevent stiffness.
• Avoid: Repetitive overhead motions, forceful pushing/pulling, and prolonged pressure on the shoulder.

Specific Activity Modifications:

• If you play sports: Avoid throwing, swimming strokes, or overhead movements until pain is controlled.
• If you do weightlifting: Avoid bench presses, overhead presses, dips, and pull-ups; instead, focus on controlled, pain-free movements.
• If you do yoga or Pilates: Modify poses to avoid deep shoulder stretching, excessive weight-bearing on the arms, or prolonged static holds.
• Avoid: High-impact activities, repetitive overhead motions, and exercises that cause joint pain.

Recommended Supplements:

• Collagen Peptides – 10g daily for tendon and joint repair.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint lubrication and cartilage health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin D3 + Calcium – 1000 IU/500mg daily for bone and joint strength.
• Turmeric (Curcumin) – 500-1000mg daily for natural pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support joint and muscle healing.
• Eat Anti-Inflammatory Foods (salmon, leafy greens, turmeric, berries, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support joint function.

Home Exercise Prescription (Rehabilitation for Shoulder Bursitis)

Early Phase (0-2 Weeks, Reducing Pain & Inflammation):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Pendulum Exercises – Lean forward, let the arm hang, gently swing in small circles, 10 reps, 2x/day.
• Wall Walk (Forward and Lateral) – Use fingers to "walk" the arm up the wall, hold 5 seconds, repeat 10 reps, 2x/day.
• Scapular Squeezes – Pinch shoulder blades together, hold 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (2-6 Weeks, Improving Joint Stability & Function):

• Isometric Shoulder Holds – Press palm against a wall without moving the shoulder, hold 5 seconds, repeat 10 reps, 2x/day.
• External Rotation with Resistance Band – Keep elbow at 90 degrees, rotate forearm outward, 10 reps, 2x/day.
• Wall Slides – Stand facing a wall, slide affected arm up and down, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Maintaining Mobility):

• Lateral Arm Raises (Light Resistance) – Raise arms to shoulder height, 10 reps, 2x/day.
• Scapular Stability Exercises (Resistance Band Rows) – Pull resistance band toward chest, 10 reps, 2x/day.
• Modified Push-Ups (Wall or Knees) – Maintain control, 10 reps, 2x/day.

Helpful Books:

1. The Shoulder Pain Solution: Simple Exercises to Prevent and Recover from Injury – John M. Kirsch, MD.
2. Overcoming Shoulder Pain: A Guide to Rehabilitation and Recovery – Peter T. J. Barrett.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.