Getting an injection for your Subacromial Bursitis? Rotor Cuff? What now!!??? STOP! Take a minute!

Getting an injection for your Subacromial – whatnow!!??? STOP! Take a minute!

The most common cause of shoulder pain in the general population can be attributed to a condition known as subacromial impingement 1,2. There are many pathologies that contribute to subacromial impingement. These includes structural abnormalities of the acromion (part of your shoulder blade); tendons (your rotator cuff); bursa; altered scapula-humeral kinematics (how you move your arm); and imbalances of muscles surrounding the shoulder 3,4.

Corticosteroid injections are commonly used as routine care for treating subacromial impingement due to their potent anti-inflammatory effects 5. However, recent studies suggest that that there is insufficient evidence to recommend the use of corticosteroid injections in subacromial impingement 6, 7, 8, 9, 10.

What does this mean??? Well this means we probably need to take another approach because quick fix injections aren’t going to help!

We do know that physiotherapy exercises are an evidence based and effective approach to the treatment of subacromial impingement in both the short and long term 11.

We believe exercise is the best medicine. At PhysioHealth we’ll help you treat the cause of your problem using the latest evidence-based exercises to quickly get you back to your best!

1. Crawshaw DP, Helliwell PS, Hensor EMA, Hay EM, Aldous SJ, Conaghan PG. Exercise therapy after corticosteroid injection for moderate to severe shoulder pain: large pragmatic randomised trial. BMJ. 2010;340.
2. Michener LA, Walsworth MK, Burnet EN. Effectiveness of rehabilitation for patients with subacromial impingement syndrome: a systematic review. Journal of hand therapy : official journal of the American Society of Hand Therapists. 2004;17(2):152-64.
3. Michener LA, McClure PW, Karduna AR. Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical biomechanics (Bristol, Avon). 2003;18(5).
4. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical therapy. 2000;80(3).
5. Bloom Jason E, Rischin A, Johnston Renea V, Buchbinder R. Image-guided versus blind glucocorticoid injection for shoulder pain. Cochrane Database of Systematic Reviews. 2012; (8).
6. van der Sande R, Rinkel WD, Gebremariam L, Hay EM, Koes BW, Huisstede BM. Subacromial Impingement Syndrome: Effectiveness of Pharmaceutical Interventions–Nonsteroidal Anti-Inflammatory Drugs, Corticosteroid, or Other Injections: A Systematic Review. Archives of Physical Medicine & Rehabilitation. 2013;94(5):961-76.
7. Akgün K, Birtane M, Akarirmak U. Is local subacromial corticosteroid injection beneficial in subacromial impingement syndrome? Clinical rheumatology. 2004;23(6):496-500.
8. Penning LIF, Bie RA, Walenkamp G. The effectiveness of injections of hyaluronic acid or corticosteroid in patients with subacromial impingement: A three-arm randomised controlled trial. Journal of Bone and Joint Surgery – Series B. 2012;94 b(9):1246-52.
9. Blair B, Rokito AS, Cuomo F, Jarolem K, Zuckerman JD. Efficacy of injections of corticosteroids for subacromial impingement syndrome. The Journal Of Bone And Joint Surgery American Volume. 1996;78(11):1685-9.
10. Celik D, Atalar AC, Güçlü A, Demirhan M. [The contribution of subacromial injection to the conservative treatment of impingement syndrome]. Acta Orthopaedica Et Traumatologica Turcica. 2009;43(4):331-5.
11. Hanratty CE, McVeigh JG, Kerr DP, Basford JR, Finch MB, Pendleton A, Sim J. The Effectiveness of Physiotherapy Exercises in Subacromial Impingement Syndrome: A Systematic Review and Meta-Analysis. Seminars in Arthritis and Rheumatism. 2012: 297-316.