Do you experience discomfort or ache in your shoulder while trying to reach overhead or behind your back? If so, this may be a sign of shoulder bursitis, tendonitis, or impingement.
In the shoulder you have four key muscles that make up the rotator cuff. The rotator cuff helps to stabilize the shoulder joint, allows for movement, and rotation of the arm and shoulder.
If the muscles of the rotator cuff or the bursa of the shoulder are injured, they become inflamed and swollen.
Shoulder tendonitis is characterized by inflammation in the tendon of the rotator cuff or bicep tendon. When the rotator cuff tendon becomes inflamed and thickened it may get trapped under the top of the shoulder blade. This squeezing of the rotator cuff muscles is called impingement.
Bursitis of the shoulder occurs when there is inflammation of the fluid-filled sac called the bursa that lies between a tendon and skin or between a tendon and bone.
Symptoms
•    Pain in the shoulder that is present both with activity and with rest
•    Pain with overhead activities
•    Decrease in the range of motion in the shoulder
•    Pain while sleeping
•    Loss of strength in the shoulder
•    Pain over the outside of the shoulder and the upper arm
Current Treatment
•    Rest - Allowing the shoulder to rest by not performing the activities that do not increase your shoulder pain
•    Anti-Inflammatory Medication - reduce inflammation and pain
•    Corticosteroid Injection - locally to reduce the inflammation
•    Ice - can help decrease the pain and swelling (use 15 minutes at a time to the painful area)
•    Surgery - In severe cases if the rotator cuff has sustained a full  tear or there is no pain relief with conservative treatment surgery may be necessary
How Can Physical Therapy Help?
Physical therapy is often very helpful for shoulder tendonitis, bursitis, and impingement.  The physical therapist will take a detailed history of the problem, and perform a thorough evaluation of the shoulder.
Treatment usually consists of the following:
•     Instructions given on how to change activities to limit trauma to the area.
•     Posture Modification
•     Therapeutic Exercises
•     Modalities (electrical stimulation, heat, ice, and ultrasound) - will help relieve inflammation and pain.
•     Manual Techniques - joint and soft tissue mobilization can help increase motion in the joint and decrease pain in the local area.