The subacromial/subdeltoid bursa is a cushion that is present under the acromion and above the rotator cuff tendons. Its function is to facilitate the smooth gliding of the tendons under the acromial arch (acromion, coraco-acromial ligament and coracoid).
If inflamed (a condition known as subacromial bursitis) the patient will present with symptoms and signs of impingement syndrome.
In most cases, these occur spontaneously, but some patients present with pain after an injury.
Treatment algorithm includes analgesia and muscle (rotator cuff and core) strengthening exercises. These are performed with the help and guidance of physiotherapists or osteopaths. The majority of patients improve with this.
Those patients who continue to complain of pain, can have a steroid injection. These can be successful in 60-70% of patients but their effect may be temporary.
If all the above fails, a key hole surgery can be performed. This is called arthroscopic subacromial decompression.