Bursa-what?

I’m sure many of you have heard of the term ‘bursitis’ or perhaps have even been diagnosed with bursitis in one of your joints.  Bursitis simply means ‘inflammation of the bursa’.  A bursa is a fluid filled sac that is found near joints and lies between tendons and bone or tendons and skin. When you move a joint like your shoulder or knee, a healthy bursa sac is essential in providing a slippery surface that reduces friction as the tendon glides over the bone or the skin. Without the bursa between these surfaces, movements of our joints would be rough and painful.

When the bursa sac is swollen and inflamed (bursitis), the smooth and slippery surface for which the tendons need to glide along is disrupted. Also, the confined space that the bursa sac is already in becomes more crowded because of the inflammation, causing even further irritation. Bursitis is commonly found at the shoulder, elbow, hip and knee joints.

So what causes bursitis? There can be a variety of reasons, but most commonly, it is due to repetitive joint movement or to prolonged and excessive pressure to the joint surface where the bursa lies. For example, if you kneel or rest your elbows on a hard surface for long periods, the excess pressure to the bursa may become irritated and inflamed.  You may notice localized swelling, redness, tenderness and warmth to the area.

Another example is if you repetitively move a joint, such as your shoulder or hip, in the same motion over a prolonged period of time, you may also irritate the smooth surface of the bursa, causing it to become inflamed.  It is also important to note that if you are using inappropriate body mechanics, or your posture is suboptimal, that you may be at a higher risk for developing such problems as bursitis.

Sometimes a traumatic injury such as a fall or a car accident can cause a contusion (bruising) which causes swelling within the bursa therefore resulting in bursitis.

Treatment of acute bursitis consists of 1) rest or avoidance of activity that aggravates the inflammation 2) ice (20 minutes about 5-8 times per day) 3) anti-inflammatory medication 4) physiotherapy treatment that consists of a variety of inflammatory reducing techniques and modalities as well as mobilizing the joint safely and effectively. For example, if you have shoulder bursitis, it is important that you learn ways to move your shoulder that will reduce the risk of further inflammation.  Additionally, a physiotherapist will show you appropriate stretching and strengthening activities that can help you avoid bursitis by using your joints and muscles in a more safe and efficient manner.  If you have chronic bursitis, the treatment may be slightly different. Use of heat may be indicated as well as different modalities or different exercises may be indicated. It is beneficial to be followed by a health care practitioner to ensure you are receiving the appropriate treatment plan for your condition and the stage that it is in.  Furthermore, it is important for your health care practitioner to rule out other conditions that may present with similar symptoms, but would be treated differently.

 

Here are some tips to prevent bursitis from reoccurring:

Take breaks: ensure to break up any prolonged repetitive tasks with micro-breaks consistently.

Cushion your joints:  if you are kneeling, kneel on some soft blankets or use knee pads.

Ensure optimal joint health and alignment:  an appropriate stretching, strengthening, and stabilization program to keep your body and joints moving smoothly, efficiently, and with optimal alignment is important in preventing not only bursitis, but many other injuries as well!

 

This article is not intended to diagnose or treat. Please consult with your physician or other health care practitioner. Shelly Prosko is a Registered Physiotherapist and Yoga Therapist at Sun City Physiotherapy Winfield. She can be contacted at the Winfield clinic (250.766.2544) or by email at winfield@suncityphysiotherapy.com.

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