I Have “Bursitis.” So What Does That Mean?
Sometimes in life, you can no longer tolerate discomfort or pain associated with activities of daily living (ADL) or sports. So, you may visit a family doctor for some medical direction. Diagnosed with bursitis, you may be advised in one of several directions. This may mean a referral to an Orthopedist or possibly even a Physical or Occupational Therapist. So, what exactly is bursitis and what can you do about it?
Causes of Bursitis
Throughout the body, there are approximately 160 small fluid filled sacs, called bursa (plural, bursae). These small, fluid filled sacs provide cushion between joints and reduce friction. Protecting the sac is a very thin membrane. Due to overuse, poor mechanics, pressure, or other underlying conditions, these membranes become inflamed. Inflammation is the ‘itis’ part in bursitis. The bursa swells with excess fluid, creating pain and tenderness in the area (1). As the condition worsens, it can create sharp, disabling pain. It can lead to restricted joint movement, and even cause bruising in the area (2).
Typically, treatment methods are conservative. In many cases, doctors recommend resting, using ice, and taking anti-inflammatory medications. However, these options treat only the symptom. They do not address the root cause. To discover and correct the cause, Physical and Occupational Therapists use a variety of techniques. If muscle weakness, joint instability, poor mechanics, or weak tendons cause the injury, therapy is highly beneficial.
Exercises ultimately need to strengthen the muscles above and below the affected joint. Take bursitis of the hip for example. Hip bridges that focus on hip flexors, glutes, hamstrings, and quadriceps will help alleviate the stress and instability that initially caused it (3). When the shoulder is involved, remember to focus on range of motion and stretching exercises. This involves more than just focusing on the biceps and triceps, the most commonly recognized muscles in the shoulder region. It is easy to forget, however, that there are even more muscles in the shoulder girdle that can create injury and they should be addressed as well (4).
Whatever the cause or how this condition may affect you, it is imperative that you recognize the need to treat the condition AND the root cause. Proper therapy that addresses muscle contractions in all phases (isometric, concentric, and eccentric) will go a long way to preventing the condition from returning. Also, therapy can improve lifting mechanics or other movement qualities that can lead to dysfunction.
Jeff Johnson, MA, ATC