Bursitis involves irritation or inflammation of the bursa, a sac that’s filled with lubricating fluid to decrease friction and irritation between tissues such as bone, muscle, tendon, and skin. It’s most common in people over 40-years-old.
Bursitis
Anatomy Of Bursa
The number of bursa vary per body, but there’s about 160 in the average human body. The major ones are located next to large-joint tendons. Bursa are each lined with synovial cells that secrete a collagen and protein- rich fluid called synovial fluid. When this fluid is irritated from excessive body movement or becomes infected with bacteria, it’s called bursitis.
Common Causes Of Bursitis
With age, tendons become less able to tolerate stress, have less elasticity, and are easier to tear. Overuse or injury to the joint near the bursa is often a cause of bursitis. This can be from normal repetitive actions or a minor or serious trauma. Specific examples might include the repetitive motion a painter might make; tennis, golf, skiing, baseball, and other sporting stresses; incorrect posture; leaning on elbows for long periods of time; constant kneeling, such as with laying carpet; prolonged sitting on hard surfaces; or simply lifting an object too heavy or for too long. Bursa can also become inflamed due to an infection (septic bursitis), an underlying rheumatic condition, or from gout crystals.
Common Areas Affected by Bursitis
Bursitis frequently affects areas with high amounts of repetitive movement such as:
* Elbow
* Shoulder
* Hip
* Knee
* Achilles tendon
Some bursae are at high risk for infection from a scrapping or puncturing injury. This is because they are located just below the skin:
* Knee
* Elbow
Bursitis Symptoms
Bursitis is usually diagnosed based on localized pain, swelling, tenderness, pain with motion of the affected area, or difficulty or loss of motion. Pain may gradually increase or present suddenly and with severe intensity depending on damage, causative factor, and area affected.
Key Points By Affected Area
Elbow (Olecranon Bursitis)
* Most common type of bursitis
* There’s usually tender, raised, red, and swollen knots behind the elbow.
* Increased pain when the elbow is bent.
* Frequently caused due to a trauma, such as striking the elbow; repeated motions, such as playing tennis; or infection from puncturing the skin near the elbow, such as during a fall.
Shoulder Bursitis
* Caused by inflammation of the bursa near the rotator cuff.
* Reaching above or lifting objects overhead is often uncomfortable.
* Pain may be worse at night.
* Decreased range of shoulder motion.
* Tender spots near shoulder.
Knee (Anserine Bursitis)
* Most often seen in those with arthritis, but also occurs as a traumatic and overuse injury too.
* Tenderness in the middle of the knee area.
* Pain intensifies when the knee is bent and at night.
* Pain may radiate to the inside of the thigh and to the calf.
* Swollen bursa is fan shaped and resembles the shape of a goose foot.
Ankle (Retrocalcaneal Bursitis)
* Occurs near the Achilles tendon in the ankle.
* Commonly the result of prolonged ambulating, wearing ill-fitting shoes, over usage during sports.
* Can accompany Achilles heel tendonitis.
* Pain is most often in the back of the heel and intensifies with resisted flexion or passive extension of the foot.
Exercises
1. In relation to a degenerative arthritic condition, the goal of any exercise is to help strengthen the muscles surrounding the joint and maintain range of motion to prevent joint degeneration from progressing. Of course, this must be done without overly stressing the anatomical structures. The Stretching and Strengthening exercises are ideal to build strength and flexibility, while not further inflaming or irritating the joint.
Massage Treatment
1. The affected area should be frequently massaged.
2. One at a time, you should gently take hold of and release each muscle group surrounding the painful area.
3. Depress and propel your fingers in a circular pattern around the soft tissues of the area, paying special attention to the crevices near joints and between bones.
ACUTE STAGE SYMPTOMS AND TREATMENT
This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the affected area because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the affected area, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the affected area as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the affected area, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the affected area, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the affected area can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your affected area to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the affected area. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the affected area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don’t heal well.
2. Massage your affected area with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in the affected area that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
Your affected area may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your affected area you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the affected area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the affected area, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your affected area with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. Sinew Injury Poultice can be used in-between applications.
2. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
