Bursae (plural of bursa) are small fluid-filled sacs found near joints. These slippery sacs help the tendons, ligaments, muscles and skin glide smoothly over the bony surfaces of the joints. Though they contain only a small amount of fluid, they also provide some cushioning to the area. These bursae play such an important role that there are actually more than 150 of them in the body.

Bursae are located throughout the body. The major bursae are located near the joints of the shoulders, elbow, hips and knees. Bursae around other joints in the body, however, can also be affected by bursitis. Keep reading to learn more about this condition.

WHAT IS BURSITIS?

Bursitis refers to inflammation of a bursa. Some people will experience repeated bouts of bursitis with resolution of symptoms in between Healthy bursae are very thin. They consist of a synovial outer membrane filled with slippery synovial fluid. When inflamed, the synovial membrane becomes thickened and increased synovial fluid is produced causing the bursa to swell. Thickening and swelling of bursae leads to the common symptoms of bursitis as these usually thin sacs are suddenly taking up more space beneath the skin, ligaments, muscles and tendons around them.

Symptoms of bursitis include:

• Pain in the area of the inflamed bursa
• Limited motion around the area
• Tenderness over the bursa
• Discomfort or pain when lying on the affected joint
• Redness and swelling if the bursa is located just below the surface of the skin

WHAT ARE COMMON CAUSES OF BURSITIS?

Because of their location, inflammation of the bursae is commonly caused by repeated motions or prolonged positions. For example, leaning on your elbow everyday while you are on the phone at work can irritate the olecranon bursa on the tip of your elbow. Throwing a baseball repeatedly at practice every week may lead to bursitis in the shoulder. Even running or climbing stairs for exercise can result in trochanteric bursitis on the lateral aspect of the hip. The one thing that each of these episodes of bursitis have in common is that there is pressure or movement across the bursae repeatedly or for prolonged periods of time.

Septic bursitis is a less common but more serious cause of bursitis. In this case the bursa becomes infected by bacteria that has entered through a cut, scrape or abrasion on the skin. Rapid identification of this condition is important to allow for initiation of proper treatment.

Finally, having certain medical conditions may make you more likely to develop bursitis. These conditions include:

• Rheumatoid arthritis
• Diabetes
• Gout

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If you decide to work with a physical therapist to help correct your bursitis issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized bursitis physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY TO ADDRESS BURSITIS

As mentioned above, physical therapy to address bursitis is a two-pronged approach. Providing symptom relief is a primary goal of physical therapy for this condition but in order to minimize the likelihood of recurrent bouts of bursitis, identifying underlying contributing factors and making a plan to address them is vital.

In the first couple days of an acute episode of bursitis your physical therapist will counsel you on how to minimize irritation and reduce inflammation in the area. Resting, avoiding painful movements and applying ice for 15-20 minutes every couple of hours can help. If pain and inflammation are severe, your doctor may recommend an anti-inflammatory medication or possibly a steroid injection into the area to reduce the inflammation.

As the pain and inflammation subside, your physical therapist will take the following steps to help you recover:

• Modify your activities to decrease irritation on the bursa
• Teach you stretching and mobility exercises to restore full range of motion in the joint. This allows you to use the joint functionally and allows the muscles around it to perform optimally
• Apply manual therapy techniques to the joint and soft tissue to improve joint alignment and movement to reduce irritation on the bursae
• Strengthen the muscles around the joint to avoid excessive stress on one set of bursae and help you return to activities without pain
• Observe how you perform the activities and movements that may have caused the bursitis and advise you on how to optimize or modify these movements to prevent a future episode of bursitis
• Help you slowly return to the activities that led to the development of bursitis now that you have improved strength, flexibility and movement coordination and optimized your movement patterns.

If you have bursitis or think your pain may be bursitis, call us today to learn more about our services and schedule an evaluation. Call 1-718-258-3300