What can PT do for Bursitis?
Bursitis is inflammation of a bursa. A bursa is a fluid filled sac that reduces friction between two structures in the body, say a tendon/muscle and a bone. Bursa are usually found near joints, as this is where movement and friction between these structures occurs. The bursa can become inflamed through trauma, say a direct blow to the area, or through repetitive stress, repeating the same motion over and over. When the bursa is inflamed, the fluid becomes somewhat sticky. So this produces pain during movement, because there is more friction.
Signs and Symptoms:
Bursitis is usually characterized by a sudden onset of pain with movement, and many people report “waking up with the pain” one day. The pain occurs with movement and is better at rest. It may also be accompanied by stiffness of the nearby joint the longer the bursa is inflamed.
Most Common Sites for Bursitis:
- The shoulder is the most common site as there are many bursa surrounding the shoulder. The most commonly involved bursa is at the deltoid, the large muscle that covers the outside of the shoulder. The pain is located at the outside tip of the shoulder and upper third of the arm. The pain occurs with raising the arm out to the side and forward, and feels better when at rest or in a sling position.
- Another common site for bursitis is the pes anserine/knee. This is located about 2 finger widths from the large bump just below the knee cap, toward the inside of the leg. Pain is produced here when the knee is actively bent or the hamstrings are resisted.
- The hips are also a common site for bursitis, usually in runners. It is located over the greater trochanter, the large bony nodule on the side of the upper thigh, just below the hip joint.
What to do:
- Keep moving, but modify the intensity or number of repetitions you are performing of the movement that hurts.
- ICE! Use an ice pack for 10-15 minutes or perform ice massage for 5-7 minutes to reduce the inflammation and pain every few hours as necessary.
- Sometimes moist heat can be used to help with stiffness if the problem has been going on for awhile, but icing following activity is recommended.
- See a physical therapist. Often the cause of the bursitis can be traced to weakness in other nearby muscles causing an imbalance or overuse of the muscle laying over the top of the bursa. A physical therapist can identify these imbalances and demonstrate exercises and stretches to correct the problem, as well as perform manual techniques to maintain range of motion, promote tissue healing, and reduce pain.