What is a bursa?
Bursae are tiny fluid filled sacs located in
areas of the body where bones, ligaments and tendons connect.
There are more than 150 bursae in the human body and they act
as cushions for joints. The bursae help to decrease friction
between moving parts and without them movement would be painful.
What is bursitis?
Put simply, bursitis is inflammation of the
bursa. When inflammation occurs, any movement or stress on the
bursa causes pain and prevents the bursa from working properly.
Some common signs of bursitis are a dull ache
or stiffness in the affected area; increased pain with movement;
tenderness; swelling; redness; and heat.
Although there are many bursae located throughout
the body, the most common areas of complaint are the shoulders,
elbows, hips and knees.
What causes bursitis?
The main causes of bursitis can be broken into
two major areas: chronic bursitis, which is caused by overuse
or repetition, and acute bursitis, which is caused by traumatic
injury.
In the first instance, any prolonged, repetitive
movement of a joint will place strain on the bursa, which over
time can cause inflammation and tenderness and result in bursitis.
For example, prolonged hammering or vacuuming can place strain
on the bursae in the elbow and wrist, and result in bursitis.
The other major cause of bursitis is traumatic
injury, which can include an impact or twisting injury to one
of the joints. Car crashes and falls commonly result in damage
to the bursae.
Bursitis Treatment
One of the most common treatments for bursitis
is anti-inflammatory drugs, although quite effective, there
are many other useful treatments. Follow the advice below and
you should see a big improvement with 7 to 10 days.
Rest and Immobilize
Once bursitis is diagnosed it is important
that the affected area be rested as soon as possible. Any further
movement or stress will only aggravate the condition and prolong
recovery. It is also important to keep the injured area as still
as possible. If necessary, support the injured area with a sling
or brace.
Ice
It is important to apply ice as soon as possible
as this will help to lay the foundation for a complete and speedy
recovery. The application of ice will also have the greatest
effect on reducing swelling and pain.
How do you apply ice? Crushed ice in a plastic
bag is usually best. However, blocks of ice, commercial cold
packs and bags of frozen peas will all do fine.
When using ice, be careful not to apply it directly
to the skin. This can cause "ice burns" and further
skin damage. Wrapping the ice in a damp towel generally provides
the best protection for the skin.
How long? How often? This is the point where
few people agree. Let me give you some figures to use as a rough
guide, and then I will give you some advice from personal experience.
The most common recommendation is to apply ice for 20 minutes
every 2 hours for the first 48 to 72 hours.
These figures are a good starting point, but
remember they are only a guide. You must take into account that
some people are more sensitive to cold than others are. Also,
be aware that children and elderly people have a lower tolerance
to ice and cold. Finally, people with circulatory problems are
also more sensitive to ice. Remember to keep these things in
mind when treating yourself or someone else with ice.
Personally, I recommend that people use their
own judgement when applying ice to themselves. For some people,
20 minutes is too long. For others, especially well conditioned
athletes, they can leave ice on for up to an hour at a time.
The individual should make the decision as to how long the ice
should stay on.
My personal recommendation is that people should
apply ice for as long as it is comfortable. Obviously, there
will be a slight discomfort from the cold, but as soon as pain
or excessive discomfort is experienced, it is time to remove
the ice. It is much better to apply ice for 3 to 5 minutes a
couple of time an hour, than not at all.
Bursitis Prevention
To follow are a number of useful strategies
that will help to prevent bursitis and other joint pain.
Firstly, learn to identify the activities that
cause bursitis and either avoid those activities or modify them
to reduce the pressure and stress on your joints. For example,
if kneeling causes discomfort and bursitis in your knee joints,
use a cushion or kneepads, or maybe you could use a small stool
to sit on instead of kneeling.
Secondly, take adequate breaks, ensure sufficient
rest periods when working out or performing repetitive tasks,
and do not perform the same activity continuously for hours
at a time.
Lastly, stretch and strengthen! The aim here
is to gradually improve the strength and flexibility of the
muscles, ligaments and tendons around the injured area.
When attempting to increase the strength of
surrounding muscles, be sure to approach this in a gradual,
systematic way of lightly over-loading the muscles and tendons.
Be careful not to over-do this type of training. Patience is
required.
An affective and relatively safe way to start
is to begin with isometric exercises. These are exercise where
the effected joint itself does not move, yet force is applied
and the muscles are contracted.
For example, imagine sitting in a chair while
facing a wall and then placing the ball of your foot against
the wall. In this position, you can push against the wall with
your foot and at the same time keep your ankle and knee joint
from moving. The muscles contract but the ankle and knee joint
does not move. This is an isometric exercise.
It is also important at this stage to introduce
some gentle stretching exercise. These will help to further
increase your range of motion and take pressure off the effected
joint. While working on increasing your flexibility it is important
to remember all the muscle groups around the injured area.
