I get so many patient’s each year that are diagnosed with bursitis or tendonitis. The problem is that after they are diagnosed, tend to walk away uninformed with what tendonitis is, what causes it, and what to do about it?
Typically, my patients tell me that they went to a doctor, were seen for about 3-4 minutes and walked away with a physical therapy prescription. While tendonitis/bursitis is not hard to diagnose, it is often an over used garbage can term thrown out by many medical professionals who notice that a patient has pain, but yet has some mobility and/or weakness, thus, tendonitis and bursitis.
So what is tendonitis? What causes it and how the heck can you finally get rid of this nagging injury?
BURISITIS:
Lets start out with bursitis. First, a bursa is a fluid filled sac within the body. It is often located near a joint where many tendons cross. The fluid filled sac (bursa) provides a cushion so that the tendons don’t rub over the bone and cause fraying of the tendons. It allows the tendons to move more easily when a joint is being used. Think of a rope that you throw over a door and start to pull and push each side. What would happen to the rope over the door? Well, it would start to fray! A cushion (bursa) in this case would help to prevent this.
Okay, so you know what a bursa is but what is bursitis? Anytime you hear “itis” you should think inflammation. So you guessed it, bursitis is inflammation of the bursa. Most of the time you hear bursitis being but bursitis can be diagnosed pretty much anywhere there is joint and tendons!
What does it feel like?
Bursitis is often tender, uncomfortable, achy, stiff. Often times, patients have swelling, inflammation, and heat or redness present.
How do you get it?
Many people get bursitis from too tight of muscles that put excess strain on the tendon and joint. This compresses the bursa and can cause the inflammation. Most times a bursa will become irritated not as a result of trauma but as a result of repetitive use (throwing a baseball, bad mechanics while walking, etc)
Tendonitis
Tendons are the extensions of the muscle that attach muscle to bone. They are often think, elastic, and very strong. You often see them portrayed in anatomy pictures as white or grey. If you were to inflame or irritate the tendon it would be called tendonitis.
What causes it?
Excess tension (tightness) on a tendon, the inability for a muscle to slide or glide properly past other muscles, repetitive use, are common ways to inflame a tendon.
What does it feel like?
Typical tendonitis can be sharp with the contraction of the muscle/tendon but it can also be achy, painful and hurt with movement or contraction of the joint. Anytime a muscle contracts, it pulls on the tendon and has the possibility to cause pain. Common areas of tendonitis include bicep tendonitis, Achilles tendonitis, rotator cuff tendonitis, forearm tendonitis (golfers elbow or tennis elbow).
What to do about tendonitis and/or bursitis?
Most of the time, patients come to me with an existing case of bursitis/tendonitis. They typically have been do a medical doctor who told them to “stop activity and rest.” Again, most patients have tried this but with no lasting results.
Most patients wait about 2-3 weeks before they end up in my office. Just a rule of thumb (and one of my mentors told me this), if your ache or pain does not go away in about 7 days on its own, its more than likely that it will linger around for some time!
Most doctors want you to stop all activity that causes you the irritation and that’s not always a bad thing, however, I feel that people should be active.
Another way to combat injury is ice. This helps reduce inflammation and allow the body to heal faster. Inflammation is not a bad thing, rather it’s a sign that the body is healing and working properly. Ice can help you move on to the next phase of healing faster.
In my office, I use a lot of Active Release Technique (A.R.T.), Graston technique, manual therapy and Kinesiotaping to help treat the injury successfully. Most of the time, tendonitis and bursitis is effectively treated when combined with manual therapy. I personally believe that a strong rehabilitation program is also important so that you don’t reinjure yourself. Hope this helps. See you soon.
