Treatment of Bursitis
What is Bursitis?
Bursitis is a commonly diagnosed injury that occurs around many joints of the body, most common in shoulder, hip, elbow and knee. It can be confirmed with diagnostic ultrasound however your trusted Physiotherapist or Chiropractor can successful treat it without the need for imaging. Bursitis meaning “inflammation of the bursa” happens when a small fluid filled sac (the bursa) that is placed in areas of high friction becomes overused and irritated. The purpose of a bursa is to help lubricate joint tendons. In this injury, the demand and friction on the bursa is too high and an inflammatory process results. This leads to painful movement or loading of the joint as the specific area is extra sensitive to compression. Warmth, redness and swelling over the area is also apparent in early stages.
How will Bursitis be Treated by a Physiotherapist or Chiropractor?
Your trusted Physiotherapist and Chiropractor will perform an assessment of the joint and the surrounding areas to confirm the diagnosis and ensure your treatment will address the reason the bursitis happened in the first place.
A Physiotherapist can apply therapeutic modalities such as Ultrasound and give you advice to help control the inflammation. Both your Physiotherapist and Chiropractor can provide manual and manipulative therapy, exercises, acupuncture and or dry needling treatment. Soft tissue release may also be indicated which can be managed through manual therapy by your physiotherapist or alternatively, they can refer you to a registered Massage therapist to help with this aspect of your rehabilitation plan.
Best Exercises to Help with Bursitis?
In the case of Bursitis, there is most likely a muscular imbalance around the joint affected. Resolution of the symptoms will typically occur once you rebalance this, by stretching what is short and tight while strengthening what is weak.
Strengthening the core and the specific joint stabilizers for endurance and motor coordination will be one goal. In conjunction with the other goal of stretching muscles that are tight. Ultimately, strength and restoring optimal length of the muscles will improving the alignment of the joint and prevent excessive compression of the bursa.
Let’s use the example of a shoulder bursitis:
In this scenario, it is often important that you strengthen the rotator cuff and scapular stabilizers such as the Serratus Anterior and middle and lower Trapezius. While stretching the Pectoralis major and minor. Ultimately, working on improving the rounded and forward shoulder alignment that can lead to shoulder bursitis.
What Should be Avoided with Bursitis?
If you suspect or have been diagnosed with bursitis it is important that you reduce the inflammation so that healing can progress. To make sure this happens quickly play close attention to what aggravating movements or postures that may have brought it on in the first place and modify or avoid them.
Make sure you avoid putting extra pressure on the area, for example if you have shoulder bursitis avoid sleeping on it or putting weight through your arms when sitting (i.e. leaning heavily on your arm rest).
What You Can Do at Home to Help Treat Bursitis?
Your exercises will be based on the joint affected, area and cause of your bursitis, but for now here are some helpful tips to help resolve your pain.
In an acute stage, it is important to apply ice to control the chemical processes that occurs with inflammation. Apply with compression every 10 min ON/OFF cycle 3-4 times a day. It may also be useful to take an over the counter anti-inflammatory medication such as ibuprofen, talk to your pharmacist about what type and dose is right for you.
Balance rest with activity. Your initial reaction to the acute pain of bursitis is going to be rest. Rest will help but if that is all you do you will never be able to get back to a pain free normal joint. So, in the early stages balance rest with activity by performing pain free range of motion exercises with the joint. Remember, you know your body best, so the ratio of rest to activity is will be best on what feels right for you.
In later stage bursitis, it is important that you are performing a daily exercise regime that is targeting the cause of the underlying muscular imbalance. Consult with your trusted Physiotherapist or Chiropractor for a personalized treatment program.
How Long Does It Take to Recover from Bursitis?
If you manage to recognize the symptoms and get control of the inflammation quickly you will have a faster recovery. In this ideal scenario, it should take 6-8 weeks for you feel fully recovered. However, you also have to make sure that you do not cause the inflammation to return or you will be delaying your recovery time. You can do this by modifying your lifestyle to avoid aggravation and completing a daily strengthening and stretching regime.
If your injury is difficult to get control over in the early stages, it can take much longer to recover and even up to a few months before you reach injury free status. This injury can be stubborn especially because once the initial irritation goes away you may not be reminded to complete your exercises. It is important that you keep consistent with them and progress them with the guidance of your physiotherapist or chiropractor for a few weeks even after the initial pain is resolved so that you prevent this issue from returning again.
If you think you may have bursitis or have been diagnosed with bursitis but can’t seem to beat the cycle of pain we encourage you to find a trusted Physiotherapist or Chiropractor. It would be our pleasure to help you if you are in the Downtown Toronto area and need help. Contact Us today.
Heather Imrie, FCAMPT Physiotherapist
Heather Imrie is a FCAMPT physiotherapist practicing at Rebalance Sports Medicine in downtown Toronto.