By request, I am going to blog about bursitis. Most people have no clue what I mean when I tell them they have bursitis, even though they may have heard of it. I like to explain it like this: Suppose you have a rope hanging over the edge of a cliff. If the rope swings or moves it will start to wear out at the point where it makes contact with the rock, right? So, to avoid the wear and tear, you place the bag that you used to carry the rope up to the top of the cliff (rock climbers and rapellers will relate) under the rope. This will help reduce friction and keep the rope from fraying.
In this analogy, the rope is like a tendon which is the continuation of a muscle that inserts it into a bone. Tendons often stretch over a bony edge, the cliff. The bursa, then, is the bag you put under the rope or tendon to reduce friction. It is, indeed, a sack that is flat and fluid filled. Because it is fluid filled, the outer edges glide back and forward on each other underneath the tendon thus limiting friction of the tendon.
Anytime you see or hear the suffix “itis” it just means inflammation. So, bursitis is inflammation of the bursa. How does it happen? There a few ways you can develop bursitis. The most common happens when you put too much tension on the tendon and therefore too much pressure on the bursa. Imagine the rope wearing out the bag. This can happen with poor muscle mechanics or just too much load. In a shoulder bursitis what comes to mind is someone with bad posture whose shoulders are slumping forward who starts to lift weights at the gym but doesn’t want to look like a sissy so they lift too much. This scenario neatly covers most of the common risk factors. (There can also be metabolic conditions that cause bursitis, like calcium deposits in the bursa and things like that but they are not as common and frankly would bore you, probably even more than this).
The way to determine if you have bursitis is through a process of resistance and elimination. The first thing you have to rule out is a tendinitis, (which you have cleverly deduced based upon earlier information is inflammation of a tendon). The tricky part is that a tendinitis feels the same as a bursitis. Usually, bursae (the plural of bursae) have more that one tendon running over them so the only way to distinguish the two is to test all of the tendons by checking resistance of all of the muscles attached to the tendons. If stress on every tendon is painful it is more likely you have a bursitis instead of tendinitis of all of the tendons. In simplicity, if it hurts when you use your arm in every motion it is most likely the bursa.
Healing bursitis can be difficult. Motion causes the bursa to work, so any motion is potential for more inflammation and pain. The key is to reduce the inflammation. You can do that through icing (15-20 minutes at a time) and rest. For diet, it may sound crazy but a half a fresh pineapple a day for 6 six days reduces inflammation like a champ. Also, Omega 3 supplements really help.
The other thing you have to address is why you developed the bursitis. If a joint is subluxated or you have bad posture you need to be adjusted to reduce the amount of pressure on the bursa. Likewise, changing how your mechanics or the amount of resistance can make a big difference.
***Photo by William Krause on Unsplash