Bursitis and tendinitis

BURSAE are tiny fluid-filled sacs that cushion the spaces where muscle passes over bone and where two muscles rub together. In your kneecaps and elbows, they form cushions between skin and bone. They can get inflamed when you injure or overwork an out-of-condition joint or even when you’re fighting fit, if you suddenly increase your workout beyond what you’re used to.

If you have tendinitis, it is not really your tendon but a ring of tissue around the tendon where it attaches to a bone or muscle that hurts. The pain is caused by overuse of the tendon which produces inflammation. We all get more aches and pains with age. But if you stay limber over the years, a burst of effort is much less likely to bring on bursitis and tendinitis. It is too little exercise, not aging itself that increases your risk of these painful ailments.

The consequences of abuse

Shoulders, elbows, hips, knees and ankles are especially vulnerable to bursitis and tendinitis. For men, shoulders are the usual problem area, because they tend to do more throwing or to have jobs that require a lot of overhead lifting. Women tend to get pain in the hips, because women’s hips are set wider which puts more stress on their joints. Any activity that requires repetitive motion or pressure increases your risk.

Bursitis and tendinitis are also caused by overdoing a favourite sport. Tennis can do in elbows and wrists, swimming can irritate the shoulder bursae, running can aggravate ankles and Achilles tendons particularly if you run on hard surfaces in the wrong shoes. Skiing can cause hips and knees to flare up.

Bursitis is often missed as a cause of lower back pain, experts say. And it often accompanies the disorder called fibromyalgia, which causes muscle pain and stiffness throughout the body. Fortunately, bursitis and tendinitis are very treatable.

Shock-absorbing your joints

The most important thing is to get into condition gradually and to ease into vigorous exercise gently. In preparation for vigorous activity, you need to do more stretches of the muscles you’ll be using. Hold a slow, sustained stretch for ten seconds, and don’t bounce. Repeat the stretch three to five times before exercising. And don’t do high-speed stretches, or you risk tearing muscle fibers or ligaments. If you’re unsure which stretching exercise is best for you, check with a qualified trainer.

If you take up a new sport, work at gradually increasing the strength and flexibility of the muscles you’ll be using. If you choose tennis or badminton, for example, take it one set at a time at first. Don’t pick up a racket and play lots of sets at once, because your shoulder is going to feel like it’s falling off. If your job or hobby calls for repetitive motion, ask a trainer to recommend strengthening and endurance exercises targeted for that motion. If you do this you can stop bursitis and tendinitis from happening over and over. Many people develop chronic inflammation from reinjuring their joints.

Typing and filing can trigger problems in your wrists and back. Use a keyboard wrist rest for typing and check that your chair is well adjusted so that your back is supported and your arms and wrists are level with each other. You should also go easy on your knees. There is little but a tiny bursa between your kneecap and the skin over it, says Dr.PekkaMooar, director of the Delaware Valley Sports Medicine Center in Philadelphia. So if you’re doing cleaning and gardening on your knees, kneel on a piece of foam rubber or wear knee pads to cushion them.

Bouncing Back

If you already have bursitis or tendinitis, the first thing to ask yourself is what have you done differently? First, stop what you’re doing because you’re overdoing it. Here’s some advice on what to do.

Put it on ice. Apply a paper cup full of ice to the painful area. Rub the icy bottom or side of the cup into the sore spot for two to five minutes, three or four times a day to control the inflammation.

Switch off with heat. After the ice, apply a microwavable heat pack or elective heating pad to soothe the pain.

Bundle up for bed. Wear a flannel shirt or a wool sweater at night to keep a painful shoulder extra warm. If you sleep shirtless in a cool room, your morning stiffness and soreness will be greater.

Use the right pain reliever. Choose an aspirin or ibuprofen pain reliever for the pain. Aspirin and ibuprofen block the production of chemicals called prostaglandins, which contribute to swelling and pain in inflamed tissue. Consult your doctor.

Swing your shoulder. Sometimes bursitis or tendinitis in the shoulder progresses to a painful condition called adhesive capsulitis or frozen shoulder. When this happens, the shoulder’s range of motion is severely restricted and the joint is nearly immobile. To avoid frozen shoulder, you need to start moving your shoulder as soon as the acute pain has passed. Lie face down on a cushioned surface such as a bed, and hang the affected arm over the side.

Gently swing your arm like a pendulum, gradually increasing the range until you can swing it in a full circle. Do this for 15 to 30 minutes, three to five times a week, to restore your range of motion.

If your pain won’t quit, a technique called friction massage may clear up the problem. When inflammation is chronic, fibrous adhesions don’t allow the bursae to glide smoothly. Friction massage can break down those adhesions, relieving the cause of bursitis pain. Also, an inflamed tendon becomes thicker and shorter which creates further inflammation in the bursa it’s rubbing over. The deep pressure of massage across the bursa and tendon can lengthen the tendon fibers again. For more information about friction massage you can visit the Coach Pacquiao Gym and Pain Clinic.

TAGS: bone, bursae, cushion, elbow, exercise, fighting, filled, fit, fluid, inflammation, injure, joint, kneecap, muscle, overwork, pass, sacs, spaces, tendinitis
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