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Bursitis Physiotherapy: Symptoms & Treatment

This article explains physio treatment for bursitis, an inflammation of the bursa, a small fluid-filled sac found around joints. Physio treatment for bursitis may include exercises to improve range of motion and strengthen the muscles surrounding the affected joint and manual therapy to help reduce inflammation and pain.

As with all injuries, this information is simply a guide, and it is always best to check in with a Physiotherapist or Athletic Therapist to have a personalized assessment and hear recommendations for what you and your body may specifically need.

Bursitis is a common condition that can cause significant pain and disability. Physiotherapy is an important component of management for bursitis, as it helps to reduce pain, improve mobility, and restore function in the affected area. This article will discuss the principles and techniques of physiotherapy for bursitis, focusing on evidence-based interventions.

What Are Bursae?

Bursae are tiny, fluid-filled sacs that cushion and lubricate the joints to reduce friction between bones, muscles, and tendons. They are located in areas of the body where muscles and tendons move over bony surfaces. Bursitis is an inflammation of these small sacs caused by repeated pressure or trauma that results in pain and swelling. It can affect any joint in the body and can be caused by excessive use or wear-and-tear of the area. It is often accompanied by torn tendons which further aggravate the affected joint.

Physiotherapy is an excellent form of treatment for bursitis as it increases the range of motion, reduces pain, and strengthens the muscles around the affected joint. Physiotherapists may also recommend rest, ice, compressions, elevation (RICE), and stretching exercises to help manage symptoms. This form of therapy is effective in reducing inflammation and pain to improve the mobility of the joint. Furthermore, physiotherapy sessions also involve educating patients about prevention strategies for future flare-ups, such as proper posture techniques and pacing activities to decrease pressure on the bursa.

What is Bursitis?

Bursitis is the inflammation of the bursa, caused by excessive friction as a result of overuse or improper use. Similar to any repetitive strain injury (such as tendonitis), it may result due to over training without enough rest, or progressing the volume or intensity of exercise too quickly. It may also result from improper use due to training with muscle imbalances or joint restrictions that create poor biomechanics or form/technique.

The good news is that physiotherapy can help to treat bursitis. Physiotherapists will use various techniques to reduce inflammation, such as heat therapy, ultrasound, massage, and stretching exercises. This helps to reduce pain and improve mobility in the affected area. It also helps to restore the normal range of motion in the joint and improve flexibility. In addition, physiotherapists may recommend lifestyle changes such as rest and avoiding certain activities that could aggravate the condition. With proper treatment, most cases of bursitis can be managed effectively without surgery.

Common Causes Of Bursitis

Bursae, like a cushion between bones, can become inflamed and painful due to bursitis. This condition is often likened to a pebble in a shoe; no matter how much the person adjusts their stride, the pebble remains and causes persistent pain. Common causes of bursitis include repetitive motions, direct trauma, infection, and underlying medical conditions.

Repetitive motions are one of the most common causes of bursitis. Examples of these motions include but are not limited to:

  • Throwing motions for sports.
  • Painting walls or ceilings.
  • Shoveling or gardening activities.
  • Working on an assembly line.

Direct trauma can also cause bursitis, such as falling onto an outstretched hand or landing on one's knees after jumping from a height. Infection is another cause that may lead to bursitis, where bacteria enter through open wounds like cuts or scrapes. Moreover, underlying medical conditions such as rheumatoid arthritis and gout can result in inflammation of the bursae and lead to bursitis.

The following are some common types of bursitis:

Shoulder Bursitis occurs when the shoulder joint's synovial fluid becomes inflamed due to irritation from repetitive overhead motions or other injuries.

Hip Bursitis affects the trochanteric area, located at the side of the hip joint leading to a stabbing sensation with movement.

Heel Bursitis is caused by pressure from ill-fitting shoes on the back of the heel bone resulting in swelling and pain when walking barefoot.

Trochanteric Bursitis occurs near the hip bone, causing discomfort when lying on one side and difficulty going up stairs or inclines.

A physiotherapist can help confirm if someone has bursitis and develop a treatment plan that includes exercises tailored specifically for each case to reduce pain and restore range of motion while preventing recurrence or flare-ups in the future.

Bursitis Recovery Time

The recovery time for bursitis depends on the severity of the pain and inflammation. Physiotherapy can help to reduce pain and restore normal movement in the affected limb.

Physiotherapists may use techniques such as heat or ice therapy, massage, and stretching exercises to reduce pain, restore normal movement, and improve overall recovery time for bursitis. It is important to follow the specific instructions the physiotherapist provides for the best results. For example, if stretching exercises are recommended, then these should be done regularly at home as part of an ongoing exercise program. Patients should also rest sufficiently after treatment sessions to allow their bodies to recover.

Following a comprehensive physiotherapy treatment plan tailored to their needs, patients with bursitis can expect their symptoms to improve over time and return to normal activities as quickly as possible.

How is Bursitis Diagnosed?

Bursitis is diagnosed through a thorough history taking and physical exam. A series of tests involving the joint of concern and surrounding joints will be performed by your Physiotherapist or Athletic Therapist. Since bursitis and tendonitis present in much the same way, it can sometimes be difficult to determine which structure is irritated. In some cases both may be irritated at the same time. There can be many observations to guide your Physiotherapist to determine if the bursa is irritated. Sometimes bursae will more painful at night. In some areas, a swollen bursa can be palpated or felt externally. An ultrasound or MRI may be recommended by your doctor to know exactly which structure is irritated. The good news is that whether your pain is caused by an inflamed bursa or an inflamed tendon, the treatment is exactly the same.

Can Physiotherapy help Treat Bursitis?

During your assessment, your Physiotherapist or Athletic Therapist will look at the affected bursa and surrounding areas to treat the injury and to address any underlying causes. It is always important to treat the cause of the pain and not just the symptoms.

Pain Relief

Your Physiotherapist or Athletic Therapist can provide manual therapy that will loosen the tight structures, not only in the tendons right over the affected bursas, but any surrounding musculature and joints that are affecting the bursa. This will allow more space for your bursa to exist, resulting in less friction. Less friction on the bursa will equal less pain. 

Inflammation Control

Your Physiotherapist or Athletic Therapist will advise you on proper use of ice, rest, elevation and sometimes pressure at home to help control inflammation. 

Improved Function

Through reduced inflammation and more elasticity in the muscles and tendons around the bursa, you will find yourself able to move more freely without pain.

Exercises to Reduce the Causes of the Problem

Customized strengthening exercises and stretches will be advised to strengthen and balance the joint while restoring a comfortable range of motion without causing further aggravation. 

What are the Best Exercises for Bursitis?

The best exercises for bursitis depending on which joint in which you are experiencing it.

Shoulder Bursitis Exercises

Postural Activation

Postural Activation

Squeeze your shoulder blades back and down towards your spine, focusing on pulling the fronts of your shoulders back to centre them in their socket.

Pec Stretching

Pec Stretching

Place your palm on the wall with your arm outstretched horizontally at 90 degrees with respect to the body. Keeping your palm on the wall, twist the torso away from the direction of the hand on the wall until a stretch is felt in the pectoral muscle. Hold the position for about 20 seconds and breathe normally.

Knee Bursitis Exercises

Quad Stretching

Quad Stretching

Lie on your side and grab the top ankle with one hand to pull your foot towards your bum until you feel a gentle stretch on front of the elevated leg. Hold the stretch, keeping your lower back neutral and return to the initial position.

Glute Med Strengthening

Glut med strengthening

This one is a complicated one, but is highly effective in many knee and hip pathologies.

Stand on one leg beside a wall with the other leg bent and touching the wall. Move your shoulder out of the way of the wall, either in front or behind. Have the support foot facing forward and your knee cap aligned with your second toe by activating your glut med muscle to externally rotate the supporting leg. Keep hips and knees level. Push your inside knee against the wall while pushing out against the floor and externally rotating through your standing leg. Hold to fatigue on one side and then repeat on the other side.

Hip Bursitis Exercises

Glute Stretching

Glut Stretching

Sit on a chair having one foot over the opposite knee in a figure 4 position.
Push on your knee to open the leg and straighten your back while you move your upper body forward until you feel a comfortable stretch in your glut.
Hold the stretch.

IT Band and TFL Rolling

IT band rolling

Place your foam roller on the floor. Take a side position with the outside of the thigh over the foam roller and your other leg in front for support.
Roll the entire outside of your leg from your pelvis to your knee in an up and down motion. Then turn to face the ground and roll the side of the front of the hip, just in front of the bone of the hip.
Maintain your abs tight and proper low back posture during the exercise.

Glute Med Strengthening

Pictured and described above under knee bursitis exercises

How can You Prevent Bursitis?

The best way to prevent bursitis is the maintain good flexibility and mobility in your muscles and joints. It is also best to avoid excessive over use to any one joint through either work, exercise or sport. Keep your body moving throughout your work day and stretch often. Warm up and get your joints moving before exercise and sport and stretch afterwards. Listen to your body. At the first moment of pain, you should stop and seek help if it does not improve with rest and exercises.

What is the Fastest Way to Heal Bursitis?

By recognizing and effectively treating bursitis in the early stages, full recovery is estimated in the typical chronic soft tissue healing time frame of about 6-8 weeks.  As always, the healing time should be the limiting factor and you should be doing as much as you can with therapy, self treatment and exercises to eliminate the pressure on the bursa as quickly as possible to allow it to heal.

Contact Us For Help

Inertia Physio+ offers Kanata and Stittsville exceptional Physiotherapy, Athletic Therapy and Registered Massage Therapy with private treatment rooms, one on one care, a maximum of two patients per hour and treatment focused on the evidence-based practices of manual and exercise therapy. Don’t suffer any longer.  If you have pain or injury, our Kanata and Stittsville Physiotherapy, Athletic Therapy, and Registered Massage Therapy team is here to help you get back to living pain-free life and activities.  Please reach out to us at (613) 672-2200 or for an appointment today! You are also welcome to book online. We also offer direct billing on Physiotherapy and Massage Therapy services whenever your plan allows.


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