What Actually Is A Bursitis?



I have recently been seeing quite a few clients suffering from bursitis, but very few actually know what bursitis is.  

Now to understand a little about bursitis and why people get it you first need to know exactly what a bursae is.

A bursae is a fluid filled sac (think of them as tiny cushions), that sit underneath tendons/bones to stop the two rubbing together.  Tendons are the anchor of a muscle that firmly fix it to a bone.

The tendons are very strong and therefore are under a lot of stress almost like a guitar string, therefore a bursae is necessary to ensure the tendon doesn’t always rub on the bone.

I’m sure you have all seen the films where the hero is dangling on an old rope desperately trying to climb to the top of the cliff whilst the rope gradually frays off the edge of the cliff.

Well this is exactly what would happen to the tendon if the bursae were not there to reduce this friction….So they are pretty important!. As the tendon continually rubs against the bursae during repetitive activities it can become inflamed (swollen) and this can in turn cause pain and discomfort.

The most common type of bursitis that I have been seeing the the clinic over the last few weeks is trochanteric bursitis, this is actually the bursae that sits on the outside of the hip.

If you feel down to the top of your side pockets you will feel a large bony area that sticks out slightly, this is known as the greater trochanter of the hip.

This is simply an area where lots of muscle tendons anchor to, similar to a limpet attaching itself firmly onto a rock in a rock pool.  Sitting just underneath these tendons is the trochanteric bursae.

The holidays are just around the corner and many people are opting to try to lose a few pounds before the festivities begin, which means repetitive stress injuries such as bursitis can increase.

Going from doing nothing to running or cycling for hours, not adequately stretching, warming up or cooling down can lead to muscles that are struggling with this increase in demand becoming tight, causing excess pressure on the bursae ultimately leading to pain (bursitis).

It is important for you to be properly assessed to determine whether or not it is a bursitis that is causing you the discomfort in this area.

There are various structures around this area and they need to be ruled out to identify the culprit for your discomfort so that it can be more effectively treated.

Signs of a Bursitis can be:

A sharp or achy pain in the outside of your hip, (near your pocket).

Pain referring down the outside of your thigh.

Pain that is worse at night or aggravated when going from sitting to standing.

Although it can be hard to avoid bursitis occurring there are certainly precautions that can be taken to help limit the chances of you developing one:

There are a few large and very powerful hip muscle tendons that pass over the trochanteric bursae therefore if any of these muscles becomes particularly tight, more pressure will be placed on the bursae so there will be more chance of developing a bursitis.

Hip stretches particularly of the gluteal muscles and Iliotibial band can help to release this pressure.

Limit repetitive activities if you start to feel this discomfort, (aggravated by repetitive hip bending and extending motions e.g cycling, running etc).

Icing the area can help to reduce the amount of swelling and reduce pressure on the bursae.

Physical Therapy:

Your physical therapist can fully assess to ascertain the exact nature of the injury and whether other structures could be involved that need attending to.

Physical therapy involving hands on Deep tissue massage can help to loosen the muscles around the hip to take stress off the bursae as well as other modalities that can help to ease the bursitis.

Start the AZ “winter” as you want to finish it…. Fully fit!!.

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Nick Hunter, PT, DPT

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