Brief Outline of Shoulder Bursitis
Shoulder bursitis is not generally an isolated condition, but is usually associated with a rotator cuff tear, or impingement syndrome, and occurs when the region between the upper arm bone (humerus) and tip of the shoulder (acromionI) becomes inflamed. Tennis, baseball, and weight training are all prone to this injury.
Anatomy and physiology
Tendons of the rotator cuff act to rotate the upper humerus, raising the arm by pulling the humeral head down. At the same time, the deltoid muscle pulls the arm up. This process can lead to irritation due to pressure from the acromion process of the scapula and the coraco-acromial ligament. Such irritation can affect the bursae – fluid-filled sacs providing a cushion between the bones and the tendons – leading to inflammation and accumulation of excess fluid, further limiting the space available for tendon movement. The subacromial bursa is the largest and most commonly injured bursa in the shoulder region.
Cause of Shoulder Bursitis
Overuse of the shoulder from throwing activites, tennis, swimming or baseball. Falling onto an outstretched arm. Infection of the bursa in the shoulder.
Signs and symptoms
Pain in the shoulder, particularly when raising the arm. Pain when turning over in bed on injured shoulder. Loss of strength and limited motion of the shoulder.
Rehabilitation and prevention
The athlete should avoid pressure to the injured shoulder and inflamed bursa(e) during recovery as well as any activities likely to irritate the condition. Begin exercising the shoulder when instructed by a medical professional in order to restore strength and shoulder mobility. Warming-up and cooling-down exercises, with an emphasis on stretching, strength training and maintaining looseness in the shoulder can help prevent bursitis from developing.
Shoulder bursitis tends to ease with proper healing and minor rehabilitation, and a full recovery to athletic activity can usually be expected, particularly if no infection of the bursa is detected. In some cases, aspiration of bursa fluid by needle is recommended to reduce inflammation and ensure no infection is present.
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Brief outline of knee bursitis
Knee Bursitis can be a painful condition, especially when located in the weight-bearing knee joint. The job of the bursa is to cushion and lubricate the joint, so if it becomes inflamed, pain will occur in most weight-bearing and flexion or extension activities. With three major bursae surrounding the knee there are many chances to injure one of them. The three major bursae of the knee are the prepatellar bursa, the infrapatellar bursa. and the anserine bursa.
Cause of Knee Bursitis
Repetitive pressure or trauma to the bursa. Repetitive friction between the bursa and tendon or bone.
Signs and Symptoms of Knee Bursitis
Pain and tenderness. Mild swelling, due to release of fluid in the bursal sac. Pain and stiffness when kneeling or when walking down stairs.
Complications if left knee bursitis unattended
The bursa is a fluid-filled sac that is used to lubricate and cushion the joint; if it is allowed to rupture and release the fluid, the natural cushioning will be lost. The build-up of fluid in the joint will cause loss of mobility in the joint as well.
Treatment for knee bursitis
R.I.C.E. Anti-inflammatory medication. Anti-inflammatory injection. Shockwave therapy.
Rehabilitation and prevention for knee bursitis
Strengthening the muscles around the knee helps to support the joint. Increasing flexibility also relieves some of the pressure exerted by the tendons upon the bursa. When a kneeling or crouching position is necessary, frequent rests also help to prevent bursitis. Identifying any underlying problems, such as improper equipment or form, is important during rehabilitation to prevent the condition from recurring.
Long-term prognosis and surgery
Bursitis is seldom a long-term concern if treated properly. Occasional draining of the fluid from the joint is necessary.
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Brief Outline of Retrocalcaneal Bursitis
The retrocalcaneal bursa helps to lubricate and cushion the tendon as it runs over the heel. This bursa takes a lot of stress during repetitive flexing and extending of the foot, such as during running, walking or jumping. Worn or incorrectly sized footwear or excessive pronation of the foot can also lead to problems with this bursa, as well as the Achilles tendon. Shoes that fit too tightly, especially in the back, may put additional stress on the tendon and bursa.
Anatomy and Physiology of Retrocalcaneal Bursitis
The retrocalcaneal bursa lied between the anterior Achilles tendon insertion and the calcaneus (heel bone). The repetitive friction of the tendon running over this bursa during active plantar flexion during push-off compresses the bursa between the tendon and bone, and can cause inflammation.
Cause of Retrocalcaneal Bursitis
Repetitive stress to the bursa by the friction of the Achilles tendon during walking, running, or jumping. Increasing duration or distance too quickly. Improper footwear or waling/running gait. Injury to the Achilles tendon.
Signs and Symptoms of Retrocalcaneal Bursitis
Pain especially with walking, running, or jumping. Tenderness over the heel area. Redness and slight swelling may be noted over the heel.
Complications of Retrocalcaneal Bursitis
The bursa can rupture completely if the injury is left unattended. This complete rupture could lead to other problems with the Achilles tendon due to increased friction. The pain may make it difficult to get up on the toes during walking, running, or jumping.
Immediate Treatment for Retrocalcaneal Bursitis
Rest, Ice. Anti-inflammatory medication and injection. Shockwave therapy.
Long-term Prognosis for Retrocalcaneal Bursitis
Proper treatment and rest should lead to a complete recovery. In rare cases the fluid that builds up due to the inflammation may need to be drained to facilitate healing. Surgery is only necessary in extreme cases that do not respond to rest and rehabilitation.
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