Bursitis: How You Get It and Its Impact on Physical Activity

It’s one of the most common overuse injuries, according to orthopedists and sports medicine experts – bursitis.

What Is Bursitis?

Simply put, it occurs when the bursa – a thin, fluid-filled sac, that cushions the bone from surrounding structures, such as tendons and muscles – swells. Usually the inflammation happens because of direct injury, but repetitive motions, chronic diseases such as arthritis, and infections may also cause bursae to swell.

“Bursae are found throughout the body, including in our knees, hips, elbows, shoulders and ankles,” said Michael Swartzon, M.D., a primary care physician who specializes in Orthopedics and Sports Medicine at Miami Orthopedics & Sports Medicine Institute. “When these become irritated, they swell. Then, the nerves in these bursae signal pain, telling us there’s something wrong.”

Who Gets Bursitis?

Dr. Swartzon often sees patients who complain of pain following sports or fitness activities. “Big serves with a tennis racket over and over, for example, can cause the bursa in the shoulder to swell,” he said. Competitive exercise is also a culprit. But, he also sees new moms who experience bursitis from carrying their babies. Gardeners, musicians and carpenters also are susceptible to bursitis, according to the National Institutes of Health, because of the repetitious nature of their joint use.

Diagnosing Bursitis

When pain flares up in a joint area, Dr. Swartzon recommends rest and seeking medical attention. A doctor will take an assessment of the pain and examine the area for any deformities or bruising. He or she will also feel the area to determine if a more serious muscle or tendon injury is present and try to recreate the movement that causes the pain to determine if bursitis may be to blame. Often bursitis causes pain away from the swollen bursa, such as when a swollen shoulder bursa causes neck pain.

Sometimes an X-ray or MRI may be necessary to diagnose bursitis. X-rays don’t show the bursa, Dr. Swartzon says, but they can help rule out other sources of pain. MRIs and ultrasound do show inflamed bursae and can be helpful to diagnose bursitis.

Treating Bursitis

Dr. Swartzon says the first step to treating bursitis is avoiding activities that cause pain. “Normally, people try the first step of treatment, which is resting the area,” he said. “Then, depending on those results, we may recommend applying ice for 15 to 20 minutes, 2 to 3 times a day, to help reduce the swelling.” The next recommendation may be to elevate or brace the joint causing the pain, but Dr. Swartzon warns this technique doesn’t work with the shoulder. Anti-inflammatory medications, such as over-the-counter ibuprofen or naproxen, may also be helpful to relieve the pain and promote healing of the bursa, according to the Arthritis Foundation. If bursitis results from an infection, antibiotics will be prescribed.

If none of these other options work on a person’s bursitis, or if it is a recurring problem, Dr. Swartzon will recommend a corticosteroid injection, physical therapy or a combination of both. “Physical therapy is generally the best option to effectively treat bursitis,” he said. Occasionally, surgery may be required.

Preventing Bursitis

Preventing bursitis starts with understanding your limitations, Dr. Swartzon says. “It’s important when training or taking on a new sport or activity that you prepare your body for the new movement you’ll be repeating,” he said. “If you’re being trained, discuss past injuries with your coach or trainer so that he or she can help you slowly build your muscles, joints and tendons to withstand these new demands.”

Dr. Swartzon says it’s also a good idea to remain in overall good physical health by regularly exercising, following the Centers for Disease Control and Prevention’s Physical Activity Guidelines. These guidelines recommend 150 minutes a week of moderate cardiovascular activity and moderate muscle-strengthening activity at least two days a week.

The key to reducing the risk of bursitis and other overuse injuries, Dr. Swartzon says, is to train well, allow your joints to rest between bouts of similar activities and know what your body can and can’t handle.