Bursitis Flashcards
Define a bursa
A small flat sac lined with synovium, usually located between tendons and bones to help reduce friction
What are some common locations for bursitis?
1.) trochanteric
2.) ischial
3.) prepatellar
4.) retrocalcaneal
5.) subdeltoid
6.) subscapular
7.) olecranon
8.) iliopectineal
What are some common causes of bursitis?
Bursitis is rarely the primary condition, it is often secondary to tendonitis and arthritis.
Other causes could be:
1.) overuse of structures surrounding the bursa
2.) mofascial restrictions
3.) muscle imbalances
4.) poor biomechanics
5.) postural dysfunction
What are some less common causes for bursitis?
1.) acute trauma
2.) infection
3.) arthritides
4.) can become infected if a needle is injected into the bursa
What kind of questions would you ask a client if you suspected bursitis?
1.) was it a traumatic onset?
2.) do you have a repetitive strain injury such as tendinitis?
3.) are you experiencing any movement restrictions?
4.) does it affect your sleep or sleeping position?
5.) have you started any new activities or modified any old ones?
What are some signs and symptoms of acute bursitis?
1.) inflammation
2.) pain may be severe “throbbing” or “constant”
3.) pain may be present at rest
4.) pain may radiate
5.) aggravated by stretch across the region
6.) occasionally painless if not being compressed or aggravated
7.) other conditions may be present
What are some signs and symptoms of chronic bursitis?
1.) pain with activity
2.) chronic inflammation/ mm spasm
3.) fibrosis/ adhesions
4.) decreased ROM
5.) potential disuse atrophy (rare)
What observations or palpable findings might lead you to think “acute bursitis”?
1.) acute inflammation over/around bursa
2.) pain with point pressure
3.) antalgic gait/ ROM restricted
4.) reluctance to move the limb
5.) spasm/ mm tension/ TP’s/ adhesions
What observations or palpable findings might lead you to think “‘chronic bursitis”?
1.) some local inflammation
2.) pain/ achy
3.) may feel bogginess
What would your goals be for treating acute bursitis?
1.) decrease inflammation/ swelling/ Edema/ prevent Adh
2.) increase RR/ decrease P
3.) decrease mm tension/ TP’s
4.) treat compensations
5.) maintain ROM
6.) educate ( ex: don’t put your elbow on the table, reduce the insult to area)
What would your goals be to treat chronic bursitis?
1.) mobilize fascia
2.) treat compensations
3.) decrease muscle tension/ TP’s/ Adh
4.) increase ROM
What adjustments or techniques would you use when treating acute bursitis?
1.) elevate and position lib for comfort
2.) lymphatic drainage proximal to bursa
3.) Swedish techniques/ NMT ( compensating structures, proximal MM, TP’s proximal that refer)
4.) GTO release on muscles affected ( as long as its not too close)
5.) O&I techniques proximal but no attachments to bursa area ( or just do O)
6.) distal gentle stroking/ mm squeezing
7.) PROM, joint mobs ( if P free)
8.) add ice to decrease P and inflammation
9.) avoid compression on area
10.) NO onsite techniques
11.) avoid techniques that place drag on surrounding tissues
12.) refer out if you suspect the bursa is infected
13.) can include P free AROM in acute
14.) isometric strength exercises for homecare
15.) educate about bursitis
16.) hydro homecare: ice for acute
What adjustments or techniques would you use when treating chronic bursitis?
1.) fascial techniques ( skin rolling, x hands, spreading, cutting etc)
2.) Swedish techniques/NMT ( compensating structures, proximal + distal limb, knead/wringing, TP’s, MM stripping
3.) PROM interspersed with massage tx, joint mobs
4.) frictions to edge of bursa, and associating structures, stretch and ice,
5.) follow periphery-central-periphery
6.) heat to increase pliability before fascial techniques
7.) contrast tx to increase tissue health. ( use after TX to increase local circulation)
8.) add stretches into tx, or give as home care
9.) isotonic strengthening
10.) educate about bursitis
11.) give hydro homecare ( heat or contrast for chronic)
