Bursal bunching, thickening and inflammation (bursitis) are common ‘soft-tissue’ related problems occurring around shoulders, hips, knees and elbows. Although acute bursal irritation can be painful and limiting, it’s usually not a serious or long-term problem.

What is a Bursa?

Bursae are thin, lubricated cushions located at points of friction between bones and soft tissue in the body.

Bursae are commonly irritated from direct contact to the area e.g. falling onto the shoulder or diving and landing on the knee. They can also become painful after repeated loading, and/or systemic issues such as infections and immune dysfunctions.

Treatment for Bursitis:

Early Stage (24hrs – 72hrs):

The initial stage of treatment is aimed at avoiding aggravating activities and reducing inflammation. This can be aided by following the simple principles of RICE (Rest, Ice, Compression and Elevation) and non-steroidal anti-inflammatory medication (NSAIDs) for example ibuprofen.

Mid-stage (5days – 2 weeks):

Depending on the length of the acute stage, as pain levels decrease we start to re-load the joint in a safe and progressive rehabilitation program. This will consist of range of movement exercises, strengthening and stretching.

Late-stage (2-8 weeks+):

This stage consists of activities specific to your sport or daily activities. This could be serving at tennis, lifting weights in the gym, or going for a walk. It’s still important to respect the tissue in this phase but its safe to exercise with an acceptable amount of pain. This stage is often missed which can result in recurrent shoulder pain. The bursal tissue is strong and resilient but still needs a progressive exercise to avoid flare-ups.

By Jason Clarke