I have Bursitis and Tendonitis! What is it?

I get so many patient’s that are diagnosed with bursitis and tendonitis and they have absolutely no idea what it is.  All they know is that they went to their doctor, they looked at the area of complaint for a second or two.  They saw that the patient can move the body part ok, but they had pain. The answer…BURSITIS or…..TENDONITIS.  What the heck is bursitis and tendonitis.  Lets begin by getting a definition, then we will break it down by location, the mechanism of injury and ultimately how to get rid of it (which is obviously the most important thing).

BURISITIS:

bursa

First, lets break the word down.  Burs- stands for bursa.  A bursa is a fluid-filled sac lined by a membrane.  It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement. Bursae are filled with synovial fluid and are found around most major joints of the body.  -Itis stands for inflammation.  Therefore, when we put it together bursitis stands for inflammation of a bursa.  The most common locations for bursitis are in the shoulder, elbow and hip. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis often occurs near joints that perform frequent repetitive motion.  If you have bursitis, the affected joint may feel achy or stiff, hurt more when you move or press on it and may look swollen or red.  A lot of my patients get bursitis from throwing a baseball or lifting something over their heads repeatedly, leaning on their elbows for long periods of time, excessive kneeling like my carpet guys or scrubbing floors like my cleaning people and my patients that sit for long periods of time, especially on hard surfaces.  Does this remind you of someone?

TENDONITIS or TENDINITIS

tendon

Again, lets break it down.  Tendon-stands for a thick elastic band that attaches the muscle to a bone.  -Itis again is inflammation.  So putting it together means inflammation of a tendon.  Sometimes the tendons become inflamed for a variety of reasons, and the action of pulling the muscle becomes irritating.  If the normal smooth gliding motion of your tendon is impaired, the tendon will become inflamed and movement will become painful.  There are too many causes for tendonitis to even list.  Anything that you do can case tendonitis if the right mechanisms are there.  Unlike bursae which are not located all over the body, every muscle has a tendon so tendonitis can occur anywhere.  The most common sites are at the base of the thumb, elbow, shoulder, hip, knee and achilles tendon.

 

 

So I have Bursitis and/or Tendonitis, what do I do?  Usually by the time my patients get to me they have tried a long period of “wait and see”.  I usually tell people to avoid the “wait and see” mentality all together.  I know its tough these days, when you look everything up on the internet and it says that most things will go away on its own.  Although, this may be true sometimes, it is definitely not true all the time.  My philosophy is that if your body can handle it, your body won’t even let you know you have something wrong.  By the time your body gives you conscious awareness of a problem (a symptom) for example pain, swelling, redness, spasm, fever it should be looked at by a professional.  Again, most things are not severe, but what if there is something severe going on and you don’t have it checked by a professional, now we have a problem.  The worst thing that can happen with a non-serious condition is that your doctor sends you home and tells you that there is nothing wrong.  However, when you don’t go to a professional and there is something serious going on, the worse case scenario can be very severe. (just my two cents!!!).  Back to the treatment.  The first thing anyone wants to do when they have bursitis/tendonitis is stop the activity that caused it from happening.  Continued irritation will only make the condition worse.  If you are throwing you need to stop throwing, if you are kneeling you need to stop kneeling.  A lot of times just eliminating the mechanism of injury will heal the problem.  Another modality to use is ice.  If you look back into my heat vs. ice blog you can learn more about the benefits of ice.  Anti-inlammatories are helpful for these conditions as well because as we said -itis is inflammation so taking an anti-inflammatory will help reduce the inflammation and help with the overall pain.  I tell all my -itis patients that if you got it once you may be prone to getting it again so strengthening is usually very helpful to prevent further episodes.  There are a few cases that do not respond to general therapies like a just listed so more aggressive or advance therapies are available.  In my office we offer a class IV 15 watt laser therapy to heal tendonitis and bursitis.  We perform techniques like Active Release Technique (A.R.T.) and Graston technique.  We use Kinesio Tape and other supports to help.  Our physicians perform cortisone injections and even P.R.P. injections for the very advanced cases.  This is not the only way to treat it but a very effective combination is usually very successful with my patients.  If treated properly a full recovery is expected and when done correctly therapy prevents the prevalence of further episodes as well.

Don’t Let The Light Fluffy Snow Fool You While Shoveling! Tips To Not Injure Your Back:

Shoveling Snow, low back pain, injury, herniated disc, sprain, strain

   Even know the snow looks light and fluffy out there, don’t let that fool you when shoveling.  Sometimes it is not the weight of the snow so much as the repetitive movements of shoveling.  This light, fluffy snow is better than the heavy, wet snow, but it can still cause injury.  Here are a few tips to help prevent an injury:

1.  Take your time – if you are anything like me you want to complete the job ask quickly as possible.  However, in the case of shoveling snow, this is a recipe for disaster.  The key is to take your time, slow and steady wins the race (winning is not injuring your back).

2. Take breaks frequently – most people don’t realize how much energy they are expending when they are shoveling.  When you do take that break, you are usually very fatigued.  The key here is to take breaks every certain amount of minutes, for example every 5 minutes.  Set a timer on your watch or phone.  This is will allow your body to recover before you continue again.

3. Bend at the knees and hips – and lift the weight with your legs as you all know you should.  Do not use your back to lift because that is the easiest way to “blow out your back”.  The small muscles of your back were never designed for lifting and carrying, it is actually the large muscles of your hips and legs that were designed to do the heavy lifting.

4. Maintain a neutral spine – what does that mean?  Most people when they lift and carry flex their spine (rounding of the back).  This puts tremendous pressure on the spine and discs which are the cushions in between the bones of your spine.  It is the easiest way to injure your back because you are applying abnormal stress to parts of the spine which can’t handle that type of stress.  To stay in a neutral spine, you want to flatten your back or even put it in a very slight arch.  This will put the weight on the correct part of your spine and minimize your potential for injury.

5. Do not reach – the last thing you should do is try to over reach to get to an area.  This creates a “long lever” which can be harmful.  When reaching you put excess pressure with less support which can lead to injury.

6. Do not hold you breath – When you hold your breath while exerting you increase the pressure in your body, and everyone knows that we don’t work well under pressure!!!  Breathing is key for so many reasons.  It helps bring oxygen to your muscles to supply them with the energy they need to perform the tasks you are asking them to accomplish.  It also prevents from over-exertion injuries which can prevent things like light-headedness and headaches.

The most common injuries are sprains and strains of the low back, herniated discs and pinched nerves.  You can prevent these injuries by following these tips.  The cold is another reason why so many people hurt themselves while shoveling.  When your body is cold, the muscles are tight and less elastic and less flexible.  When you put stress on a cold, tight muscle it is much easier to injure.  Another way to prevent injury while shoveling is by warming up and more importantly staying warm.  Drinks lots of water to keep your body hydrated as well.  Please use these tips wen getting out there to shovel.  If you have any questions you can always contact us at the office and we can provide you with even more information to help you with an injury free winter!

Sprain or Strain Treatment? Should I Use Ice Or Heat???

Ouch, I’m hurt! Do I Ice or Heat the Pain?

If you’ve recently injured yourself and are not sure what to do, then read on.

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More often then not, our patients are confused about when to ice or heat an injury. Is it a sprain or is it a strain? There are various methods to decide whether icing or heating is the way to go for an injury, but you should always consult your doctor or chiropractor if you are not sure. This article will help injury sufferers with causes and possible answers.

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I think the first thing we should do is talk about what effects each of those have on your body.

Ice (cold), causes a response called vasoconstriction.  Vasoconstriction means that the blood vessels that are being stimulated by the ice are narrowing or constricting.  This causes less blood flow to an area thus reducing inflammation (swelling).

Heat (warm), causes a response called vasodilation.  This means that the blood vessels being stimulated by the heat in the area actually enlarge or dilate to bring more blood to the area.  This brings oxygen and nutrients to an area to support healing.

So…now for the answer.  The cardinal rule is always use ICE for the first 72 hours or 3 days.  Why?  Because when you injure an area there is a tremendous amount of swelling (inflammation).  Ice, because it causes vasoconstriction, will reduce the amount of inflammation.  The will provide the natural anti-inflammatory effect by reducing swelling as well an analgesic effect (pain killer) by numbing the area.

Following the first 72 hours, usually you can transition to heat.  This will cause vasodilation bringing more blood to the area which also brings oxygen and nutrients to begin the healing process.  There is also an analgesic (pain killer) effect.

We can get very technical and talk about contrast baths and alternating therapies with using a combination of ice and heat, but for now to keep it simple, let’s just say ice for the first three days and heat after that.  If you forget that then just always remember ice is always appropriate but heat may have a negative effect.

Remember, No advice should ever take the place of seeking professional care. If you are at all unsure of the severity of your injury, please contact your physician.