Bursitis

By Kenny Merlevede

Senior Physiotherapist, Founder and Director · Registered with the AHPRA (PHY0002060505)

Sports Rehabilitation · Musculoskeletal Problems · Sport Injuries · Neck pain, headaches, dizziness, jaw related neck pain

Kenny is a physiotherapist with over 18 years’ experience in musculoskeletal and sports rehabilitation. He has a focus on identifying the contributing factors behind pain and treating complex presentations including chronic spine pain, neck and headache disorders, jaw dysfunction, and persistent sports injuries. His approach combines manual therapy, dry needling, and active rehabilitation with strong emphasis on education and patient outcomes. He is also a GEMt dry needling teacher and demonstrator. As an endurance athlete with experience in marathons, Ironman, CrossFit, basketball, and ultra endurance events, he brings a performance athlete's perspective to rehabilitation and load management.

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Bursitis is inflammation of the bursa. A bursa is a sac, filled with fluid that acts as a cushion between your bone and the soft tissues (muscles, tendons, ligaments, skin, fascia,...). The reason why we have these bursae (plural of bursa) is to minimise friction and assist with joint movements. We can compare bursa fluid with the oil in your car or in a machine: everything moves smoother with a bit of extra lube or oil.

WHERE COULD YOU HAVE BURSITIS?

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There are over 150 bursae in the body, so there are many different areas where your bursa could get inflamed! The most common joints are the places you put a lot of pressure on. The top 5 we see and treat at Physio K are:

• Shoulder bursitis (subacromial bursitis)

• Elbow bursitis (olecranon bursitis)

• Hip bursitis (trochanteric bursitis)

• Knee bursitis (prepatellar bursitis)

• Feet: big toe, heel or ball of the foot

CAUSES OF BURSITIS: THE MILLION-DOLLAR QUESTION

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"The most common cause is overuse or repeated pressure on a part of the body."

Many patients arrive at our clinic with an ultrasound scan showing bursitis. At Physio K, we tend not to see this as a diagnosis, but as a result of a problem. Let’s explain this with a few examples:

Posture induced overpressure causing bursitis is quite common. Treatment for the bursitis will only address your current symptoms, but does nothing to address contributing factors such as your posture.

Repetitive gym workouts could cause overpressure in a joint (for example the shoulder joint) and because of that give inflammation of the bursa. Shoulder instability or imbalance of the shoulder muscles can be an important contributing factor to address, alongside treatment for the bursitis.

Bursitis can also be caused by acute trauma, such as motor vehicle accidents, falls and  sporting collisions.

SYMPTOMS OF BURSITIS:

The most common symptoms are:

• Localised pain

• Swelling

• Stiffness

• Warmth or heath in that area

• Redness of the skin in that affected area

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TREATMENT OF BURSITIS:

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As mentioned above (in causes of bursitis), it is important to address contributing factors, rather than just treating the symptoms. Anti-inflammatory medication, relative rest, cold packs and sometimes corticosteroid injections may resolve the symptoms. But if the same patterns continue, these symptoms are more likely to return. A thorough assessment can help identify the contributing factors, which is what we focus on at Physio K.

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DOES DRY NEEDLING HELP BURSITIS?

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With bursitis, alongside treatment for the symptoms, it's often helpful to address the contributing factors. Sometimes, that can be a wrong movement pattern or muscle tension that has been building up over time. Releasing a taut band and trigger points in the affected muscle can ease the pressure in the joint and therefore ease the bursitis. To learn more about dry needling, click here.