Is my knee going to get worse if I exercise on it?

No, appropriate exercise does not wear the joint out. In fact, the opposite is true: controlled, progressive loading strengthens the muscles that support the knee, improves joint nutrition, and reduces pain. A lot of knee pain, especially the overuse kind, is a loading problem rather than a structur

Is there any point trying physiotherapy if I have "bone on bone" arthritis?

Yes, absolutely. Even when X-rays show significant cartilage loss, exercise and physiotherapy can reduce pain, improve function and help you stay active. Scans often show things like mild wear or changes that are completely normal for someone's age and activity level, and not actually the cause of t

Can a physiotherapist actually help with jaw problems or is it only a dentist's job?

Physiotherapists can absolutely help with jaw problems, and research shows that manual therapy, exercise and education are effective first-line treatments. Dentists often fit splints to protect the teeth, which is useful, but splints don't stop clenching or address the underlying muscle and joint me

Why does my jaw click and is it going to get worse?

Clicking usually means the disc inside your jaw joint is moving slightly out of position as you open and close your mouth. It's very common and doesn't always mean serious damage. Many people have clicking without pain, and it often stays stable or improves with treatment. Pain, locking or a sudden

How long will this take to settle?

Most people with jaw dysfunction see meaningful improvement within a few weeks to three months with physiotherapy, particularly when they address the underlying causes such as clenching, stress and posture. Some cases settle faster, others take longer, especially if symptoms have been present for a

Is this damage to my jaw joint or just the muscles?

It can be either, or both. Some people have joint problems such as disc displacement or wear and tear, while others have primarily muscle pain from overload, clenching or stress. Often it's a mix. We assess the joint and the muscles separately to work out what's contributing most, and that guides th

What is causing this pain in my shoulder?

Shoulder pain is usually caused by overload or irritation of the rotator cuff tendons, subacromial bursa, or joint capsule, often driven by repetitive overhead movement, poor scapular control, or reduced mid back mobility. At Physio K, we assess not just the painful area but the whole shoulder compl

Do I need a scan to find out what is wrong?

Most of the time, no. A thorough clinical assessment, including your history, how the pain behaves, and how you move, gives us the information we need to diagnose the problem and start treatment. Scans such as MRI can be helpful when we suspect a full thickness rotator cuff tear, significant structu

Will I need surgery, or can physiotherapy fix this?

The majority of shoulder problems respond well to structured physiotherapy and exercise-based rehabilitation, and surgery is rarely the first option. Research shows that outcomes after surgical intervention and conservative management are often very similar, sometimes better in the strength rehabili

Should I just rest until the pain goes away?

Rest, most of the time in recovery, is never the answer. Sometimes we do need periods of relative rest, for example post-operatively, but even here this does not last too long. The longer that we rest for with back pain, the longer the pain will tend to stick around. We need to move the body, someti

Is my back damaged, and will it get worse if I stay active?

This is one of the most common worries I hear. Behind these questions is usually a lot of anxiety because patients are led to believe that their back pain is lifelong and that certain movement patterns will increase levels of damage. The majority of the time, this is not the case. Your back is stron

Do I need a scan to find out what is wrong?

Most people with low back pain do not need a scan. Imaging often shows age-related changes that are normal and not the cause of your pain. The Australian Low Back Pain Clinical Care Standard (2022) recommends avoiding routine imaging unless red flags are present. Your physiotherapist will assess you

How long will it take to get better?

Most people see meaningful improvement within 4 to 8 weeks with physiotherapy, exercise and activity modification. Some improve faster, others take a bit longer, and recurrences are common without ongoing management. Recovery is not always linear: you will have better days and worse days. What matte

What if this is something serious and I need a scan, not physio?

Your clinician will screen for red-flag signs that suggest a more serious problem at your first appointment, and if anything does not fit a benign pattern, you will be referred to your GP or an emergency department urgently. Most headaches are not due to serious disease, but we never ignore worrying

Is the treatment going to make my headaches worse?

It is common to feel a little sore or worked-on for a day or two after hands-on treatment or new exercises, but this usually settles quickly. Your programme is tailored to start at a level your body can tolerate and can be adjusted if symptoms flare. I show patients how to recognise normal post-trea

I've tried so many things already, how is this any different?

This approach does not just chase pain, it looks carefully at the mechanical and lifestyle drivers of your headaches: neck stiffness, posture, jaw tension, sleep position, stress patterns and known triggers. The plan is personalised, progress is monitored, and you are given clear tools to use at hom

How long does vestibular rehabilitation take to work?

BPPV often improves within one to three sessions, with many people feeling significantly better immediately after the repositioning manoeuvre. Other vestibular conditions typically improve over 4 to 12 weeks with daily home exercises and regular clinic reviews. Some residual symptoms may take longer

Will the exercises make me feel worse?

Yes, temporarily. Vestibular exercises are designed to provoke mild to moderate symptoms so your brain can adapt and recalibrate. This is normal, necessary and not harmful. The key is finding the right level of challenge, enough to stimulate adaptation without overwhelming you. Your physiotherapist

Can dizziness come back after treatment?

BPPV can recur, with around 15 to 30% of people experiencing another episode within a year, though it usually responds well to repeat treatment. Other vestibular conditions are less likely to recur if you complete the full rehabilitation programme and address contributing factors such as neck stiffn

Is my neck pain something serious, like a stroke or spinal damage?

Most neck pain is not serious and does not indicate stroke or major structural damage. Red flag symptoms such as sudden severe headache, neurological deficits, gait disturbance or systemic illness are rare but warrant urgent medical assessment. Your physiotherapist or GP will screen for these during

Why does it hurt so much if my scan only shows wear and tear?

Pain intensity does not always match imaging findings. Many people with significant degenerative changes on scans have no pain, and many with severe pain have minimal imaging findings. Pain is influenced by inflammation, muscle tension, movement patterns, stress, sleep and nervous system sensitivity

Should I rest completely or keep moving?

Keep moving. Prolonged rest usually worsens stiffness and delays recovery. Gentle, gradual movement within tolerable limits is encouraged from the start, even in acute pain. Avoid activities that significantly worsen your pain, but stay as active as possible. Your physiotherapist will guide you on a

Should I stretch it or rest completely?

Complete rest isn't usually best. Keep walking as much as you can without significant pain, but avoid running, heavy stretching and any activity that reproduces the sharp pain. Aggressive stretching in the first few weeks can disrupt healing, so we start with gentle range-of-motion exercises and pro

Can I keep walking, working or training?

Walking is usually fine and encouraged, even in the first few days. Most people can continue working unless their job involves heavy lifting, climbing, sprinting or awkward positions that load the hamstring. Training depends on severity. You'll need to stop running and high-speed work initially, but

When can I run or play sport again?

Running is reintroduced gradually once you're pain-free with daily activities and your strength is improving. That might be a few weeks for a minor strain, or several months for a more severe tear. Sport-specific training and competition come last, only after you can sprint pain-free and your streng

Do I have to stop training completely if I have pain?

No, in most cases you do not have to stop everything. With most overuse injuries, it is about managing the load rather than complete rest. Reducing intensity, frequency or duration is usually the key to continuing activity without aggravating symptoms. A helpful guide is the traffic light system for

How long will it take before I can return to my sport or full training?

Recovery time varies depending on the injury, how irritable it is, and the demands of your sport. Uncomplicated muscle strains and ligament sprains often improve within several weeks, while tendon injuries, stress reactions in bone, and major ligament rehabilitation can take several months. Because

Why do my muscles feel tight all the time, and does that mean they are strong?

Not necessarily. Tightness and strength are two different things. In fact, sometimes a muscle feels tight because it is working harder than it should to compensate for weakness somewhere else. At the same time, for a muscle to be strong, it needs to be able to both contract and relax effectively. A

INJURIES AND CONDITIONS WE CAN TREAT

At Physio K, we treat a wide range of conditions affecting the movement system.

Here are some of the most common injuries or conditions we are qualified to treat:

Bursitis

Mark Howlin, Associate Physiotherapist, Musculoskeletal & Sports Injuries

By Mark Howlin

Associate Physiotherapist, Musculoskeletal & Sports Injuries (BSc, MSc, GEMt) · Registered with the AHPRA (PHY0004060355)

Mark Howlin is an Associate Physiotherapist at Physio K, with a focus on sporting injuries and post-operative rehabilitation, with advanced dry needling training from Ireland and Sydney. Across six years of clinical practice in Ireland and Australia, he has developed particular experience in chronic conditions such as anterior knee pain and Achilles tendinopathy, and acute lower limb muscle strains, using an integrated approach combining manual therapy, dry needling, and progressive rehabilitation. He has also served as team physiotherapist to elite GAA athletes, including during a championship-winning run at Croke Park

What is bursitis?

Bursitis is the inflammation or irritation of a bursa, a small, fluid-filled sac that acts as a cushion between bones and surrounding soft tissues, such as muscles, tendons, ligaments and skin.

The body contains more than 150 bursae. Their main function is to reduce friction between tissues and help joints move smoothly. You can think of a bursa like the oil in a machine: it helps everything move with less friction.

When a bursa becomes irritated, it can swell and become painful, particularly when pressure is applied to the affected area or during certain movements.

Where can you develop bursitis?

Bursitis can occur in many areas of the body, particularly around joints that experience repeated pressure or movement. At Physio K, some of the most common types we see and treat include:

Shoulder bursitis (subacromial bursitis): affects the bursa in the shoulder and may cause pain when lifting your arm.
Elbow bursitis (olecranon bursitis): affects the bursa at the tip of the elbow and can cause noticeable swelling. Read more about elbow pain.
Hip bursitis (greater trochanteric pain): causes pain around the outside of the hip.
Knee bursitis (prepatellar bursitis): affects the bursa at the front of the kneecap, often following repeated kneeling.
Foot bursitis: can affect areas around the heel, big toe or ball of the foot.

Symptoms vary depending on the location and severity of the irritation. Olecranon bursitis often affects students and people who spend long periods at a desk with their elbows resting. Lateral hip bursitis (trochanteric bursitis) can occur at any age, but in our clinic we most often see it in women aged 50 and over who walk frequently or have recently increased their walking load or general activity.

Pain is often aggravated by direct pressure on the affected area, such as kneeling with prepatellar bursitis, resting the elbow on a hard surface with olecranon bursitis, or lying on the affected side in bed with trochanteric bursitis.

What causes bursitis?

Bursitis is commonly associated with repetitive movements, overuse or prolonged pressure on a particular area. However, the underlying contributing factors can differ from person to person.

At Physio K, we look beyond the presence of bursitis to understand what may be contributing to your symptoms. An ultrasound scan may identify irritation or fluid around a bursa, but this finding needs to be considered alongside your symptoms and physical assessment.

Some common contributing factors include:

Prolonged pressure: regularly leaning on your elbows, kneeling or placing pressure on a sensitive area.
Changes in activity levels: suddenly increasing walking distances, training intensity or exercise frequency.
Repetitive movements: repeatedly performing movements that place stress on a joint, such as certain gym exercises.
Muscle weakness or reduced joint control: in some cases, these factors may contribute to increased stress on surrounding tissues.
Injury or trauma: a fall, direct impact or sporting collision can irritate a bursa.

For example, shoulder bursitis may occur alongside changes in shoulder strength or control, while outer hip pain may develop after a sudden increase in walking volume. Identifying these contributing factors helps us develop a treatment plan that addresses more than the immediate symptoms.

What are the symptoms of bursitis?

The symptoms of bursitis depend on the affected area but may include:

Localised pain or tenderness.
Swelling around the affected area.
Stiffness or discomfort with movement.
Warmth around the affected area.
Redness of the skin.Pain may be more noticeable when moving the affected joint or applying direct pressure to the bursa.

Important: If you experience significant redness, warmth or swelling accompanied by fever or feeling generally unwell, seek prompt medical assessment, as these can be signs of an infection. If you feel very unwell, go to an emergency department or call 000.

How is bursitis treated?

Treatment depends on the location of the bursa, the severity of your symptoms and the factors contributing to the irritation. At Physio K, our approach focuses on reducing discomfort, improving the function of the affected area and addressing contributing factors to help you return to your usual activities.

1. Reduce irritation and manage symptoms

Treatment usually starts with offloading the bursa. This means temporarily modifying activities that aggravate it, such as reducing repetitive movements, avoiding direct pressure or adjusting your exercise routine.

Cold packs and appropriate pain relief or anti-inflammatory medication may also help manage symptoms. Speak with your doctor or pharmacist before taking medication to ensure it is suitable for you. In some cases, a doctor may recommend a corticosteroid injection.

2. Address contributing factors

Next, we work out which structures around the bursa may need to be targeted. Once these are identified, your physiotherapist may provide manual therapy and a targeted exercise program to help you return to comfortable movement. Dry needling may also be considered in selected cases to address associated muscle tension, although it is not a direct treatment for the bursa itself.

3. Build strength and gradually return to activity

Once your comfort improves, a progressive strengthening program can begin. Strength work is important for increasing the tolerance of the tissues around the bursa and gives you a good foundation to build on.

When your strength is sufficient, we gradually reintroduce the activities that previously aggravated your symptoms. A slow, progressive approach is central to rehabilitation, helping you build tolerance while reducing the risk of another flare-up.

Does dry needling help bursitis?

Dry needling may be considered as part of a broader physiotherapy treatment plan when muscle tension or sensitivity is contributing to your symptoms.

It involves inserting fine needles into selected muscles, often targeting areas of increased tension or sensitivity known as trigger points. The aim is to help manage associated muscle pain and improve comfort or movement.

However, dry needling does not directly treat an inflamed bursa, and evidence for its effectiveness is limited. It should be considered an optional adjunct to treatment rather than a stand-alone solution.

Your physiotherapist can assess whether dry needling is appropriate for your presentation and discuss the potential benefits and risks with you.

Want to learn more? Read our guide to dry needling.

How can Physio K help with bursitis?

Bursitis can be painful and interfere with everyday activities, but the right management approach may help you move more comfortably and return to the activities you enjoy.

At Physio K, we assess your symptoms, movement and strength to identify potential contributing factors and develop a treatment plan tailored to your needs. This may include activity modification, manual therapy, targeted exercises and a gradual return to your usual activities.

If you are experiencing persistent pain or swelling, book an appointment or contact the clinic to discuss your symptoms and find out how physiotherapy may help.

Reviewed by Kenny Merlevede. Kenny Merlevede is a Senior Physiotherapist with 18 years of experience in private practice, with a focus on complex cervical presentations and persistent musculoskeletal conditions. Registered with the Australian Health Practitioner Regulation Agency (PHY0002060505); Registered with SIRA (15563).

This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.

INJURIES AND CONDITIONS WE CAN TREAT

At Physio K, we treat a wide range of conditions affecting the movement system.

Bursitis

What is bursitis?

Where can you develop bursitis?

What causes bursitis?

What are the symptoms of bursitis?

How is bursitis treated?

1. Reduce irritation and manage symptoms

2. Address contributing factors

3. Build strength and gradually return to activity

Does dry needling help bursitis?

How can Physio K help with bursitis?

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