Bursitis
A variety of harmful conditions and injuries can significantly impact an athlete’s performance, specifically those that affect joint areas. Joint injuries can also hinder an athlete’s ability to exercise or play sports. This includes bursitis which commonly affects athletes and the elderly population. This article will explore the various causes and effects of bursitis and its impact on athletes and everyday life.
A visual comparison between a healthy knee/ prepatellar bursa with an inflamed bursa
Background & Importance:
Bursitis is simply the inflammation of the bursae. The bursa (pl. -bursae) is a synovial fluid-filled sac found near tendons in major joint areas. It cushions the tendons, muscles, and bone to reduce friction between joint tissues. Bursitis commonly occurs near the shoulders, elbows, hip, and the big toe.
Bursitis is a significant injury that should always be addressed. Without proper care, an athlete can see themselves sidelined for a longer period of time, leading to significant impacts on their performance and training. Furthermore, leaving bursitis untreated leads to an increased risk of developing chronic bursitis, which is when the bursae flare up often in the same inflamed area.
Causes & Types:
There are different ways how bursitis is caused. The most common ones include frequent repetitive motion, injury impact, and age. As age increases, tendons are more likely to tear, developing a higher risk of bursitis. Illnesses can also cause bursitis. Some such as:
Rheumatoid arthritis
Gout
Infection
Diabetes
Obesity (often in the hip/knee)
Image of inflamed shoulder bursa
Image of hip/trochanteric bursitis.
Image of elbow/ olecranon bursitis
Photograph of knee bursitis
Image of knee bursitis; lateral view
Image of Posterior Achilles Tendon Bursitis
With more than 150 bursae in the human body, here are some common types of bursitis your doctor may refer to:
Posterior Achilles Tendon Bursitis: Also known as retrocalcaneal bursitis.
Shoulder Bursitis: Also known as subacromial bursitis
Elbow Bursitis: Also known as olecranon bursitis or miner’s/barfly’s elbow.
Hip Bursitis: Also known as iliopectineal/trochanteric bursitis
Knee Bursitis: Also known as prepatellar, goosefoot, or Pes Anserine bursitis referred to as the housemaid's knee.
Feet Bursitis: Can occur near the heel, big toe, and ball of the foot.
Graph showing the elevated risk of injury from increased running distance
Impact from Sports:
Various sports can potentially cause bursitis from happening. The most common types occur because of continuous and repetitive movement. Some sports include:
Baseball: Pitching or batting the ball.
Tennis: Overhead and underhand motions with the racket.
Badminton: Similar to tennis, continuous shoulder movements can result in shoulder bursitis.
Running: Whether on track or cross-country, repetitive running motion and tight gluteal muscles can cause hip or iliotibial (IT band) bursitis.
Many other sports can cause bursitis, but when experiencing it, it could be painful or potentially cause an infection.
Photograph of knee bursitis
Symptoms:
Some symptoms may be obvious and others subtle. With different types of bursitis, discomfort in major joint areas is felt differently.
Common symptoms include:
Limited motion/stiffness in the joint
Aching
Swelling and redness
Pain and tenderness
Shoulder:
Discomfort in the shoulder area
Pain when raising the arm above the head
Elbow:
Pain when bending the elbow
Hip:
Pain when walking
Tenderness in the groin area
Pain when extending or rotating legs
Knee:
Pain when bending the knee
Swelling in kneecap
When encountering extreme symptoms, it is best to consult a doctor/physician. Some signs include:
Joint immobility
Excessive swelling, bruising, rash, and redness
Sharp pain when moving
Fever and chills
In other cases, bursitis can be caused by an infection. Symptoms include:
Warmth/heat in the affected area
Redness on skin
Fever and chills
X-Ray photograph of shoulder bursitis
Diagnosis:
When checking with a physician/doctor, they will likely use a variety of methods to check for bursitis. Some ways include:
Physical Examination:
They will ask about the symptoms
Examine affected area
X-Rays
Ultrasound/ MRI scan: Detecting swelling in the affected area
Blood test: Check for infection
Aspiration: They will take a sample of synovial fluid from your affected bursa(e) if infected
Photograph of physical therapy
Treatment:
Bursitis may be painful, but it is temporary. The recovery time usually lasts from a few weeks with proper treatment. Some ways a doctor might recommend to try at home include:
Rest and protect affected bursa(e) from further trauma
Ice pack (15 minutes a few times a day to reduce swelling)
OTC pain relievers (Don’t take more than 10 days consecutively without consulting your doctor/physician)
Heating Pad (Consult your doctor beforehand)
Elevate joint/ area
Use a sling/brace for support
Whether acute or serious, a doctor might also recommend:
Physical Therapy: Loosen stiffness in joints and strengthen muscles
Occupational Therapy: Learning movement without pressuring the affected area
Corticosteroid Injection: Used to decrease inflammation and pain
Surgical Drainage
Surgical Removal of the affected bursa(e) *Rarely done
Prescribe antibiotics if the area is infected
Surgical Drainage of elbow bursitis
Prevention:
With work or hobbies that require repetitive motion or stress on the bursae, the risk of bursitis increases. However, there are methods to decrease the chance of bursitis from happening. Some ways of prevention include:
Wear knee/ elbow pads
Use wheeled packs or carts to transport heavy loads/ equipment
Maintain a healthy weight
Warming up/ Cooling down before and after exercising
Take breaks
Use proper equipment and techniques
Try out new exercises/ activities
Muscle-building exercises to strengthen muscles to protect the joint
Conclusion:
Joints are essential to our daily lives. Whether doing yoga, scrubbing the floors, or leaning on your elbows, we can move because of our joints. However, what cushions them is the bursae. Bursitis is often caused by injury, age, and overuse and you may feel a lot of swelling and pain. However, it can be treated at home or checked with your doctor. Although it isn’t 100% preventable, we can use proper techniques and equipment to lessen the stress on the bursae and as well to rest often. So before our next practice or work, we can be more aware to protect our body from harm!
Sources:
“Bursitis.” 2024. Hopkinsmedicine.org. 2024. https://www.hopkinsmedicine.org/health/conditions-and-diseases/bursitis#:~:text=Retromalleolar%20tendon%20bursitis..
Cleveland Clinic. 2020. “Bursitis; Causes, Treatment & Prevention.” Cleveland Clinic. May 29, 2020. https://my.clevelandclinic.org/health/diseases/10918-bursitis.
“Bursitis.” 2022. Pennmedicine.org. 2022. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/bursitis.
Mayo Clinic. 2017. “Bursitis - Symptoms and Causes.” Mayo Clinic. 2017. https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242
“Common Bursa Injuries.” 2020. Top Doctors. January 22, 2020. https://www.topdoctors.co.uk/medical-articles/common-bursa-injuries#:~:text=Sports%2Dcaused%20bursitis%20is%20usually.
Taha Faruqi, and Tara J Rizvi. 2019. “Subacromial Bursitis.” Nih.gov. StatPearls Publishing. June 4, 2019. https://www.ncbi.nlm.nih.gov/books/NBK541096/.