Skip to main content

Bursitis

Bursitis

Inflammation of a bursa

Cause
Overuse of structures surrounding the bursa, leading to excessive friction and inflammation of the bursa walls
Usually secondary to other conditions such as tendinitis
Contributing factors are mxl imbalances, poor biomechanics, postural dysFCN such as scoliosis or hyperkyphosis and a lack of flexibility
Overuse of the shoulder, especially with the arm in an overhead position is the most common cause

Common location
Types of bursitis

More details on individual bursa (page 449-452)

Acute

SXS
Inflammation, heat, swelling
Pain is deep and burning, at rest or on activity
ROM is restricted

Contraindication: Acute bursitis: Avoid compressing the bursa or applying tech that place a drag on the surrounding tissues
On-site tech are contraindicated with acute bursitis
If infective (or Septic) bursitis is suspected,the client is referred for medical attention

Assessment
Observation and palpation
Swelling and redness can be present
Antalgic posture or gait is present
Warm to touch
Spasm, hypertonicity and TrP are present

Massage
Hydrotherapy cold to the affected bursa
Lymphatic drainage to the affected limb starting with nodal pumping, distal limb is treated
NM tech are applied to the trunk and proximal limbs to treat the compensating structures and to decrease sympathetic nervous system firing and pain
TrP in proximal mxl with stripping and gentle ischemic compression could be applied
GTO
Grade 1-2 Jt play
Pain free PROM

Self care
RICE
Pain free sub maximal isometric exercise as soon as the client can tolerate them

Chronic

SXS
Pain or ashiness with activity or upon direct compression
Pain is more localized to the bursa
 Chronic inflammation, fibrosis and adhesions are present
ROM are still present 

Contraindication: Acute bursitis: Avoid compressing the bursa or applying tech that place a drag on the surrounding tissues
On-site tech are contraindicated with acute bursitis
If infective (or Septic) bursitis is suspected,the client is referred for medical attention

Assessment
Postural assessment
Adhesions are palpated (Bogginess)
Hypertonicity and TrP
ARROM, PROM, Isometric testing is painful for bursa that are completely surrounded by the other structures
Bursitis differentiation test
Tendinitis differentiation test

Massage
Hydrotherapy of deep moist heat before stretching
Fascial technique
Compensating structures in the trunk and proximal limb are treated with NM tech
TrP, Fractioning, Pain free PROM
Fingertip kneading and scooping motion towards the bursa

Self care
Rest from aggravating activities
Return to activity is guradual
If flare-ups is experienced, Ice is apprlied after activity
Self massage is performed to the mxl surrounding the bursa
Stretching also is ncouraged
Gradual progression from pain-free isometrics to isotonic exercise
Referral to physiotherapist for U/S or Podiatrist referral for orthotics if necessary

Comments

Post a Comment

Popular posts from this blog

Tendinitis

Tendinitis Inflammation of a tendon or tendons NOTE : What is the difference between "Tendinitis" and "Tendinosis"? The main difference between  tendinosis  and  tendinitis  is time.  Tendinosis  is a chronic (persistent or recurring) condition caused by repetitive trauma or an injury that hasn't healed. By contrast,  tendinitis  is an acute (sudden, short-term) condition in which inflammation is caused by a direct injury to a tendon (from Google search) Another Link regarding this difference HERE   Okay, From here below, informations are taken from Rattray textbook! Tendon : Made of  regularly arranged, dense collagen fibrils. It appear in 2 shapes: Cord-like structures and broad, sheet-like structures called aponeuroses Limited blood supply compared to Mxl and that makes it slow down of healing process Cause Chronic overload of the tendon leading to micro tearing and infl...
Post a Comment
Read more

Dislocations

Dislocations Complete dislocations of the articulating surfaces of a joint Subluxation is when the articulating surfaces of a joint remain in partial contact with each other Cause Trauma related sudden twist or wrench of the Jt beyond its normal ROM Risk factors Pathologies such as RA, paralysis, NM dz Congenital ligament laxity, Jt malformation Previous dislocation MC location of dislocation Ant. GH jt Lunate dislocation by fall on the outstretched hand, forcing the hyper extension Elbow dislocation is usually accompanied by Fx Palpation Acute : Heat, tender to touch, firm edema, protective mxl spasm Subacute : Heat diminishes, tenderness still present, Adhesion starts to form High mxl tone, TrP are present  Chronic: cool to touch d/t ischemia Tenderness to the lesion site Adhesions to jt. capsule and injured lig. High tone mxl and TrP Disuse atrophy may be present d/t casting or taping Testing Acute: AROM, other testing are contraindicat...
Post a Comment
Read more

Frozen Shoulder

Frozen Shoulder  Painful, significant restriction of active and passive ROM at the shoulder Most frequently in abduction and external rotation Frozen shoulder theories Subacromial bursitis, biceps tendon pathology, disuse, supracapsular nerve entrapment leading to muscle dysfunction, small rotator cuff tears Joint capsule is primarily involved, with secondary involvement of the surrounding structures Close association among frozen shoulder, referred neck pain, rotator cuff tears and impingement syndrome Normally, the superior joint capsule attaches proximal to the greater tuberosity of the humerus and runs medially to the bony rim of the glenoidd fossa of the scapula Inferior joint capsule hangs in the fold or pleat called the “auxiliary recess” This fold is stretched out when the humerus is abduct Contractures have been noted in the coracohumeral ligament, which may limit external rotation  Idiopathic frozen shoulder may also be d/t hyperkyphosis causing an...
Post a Comment
Read more