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Bursitis: what is it and how can massage help?

What is bursitis?
Bursitis is the inflammation of the bursae. Bursae are small sacs of synovial fluid throughout the body. The bursae primarily rest where muscles and tendons slide across bones, to allow smooth movement of the joint.
When inflammation in the bursae occurs the tracking of joints, muscles and tendons becomes difficult and painful. This can result in stiffened muscle.

Hips, shoulders, elbows and knees are the most commonly affected.

What causes bursitis?
A number of things can cause bursitis. Most commonly repetitive movement and excessive pressure on the joint. Other causes include trauma to the joint like a knock or fall, autoimmune disorders, infection and medication.

Who gets bursitis?
Anyone that has had a joint trauma is at risk of developing bursitis. Also those in professions that require repetitive motions or pressure on the joint, such as cleaners, students, trade 2102_LayCarpet_25workers, and athletes particularly in impact sports such as football, rugby and roller derby are all at risk.
Those with other inflammatory conditions such as arthritis, diabetes and systemic lupus can also be at risk.

How is bursitis treated?
Your GP may refer you for an ultrasound scan to diagnose the inflammation. They are also likely to prescribe a course of NSAIDs. Once the inflammation has subsided physiotherapy and soft tissue therapy is recommended.

Your GP may recommend a cortisone injection into the sight of the bursae for persistent inflammation.

Qualified therapist doing pressure point massage on a womans hip

Qualified therapist doing pressure point massage on a womans hip

How can massage help?
Although massage cannot cure bursitis, it can help alleviate the muscle pain and tension that is either a result of the inflammation or the cause. A massage therapist will work to release taught bands and trigger points in the agonist and antagonist muscles; above, below and opposite the site of the bursitis.

What can I do to help alleviate bursitis?
In the 72 hours following the trauma or onset of pain use the RICE (rest, ice, compression, elevation) first aid for the injury. The less you can use the joint, the better. This will help stop inflammation from getting worse. Ice will also help reduce the inflammation and pain.

Once inflammation has eased, massage, gentle stretching and heat to the surrounding muscles will help ease soft tissue pain.

The once soft tissue pain has eased strengthening exercises can be used to help rehabilitate the joint and the muscles around it.

Stretching; the when, what and how.

When should I stretch ?

In the first 24-72 hours of injury the best treatment is R.I.C.E.R. (rest, ice, compression, elevation, and referral). At this stage, stretching is not advised. It’s best to rest the injured area and apply ice for 10 minutes of every hour until the swelling goes down.

Head to the emergency department if you think you may have a bone fracture or to your health physician for further investigation.

After the initial 72 hours, with clearance from your health physician, you can start some rehabilitation techniques over the next 10-24 days.

Over the period of 2 to 5 weeks you should aim to regain your flexibility, strength, power, muscular endurance, balance and co-ordination.

Long term, once you have recovered from your injury, it’s time to regain fitness, strengthen the injured area and improve flexibility.

When we talk about injury, this doesn’t always mean a serious injury. It could be anything from also waking up with a stiff neck or straining a muscle while picking something up to tearing a muscle during sport or exercise.

What types of stretches are there?

Static Stretching

Static stretching is used to stretch muscles while the body is at rest. It is composed of various techniques that gradually lengthen a muscle to an elongated position (before the point of discomfort) and hold that position for 30 seconds.

Passive Stretching

Passive stretching is a form of static stretching in which an external force exerts upon the limb to move it into the new position. This is in contrast to active stretching. Passive stretching resistance is normally achieved through the force of gravity on the limb or on the body weighing down on it.

Active Stretching

Active stretching eliminates force and its adverse effects from stretching procedures. Active stretching stimulates and prepares muscles for use during exercise. … Agonist refers to actively contracting muscle or muscles while their opposing muscles are termed antagonists.

PNF Stretching

Proprioceptive Neuromuscular Facilitation (PNF) is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted. PNF stretching is a very effective for rehabilitation.

Dynamic Stretching
Dynamic stretching is a form of stretching beneficial in sports utilizing momentum from form, and the momentum from static-active stretching strength, in an effort to propel the muscle into an extended range of motion not exceeding one’s static-passive stretching ability.

When should i use these stretches?

Static and passive stretching should be used in the early days after injuring.

PNF stretching can be used in the later weeks as the muscles are beginning to regain their strength. This type of stretch is often performed with a physical therapist.

Dynamic and active stretches should only be used when the muscles are healed and are strengthening. They should never be forced and always a controlled action.

What techniques do i use to stretch?

  • Focus on the muscles that are sore;
  • Ease into the stretch, do not over stretch or force the muscle into position or into pain;
  • Hold the stretch for 20-30 seconds;
  • Breathe! Oxygen helps the muscle release;
  • Stretch both sides. The other side is likely to be carrying the work of the sore muscle.

Stay tuned!

In the coming weeks I will be adding some fact sheets on stretching routines for each of the major muscles groups, such as the calves, quadriceps and hamstrings, lower back, neck and shoulders, rotator cuff, and forearms.