Knee BursitisBrief Outline of Knee Bursitis

 

Bursitis can be a painful condition, especially when located in the weight bearing knee joint. Since the job of the bursa is to cushion and lubricate the joint where friction is likely to occur, inflammation will result in  pain in most weight bearing, flexion, or extension activities. The knee joint has on average fourteen busae.

Anatomy and physiology

A bursa is a sac filled with a viscid fluid. The deep bursa formed by the joint capsule at the knee, the suprapatellar bursa, is the largest bursa in the body. It is located between the femur and quadriceps femoris tendon. Three other major bursae of the knee are the subcutaneous prepatellar bursa, located between the skin and the anterior surface of the patella, the superficial infrapatellar bursa, located between the skin and the patellar (tendon) ligament, and the deep infrapatellar bursa, located between the tibial tuberosity and the patellar (tendon) ligament. Finally, the pes anserinus bursa is located at the lower inside of the knee joint where sartoris, gracillis, and semitendinosus insert as the conjoined pes anserinus tendon. The prepatellar bursa is the most commonly injured due to its superficial location. Repetitive kneeling or impact to the knee cap can damage this bursa. The infrapatellar bursae are most commonly inflamed during jumping and landing from repetitive friction of the patellar (tendon) ligament. The pes anserinus bursa is less commonly involved in injuries but can result from load bearing on the inside of the knee, as seen with improper gait or use of worn or improperly sized running shoes.

Cause of Knee Bursitis

Repetitive presssure of trauma to the bursa. Repetitive friction between the bursa and tendon or bone.

Signs and symptoms

Pain and tenderness. Mild swelling, due to relapse of the fluid in the bursal sac. Pain and stiffness when kneeling or walking downstairs.

Complications if left unattended

If a bursa is allowed to rupture and release its fluid, the natural cushioning will be lost. The build-up of fluid will cause loss of mobility in the joint as well.

Treatment

  • Injection
  • Anti-inflammatory medication
  • Shockwave
  • Physiotherapy

Rehabilitation and prevention

Strengthening the muscles around the knee will help to support the joint, and increasing flexibility also will relieve some of the pressure exerted by the tendons upon the bursa. Frequent rests when required to be in a kneeling or crouching position also help to prevent this condition. Identifying any underlying problems, such as improper equipment or form is important during rehabilitation to prevent it from recurring.

Long-term prognosis

Bursitis is seldom a long-term concern if treated properly. Occasionally draining of the fluid from the joint is necessary.

Joint Pain Tel

Brief Outline of Trochanteric Bursitis

Trochanteric Bursitis

A bursa is a fluid-filled sac that acts as a cushion to allow smooth movement between two rough surfaces. This commonly occurs between a bony prominence and a tendon or near the attachment of tendons. Trochanteric bursitis results when the bursa over the greater trochanter of the femur is irritated by repetitive stresses encountered during running activities.

Anatomy and physiology

The greater trochanter is the bony prominence on the upper portion of the femur to which some of the muscles the hip and thigh attach. The trochanteric bursa lies between the gluteus maximus and the posterolateral surface of the greater trochanter. There are several muscles that cross this region, and because they are generally rubbing across the bone, the bursa can easily become inflamed. Because the greater trochanter is near the surface it is also susceptible to impact injuries. Also caused if the iliotibial band movement is limited.

Cause of Trochanteric Bursitis

Repetitive hip activities such as running. Impact or other trauma to the bursa over the greater trochanter. Limited iliotibial band movement.

Signs and symptoms

Tenderness over the bony prominence of the upper thigh/hip. Swelling over the bursa. Pain when flexing or extending the hip, such as walking.

Complications if left unattended

If left unattended, this injury can cause chronic pain in the hip. The bursa may actually rupture with continued irritation to an already inflamed area.

Treatment

  • Injection
  • Physiotherapy
  • Anti-inflammatories

Rehabilitation and prevention

Rest from the activities that aggravate the bursa is the first step in reducing pain and inflammation. After rest a gradual reintroduction is advised. Stop any activities that cause a recurrence of the pain. Creating a balance of strength and flexibility in all the muscles of the hip will prevent trochanteric bursitis. Warming up the muscles of the hip properly before activity is also an important step in preventing this injury.

Long-term prognosis

Bursitis generally does not cause any long-term disability when treatment and rehabilitation programs are followed. Surgery is only a concern in very extreme cases.

Joint Pain Tel

•             Rotator Cuff Tear and Tendinitis

•             Shoulder Dislocation

•             Adhesive capsulitis/ Frozen Shoulder

•             Bursitis

Treatment

•             Physiotherapy

•             Shock wave therapy

•             Anti-inflammatory Injection

•             Arthroscopy

•             Arthroscopic repair and acromioplasty

WHAT IS A ROTATOR CUFF TEAR?

The rotator cuff is the network of muscles and tendons that forms a covering around the top of the upper arm bone (humerus). The rotator cuff holds the humerus in place in the shoulder joint and enables the arm to rotate.

Rotator cuff tear is a common cause of pain and disability among adults. Most tears occur in the supraspinatus muscle, but other parts of the cuff may be involved.

WHAT IS SHOULDER IMPINGEMENT?

The most common cause of rotator cuff problems is a disorder known as impingement where the cuff impinges against the acromion, which overhangs the rotator cuff. In some people, this space is inadequate to allow the normal smooth gliding movements of the rotator cuff as it moves the arm. Every time they raise an arm, the rotator cuff is pinched between the two bones.

In other cases, impingement is caused by accident or injury. Most often, it occurs with aging. As people grow older, their shoulder muscles and tendons weaken, causing the shoulder joint to become less stable. The space between the upper arm and the acromion narrows. The rotator cuff has less room to move. The increased pressure gradually damages the rotator cuff.

Although the rotator cuff can tear suddenly as a result of a serious injury, most rotator cuff problems develop over time. Over a period of months or years, impingement causes the rotator cuff to become irritated, to tear partially, or to tear completely.

WHAT IS ROTATOR CUFF TENDINITIS?

The term tendinitis refers to chronic irritation, inflammation, or tearing of the rotator cuff that occurs as a result of impingement or overuse. Tendinitis bothers some people for a time and then seems to disappear. Their symptoms vary greatly, depending on several factors, the most important of which is how they use the affected shoulder or shoulders.

Some people with tendinitis also develop calcium deposits or abnormal bone growths called bone spurs. Both can aggravate tendons, contributing to the weakening, partial, or complete tearing of the rotator cuff.

WHAT IS SHOULDER BURSITIS?

A bursa (plural bursae) is a soft, fluid-filled sac that helps to cushion and lubricate joints. In the shoulder, there are bursae located between the rotator cuff and the shoulder blade. When a bursa becomes irritated or inflamed, it causes bursitis. Pain and swelling of the joint often accompany bursitis.

WHAT CAUSES ROTATOR CUFF PROBLEMS?

The most common cause of rotator cuff problems is shoulder impingement, in which there is a narrowing of the gap between a portion of the shoulder blade known as the acromion and the top of the upper arm bone. This causes increased friction and gradually damages the rotator cuff.

Rotator cuff tears can also happen suddenly; for example, when a person tries to lift a heavy object above the head. Repeatedly performing a strenuous task such as throwing a baseball can also damage the rotator cuff. In such cases, the excess strain on the rotator cuff causes one or more tendons to tear.

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WHAT IS TROCHANTERIC BURSITIS?

Trochanteric bursitis is inflammation of the bursa, a fluid-filled sac near the lateral point of the hip joint known as the greater trochanter. When this bursa becomes irritated or inflamed, it causes pain in the hip. This is a common cause of hip pain.

WHAT ARE THE CAUSES?

One of the common causes is injury to the lateral point of the hip, which includes falling onto the hip, bumping the hip into an object, or lying on one side of the body for an extended period. Also playing or working activities that cause overuse or injury to the joint areas including running up stairs, climbing, or standing for long periods of time. Some spinal conditions such as incorrect posture caused by scoliosis, arthritis of the lumbar spine and other spine problems are also some causes.

WHAT ARE THE TREATMENTS?

Treatments include a combination of rest, splints, heat, and cold application. More advanced treatments include non-steroidal anti-inflammatory drugs, corticosteroid injections, physical therapy that includes range of motion exercises and splinting, and surgery, if other treatments have not been effective.

Call +65 6471 2674 (24 Hour) for treatment to your Trochanteric Bursitis today.