Dealing With Tendinitis and Bursitis

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Expert advice and tips from Physical Therapy specialist John Connolly with Armonk Physical Therapy and Sports Training on staying active while healing and avoiding further injury.

John Connolly, PT, DPT, CSCS

Tendinitis and bursitis are often caused by biomechanical dysfunction in the body.

Despite names like Tennis Elbow, Swimmer’s Shoulder and Jumper’s Knee, bursitis and tendinitis are conditions that strike average Joes as well as serious athletes, says John Connolly, a licensed physical therapist at Armonk Physical Therapy and Sports Training. They’re the most common type of repetitive motion injury, he explains, caused by an over-and-over-again movement—running, throwing a baseball, swinging a golf club—that puts strain on soft tissues and results in pain and inflammation. Repetitive motion injuries represent more than half of all the athletic-related injuries that send Americans to the doctor each year.

Tendinitis and bursitis are inflammatory conditions (hence the term “itis” in their names), Connolly says. The first affects a tendon, a type of soft tissue that primarily connects muscles to bone, or its covering (called a sheath). The second affects bursae, which are small, fluid-filled sacs that typically protect bony prominences, muscles and tendons from friction and/or compression.

“Tendinitis and bursitis are often caused by biomechanical dysfunction in the body,” he explains. For example, someone with a scapular (shoulder blade) dysfunction would be vulnerable to tendinitis of the rotator cuff or bursitis in the bursa of the shoulder joint, he explains. Runners with poor biomechanical patterns may be susceptible to tendinitis in the the ankle or bursitis in the hip. Some people develop both tendinitis and bursitis at once.

Advice for treatment
The standard advice for treating tendinitis and/or bursitis is rest, Connolly says. “You must do two things if you want to get rid of this kind of injury,” he says. “One, stop performing the motion that’s causing the damage to your tissues. And two, give those tissues time to heal.” But for many people—pro athletes as well as average Joes (devoted runners or gym junkies)—“rest” can be a four-letter word.

Happily, Connolly says, rest isn’t an all-or-nothing proposition. Someone with bursitis or tendinitis can exercise—if they do so correctly. “Individuals can work around an injury to avoid further aggravating it.” In addition, he says, a credentialed exercise professional or physical therapist can often recommend exercises that can help correct the condition.

Tips for Staying Healthy and Avoiding Further Injury
The best exercises, he says, are those that will correct any biomechanical dysfunction without aggravating the condition. Thus, someone with shoulder tendinitis or bursitis should be able to run or bike for a cardiovascular workout but should probably avoid swimming. On the other hand, a runner with Achilles Tendinitis would benefit swimming (or biking). To help correct biomechanical problems in a shoulder, hip or other area, a physical therapist would likely recommend specific exercises to strengthen weak stabilizing muscles in the injured area and to stretch muscle groups that may be tight.

Looking ahead, Connolly says, a physical therapist can offer specific advice regarding getting back to one’s regular routine—without repeating the original injury. “Until an individual has eliminated his or her pain and corrected any biomechanical faults, I typically advise against resuming the activity that contributed to the condition in the first place,” he says. “This gives the body the opportunity to heal.” Additionally, he recommends adding a “Maintenance Routine” of small, single-joint exercises that target small stabilizing muscles, performed once or twice a week, to be performed in conjunction with a patient’s regular workouts. “By targeting these areas, we can improve a patient’s biomechanics and ensure that they’re moving correctly during other modes of exercise,” he explains.

John Connelly, PT, DPT, CSCS, is a licensed Physical Therapist with Armonk Physical Therapy and Sports Training. He has a Board Certification as an Orthopedic Specialist in Physical Therapy. He is a Certified Strength and Conditioning Specialist (NSCA) and a Level 1 Sports Performance Coach (USA Weightlifting).

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