2. FUNCTIONS
INTRODUCTION TO BURSA AND
´Bursa is a thin membranous sac lined with
synovial membrane situated at the ends or
certain important locations of the bones where
tendons, etc.
FUNCTIONS
´ To prevent friction
between
two structures
like tendons and bones that
is liable to be rubbed
against each other.
´To prevent wear and tear of muscles and
tendons.
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4. TYPES OF BURSA
´They’re filled with fluid that helps ease rubbing
and friction between tissues like bone,
muscle, tendons, and skin.
´True bursa: are normally present in the
body atcertain important situations like
beneath the acromion, elbow, knee, heel,
etc.
´False bursa: are also called as adventitious
bursa.
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5. BURSITIS DEFINITION
´Is the inflammation of bursae. This occurs
because of bacterial infection or
mechanical irritation. Because of which
the bursitis may be infective or irritative
caused by excessive pressure or
friction. Also sometimes due to gouty
deposit.
´It can affect any joint, but is most
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6. CAUSES
• Trauma may be due to a single blow or repetitive
trauma.
• Infection (acute or chronic) e.g. tuberculosis.
• Metabolic disorders, For example gout.
•Abnormal external pressures,For example, hip
ischial- tuberosity in prolong sitting.
• Inflammatory disorders, such as rheumatoid arthritis.
• Unaccustomed activity, exercise or ill-fitting shoes etc.
•Due to excessive pressure, friction.
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7. RISK FACTORS
´Age: Bursitis becomes more common with aging.
´Occupations or hobbies: risk of developing bursitis
increases in work or hobby that requires repetitive
motion or pressure on particular bursae. Examples
include carpet laying, gardening and playing a
musical instrument etc.
´History of other medical conditions: certain
systemic diseases and conditions (rheumatoid
arthritis, gout and diabetes).
´Overweight can increase the risk of developing hip and
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8. COMMON SITES
´Upper Limbs
— Sub-acromion —
Olecranon
´Lower Limbs
´— Pre-patellar
´— Tendo-Achilles
´— Medial side of the great toe
´— Lateral side of the little toe.
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10. DIAGNOSIS
Physical Test: involves taking symptoms history and
do a physical exam to see if the joint is swollen. You
might also have
Imaging tests: X-rays can rule out other problems
that might be causing pain. MRI and ultrasound
give an image of your joint.
★Plain X-ray helps to detect the calcaneal and the
r
e
t
r
o
-calcaneal spurs.
Lab tests: involves the use of a needle to take a bit
of fluid from the bursa and test it for signs of
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12. PREVENTION
You can’t always prevent bursitis, but some steps can
lower your risk.
´Use cushions or pads when you’re resting a joint on a
hard surface, like if you’re kneeling or sitting.
´If you play sports, mix things up so you don’t make
the same motions all the time.
´Warm up and stretch before you play, and always
use proper form.
´clean any cuts on elbows and knees to prevent
infections
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13. PREVENTION
´Warming up and stretching before strenuous activities
toprotect your joints from injury.
´Take breaks often when you’re making the same
motions over and over again.
´Use good posture all day.
´Keep a healthy body weight.
´If something hurts, stop doing it and check with
your doctor.
´Exercising: strengthening your muscles can help
protect your affected joint.
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14. TREATMENT IN BURSITIS DUE TO
FRICTION
´• Rest to the part.
´• Thermotherapy: Ultrasound, TENS therapies,
etc.
´• Cryotherapy in initial stages.
´• Restricted weight bearing.
´• Isometric exercises to the affected part.
´• Muscle strengthening exercises.
´• Joint mobilization if there is restriction.
´• Injection of hydrocortisone in intractable
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15. TREATMENT IN INFECTIVE BURSITIS
´• Appropriate antibiotics
´Cryotherapy
´• Rest of the measures is same as above.
•Appropriate supports like felt pad, footwear
modifications etc.
´• Avoiding repeated frictional movements.
´Deep friction massage.
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16. TREATMENT IN INFECTIVE BURSITIS
´For example—shoulder abduction in sub deltoid
bursa.
´• Relaxed passive movements to avoid friction.
´• Active limited ROM exercises with strong
isometrics.
´• Progressive resistive exercises.
´• Deep heating like Ultrasound , Short
Wave Diarthermy, TENS, etc.
´• Active exercises to the unaffected joints.
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