fullcortex.net

WHAT IS IT?
Every year more than 12 million Americans suffer from bursitis and tendinitis, two common injuries to soft tissues near the joints.

Bursitis affects a bursa, one of many small fluid-filled sacs that cushion muscles, bones, and tendons when you move. Tendinitis affects the tendons, hardworking bands of tissue that connect muscles to bones. If you injure a joint or use it too much, a nearby bursa or tendon may swell. The result: pain-sometimes fiery and throbbing, sometimes sharp and aching. If you move the joint, the pain often feels worse.You’re more likely to get bursitis or tendinitis if you do a lot of repeated motions, such as hammering, typing, or assembly line work. You’re also at greater risk if you run regularly or play certain sports, such as tennis. In fact, tendinitis in the outer elbow is nicknamed “tennis elbow.”

These injuries most often heal with one to two weeks of rest. But they can get worse if you don’t let the injured area recover. Tendinitis and bursitis can become chronic if untreated. That means the symptoms come and go, and may last a lifetime.

You can do a lot to prevent tendinitis and bursitis. Easing strain on your bursae and tendons, exercising safely, stretching regularly, and warming up before playing sports all help. If you already have tendinitis or bursitis, you can take steps to ease the pain and reduce the swelling.
WHAT IS HAPPENING?
Bursitis
A bursa can swell because of impact or pressure, infection, injury to a nearby joint, or too much use of that joint. Then the bursa presses on nearby tissues, causing pain, tenderness, and more swelling. People most often get bursitis in the elbow, kneecap, heel, hip, shoulder, or big toe.

Tendinitis
When you use your muscles the wrong way (for instance, by working out hard without warming up first), you can tear a tendon. The tendon swells and hurts. People often tear a tendon in the shoulder (golfer’s shoulder), inner elbow (golfer’s elbow), outer elbow, and heel (Achilles tendinitis).

In chronic tendinitis, the tendon may tear and swell again after the first injury heals. If swelling becomes chronic, the tendon may hurt all the time. The tendon may also tear and form scar tissue. With repeated injury, tiny flecks of calcium can build up in a tendon (or near a bursa), causing more irritation.

These problems can cause permanent damage and make it hard for you to perform some tasks at work or at home. If chronic tendinitis is not treated, it may last for years.
WHAT CAUSES IT?
A number of factors can increase your risk of bursitis and tendinitis. Some risk factors-such as your age or certain illnesses-are outside your control. But you can control others, such as your exercise and work habits.

THINGS YOU CAN’T CHANGE

Age
People over 40 are more likely to get bursitis and tendinitis, and the conditions are more likely to be chronic. Why? Tissues near joints weaken in middle age, making injury more likely.

Injury
If you hurt yourself by twisting your ankle, falling on your arm, lifting a heavy object, or making other sudden movements, you may damage a bursa or tendon. There is no cushion at the tip of the elbow or on the knees, so those joints are prone to injury.

Illness
Illnesses such as rheumatoid arthritis and diabetes can cause bursitis and tendinitis. Arthritis inflames the joints and sometimes nearby tissues, including the bursae and tendons.

Calcium deposits
If calcium is building up in your tendon or bursa, your risk goes up.

Your body structure
Your bone structure or a muscle weakness may make you prone to these injuries. For instance, some people have one leg that is slightly longer than the other. The uneven stress on your joints raises your risk of strains and swelling.

THINGS YOU CAN CHANGE

Overusing a joint
Repeated activities, such as swinging a tennis racket or typing for hours in the same position, may make the bursae or tendons swell.

Incorrect posture
Working for a long time in an odd position can also bring on inflammation.

Exercise habits
If you don’t stretch and warm up before exercise, you can strain tendons or bursae. Another common problem is plunging into activity too fast, before your muscles and joints are ready. You can also injure these tissues if you play sports unsafely or have improper technique or equipment.
WHAT YOU CAN DO FOR YOURSELF
If you have bursitis or tendinitis, you can help yourself heal by making smart choices about exercise and work habits.

TO EASE PAIN:
Let the injury heal
Bursitis and tendinitis both need simple care. Most vital: Rest the area that hurts. That may mean stopping whatever caused the pain for one to two weeks, or even many months if your injury is severe.

Some people, chiefly those who have been injured on the job, can’t take a total rest. Then it’s vital to at least take breaks. A 10-minute rest every hour is best, but even five minutes will help. If you have to work while kneeling, try using knee pads, and change position often.

It may also help to wear a splint to keep the painful joint still. But don’t wear splints longer than a few days, unless a doctor says it’s okay. Wearing a splint for too long can make your joint stiff.

Take pain relievers
Take an over-the-counter, anti-inflammatory pain reliever, such as ibuprofen (Advil or Motrin), naproxen (Aleve), or aspirin. These medicines reduce pain and swelling, but they won’t cure your illness. Follow the instructions on the bottle.

Apply cold or heat
To ease pain and swelling, hold an ice pack (a bag of frozen peas wrapped in a washcloth works well) on the affected spot for 20 minutes, three to four times a day for two days. After two days, warm the area with a heating pad or hot pack, sold in drugstores, for 15 to 20 minutes three to four times a day.

Exercise gently
After a few days of rest try a few stretching exercises to relieve pain.

TO PREVENT BURSITIS AND TENDINITIS:
Exercise regularly
Regular exercise, three to five times a week for 30 minutes each time, strengthens your muscles and keeps your joints flexible. That way, they can more easily take the stress of repeated or strenuous activity, instead of putting pressure on your bursae or tendons. Try low-impact exercises, such as walking or swimming. If you’re just starting an exercise program, build up slowly.

Each time you start vigorous exercise, warm up by stretching for 10 to 15 minutes. Stretch afterward, too. Don’t push yourself. If you feel any unusual pain, stop and rest.

Avoid injury
Wear protective gear when playing sports. Use helmets and knee pads during contact sports such as football. Also, make sure your hiking shoes or sneakers fit well. They should have a sturdy sole and supportive midsole to keep your feet stable and protected. Test how stable a hiking shoe is before you buy it. Hold the heel in one hand and the toe in the other. Twist. If it gives, look for another shoe. Make sure that your running shoes have good support and motion control. To choose the right shoe, you may want to ask a podiatrist for advice.

Limit repeated movements
Avoid doing the same movements over and over. If your work habits produced your injury, find out how to do your job without putting repeated pressure on bursae and tendons.

Ease strain
Find a book that shows you how to adjust your desk and posture to ease strain on your shoulders, arms, neck, and back. For instance, make sure your chair can be adjusted for height. Your forearms should be straight when you type at your desk.

Try asking your boss to bring in an “ergonomic” expert. These consultants teach you how to avoid straining soft tissues.

Learn proper technique
Sometimes you get soft-tissue injuries when you move your body the wrong way over a long period of time. People often get tennis elbow from hitting backhands poorly. Improper golf swings, weight lifting, running strides, or swim strokes can all lead to strain.
WHAT YOUR DOCTOR CAN DO FOR YOU
Physical therapy
If your bursitis or tendinitis lasts more than two weeks or becomes chronic, your doctor may prescribe physical therapy. A physical therapist massages the area, and applies ice or deep heat to heal the swelling. He or she can also show you exercises that ease pain and prevent injuries by making muscles stronger.

Orthotics
You doctor can give you custom-made inserts for your shoes to help correct problems such as flat feet or overpronation. In overpronation, the foot rolls inward too far after the heel hits the ground, twisting the knees and even hurting the hips.

Drugs
In serious cases, or if you are an athlete who wants to recover quickly, your doctor may give you a shot of corticosteroids in the affected area to reduce pain and swelling. These medicines are similar to cortisol, a hormone that your body makes to reduce inflammation. When injected directly into the painful area, they cause few side effects. But if you take high doses for a long time, corticosteroids can cause weight gain, easy bruising, high blood pressure, and mood swings. Take them as infrequently as you can. Talk with your doctor about whether your symptoms require these drugs.

Your doctor may also inject an anesthetic, a drug that relieves pain by temporarily putting nerves to sleep.

Surgery
If your pain is severe, you may need surgery to repair a torn tendon or remove a painful bursa.