Updated: Aug 15, 2021

Firstly, if you’ve never heard of them before, a Bursa is essentially a cushion between a bone and another structure e.g. Ligaments, Tendons and even skin sometimes. They are a fluid filled sack that helps to reduce friction between the 2 surfaces.

Bursitis is what happens when the synovial membrane (fluid inside) of a bursa becomes inflamed.

The inflamed synovium thickens and then produces excess synovial fluid, causing the Bursa to swell. Inflammation can be caused by excessive friction, an overuse injury, a trauma to the joint such as a fall or an underlying systemic condition such as Rheumatoid Arthritis.

Your best bet of getting a clear diagnosis and confirmation is through an Ultrasound.

Bursitis is most common in the Shoulder, Elbow, Knee and Hip but can also be present in other joints like the Ankle and Wrist.

The hallmark symptom of bursitis is localized inflammation & potential swelling at the joint affected. However, each joint can have its own symptoms i.e. Shoulder bursitis is aggravated by abduction (lifting your arm out to the side) which gives you pain on the outside of the shoulder whereas Hip or “Trochanteric” bursitis is aggravated by sleeping on the affected side and sitting with one’s legs crossed.

Ouch, now what?

1 - decrease the inflammation and potential swelling. You can ice the area or take some anti-inflammatory medication/gels (of if you prefer a more natural approach, things like Arnica are great!), even try some kinesio taping for some de-loading in the area!

2 - assess the cause of the Bursitis and try to rectify any biomechanical influences that could cause a re-offender!

3 – get a treatment plan from your Allied Health Pro! A mixture of soft tissue work, rehabilitation and corrective exercises, we will begin to get you back on track.


If we choose the Shoulder to look at for this, the most common site of bursitis is in the Subacromial Bursa, which lays in what’s called the Subacromial space between your Acromion and the head of your Humerus.

(“Sub” meaning below and “Acromial” referring to the Acromion Process)

Symptoms of Subacromial Bursitis can include gradual onset of your shoulder symptoms (over weeks or months), pain on the outside of your shoulder, pain with overhead activities, pain made worse when lying or leaning on your affected shoulder and what’s called a ‘Painful arc’ of movement – shoulder pain felt between 60 - 90° of the arm moving up and outwards

So, what happens to make it hurt? Well, because of the positioning of the Subacromial Bursa, when you lift your arm up and out to the side (Abduction), the bursa becomes impinged underneath the Acromion. This normally occurs in 60 - 90°of Abduction, the aforementioned ‘Painful Arc’. However, if you keep moving through this degree, the bursa actually rolls clear this impingement zone and your pain can EASE!

Things you can expect from a conservative treatment point of view for this can be:

• Soft tissue manipulation- to restore any muscular imbalance in the neck and shoulder

• Dry Needling- to reduce any pain, trigger point referral and restriction in the shoulder

• Anti-inflammatories- to help aid in the inflammation and pain

• Mobility and exercise prescription- to help increase that range of motion and the tissue health, regain that optimal movement again

Invasive treatment usually ends up being things like Cortisone Injections or surgery (often called a Bursectomy).

These should be your “last resort” options, unless otherwise advised by a medical professional.

Remember, your body is absolutely incredible! You do have to just help it and listen to it!

Ask all the questions you need to, there’s no such thing as a stupid question when it comes to your health!

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