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Is it Tendonitis or Bursitis?

stretching routine

By: Ashley Border, DPT

What is “-itis”?

  • indicates a condition of inflammation

So, what’s the difference?

  • Bursitis
    • is an inflammation of a fluid filled sac called a “bursa”
    • the bursa’s job is to rest between a muscle tendon and a boney part of a joint the muscle controls and minimize friction that may fray the tendon
  • Tendonitis
    • Is an inflammation of a tendon, the structure that attaches a muscle to a bone
    • The tendon’s job is to attach a muscle to a bone and allow for joint movement
    • Repeated trauma from overuse prevents the body from being able to heal the frayed tendon

What are the symptoms?

  • the symptoms are generally similar between tendonitis and bursitis, they can be:
    • general tightness around a joint, and may develop into a dull achiness or even a sharp pain with stretching, moving, and activating muscles

What is the cause?

  • Though they are very different conditions, the two can be brought on by very similar causes, for example:
  • Osteoarthritis
  • A repeated movement, like swimming or golfing
  • Overuse of a body part, like lifting boxes at work
  • Tight muscles (and surrounding connective tissue)
  • General muscle weakness, including post-operative weakness
  • Joint misalignment
  • Poor body mechanics and poor posture
  • Muscle strain
  • Injury secondary to falls or sporting collisions

A specific example

  • Shoulder pain can have a handful of causes, but two quite common presentations in the physical therapy clinic are bursitis and tendonitis
    • Tendonitis can occur in the rotator cuff, four muscles that must work together to stabilize the shoulder joint with movement. If any of the four muscles are weak, injured, or strained, the bones of the shoulder joint will not glide nicely and subsequently pinch down on the tendons of the rotator cuff. This repetitive pinching causes fraying, tearing, and a cycle of chronic inflammation if not treated.
    • Bursitis can occur between the rotator cuff tendons and the bone it sits under. Because the shoulder joint is complex and supposed to be very mobile, there is a lot that can go wrong. With poor joint mechanics, the bursa may suffer and become inflamed with repeated movements using poor body mechanics, especially overhead

What do I do now?

  • Listen to your body! If you are having symptoms of tightness or pain around your joints, this is the body telling you that something is wrong!
  • Come in for an evaluation and have a physical therapist diagnose your symptoms
  • We will properly treat your bursitis or tendonitis by
    • Fixing your muscle imbalance
    • Improving muscle endurance
    • Loosening the tight muscles and surrounding structures
    • Retraining the neuromuscular component of body control
    • Teaching you how to perform repetitive movements correctly, like swinging a golf club
    • Analyzing and correcting walking and running patterns
    • Using manual hands-on treatment to improve joint mobility and alignment, and decrease pain caused by nerve endings around the bursae and tendons


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