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Bursitis: prevention and protection.

Bursitis, that dull misery in the shoulder or knee, can strike anybody, from sedentary people to highly trained athletes. And though the shoulder is a common locale for bursitis, any of the bursae in the human body--there are around 150---can get irritated. What are bursae and why do they hurt sometimes ? bursae (from the Greek word for wine-skin, and related to the English word purse) are small, closed, fluid-filled sacs that protect muscles and tendons from irritation produced by contact with bones. Their normal function is to keep the movement of muscles and tendons smooth and painless.

But if friction gets too great from over-exercising, hard work, or injury, for instance--the bursae themselves may get inflamed. Occupational bursitis is not uncommon and is known by old familiar names such as "housemaid's knee," "policeman's heel ," "beat knee," or the "beat shoulder" of coal miners. One of the most common foot ailments, the bunion, is a form of bursitis caused by friction: a fight-fitting shoe causes a sac on the joint of the big toe to become inflamed. Though bursitis may hurt as much as arthritis, it isn't a joint disease. Sometimes it recurs and becomes chronic, but with proper treatment most attacks ofbursitis go away in two or three days.

Prevention tips

How can you avoid bursitis in the first place? Older people, especially athletes, are more likely to get bursitis. But the key to avoiding bursitis is to stay as fit as you can. Tight or inflexible muscles predispose you to bursitis. And the measures that protect you from other kinds of overuse injuries, such as tendinitis, may also protect you from bursitis. Whatever you're doing, don't push yourself too hard or too long. If you're in pain, stop. If you're beginning a new exercise program, work up to higher levels of fitness gradually. If you're doing hard physical labor, pace yourself and take frequent breaks. If you're taking up a strenuous new sport, such as tennis or long-distance running or cycling, teach yourself proper techniques--or get professional advice-- before you throw yourself wholeheartedly into it.

You can't always avoid the sudden blow, bump, or fall that produces bursitis. But you can protect your body as follows: Overall. Keep yourself in general good shape with strengthening and flexibility exercises.

Shoulders. Make sure your technique is correct if you play tennis or golf or any sport that may strain your shoulder.

Elbows. One common form of bursitis in the elbow is brought on by constantly resting the elbow on a hard surface, such as a desk. If you habitually lean on your elbow, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you need not lean on your elbow to read, write, or view your computer screen.

Knees. If a task calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change position frequently, and take breaks.

Feet and hips. High-heeled or iII-fitting shoes cause bunions; fight shoes can also cause bursitis in the heel. Problems in the feet can also affect the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that's too short or too narrow or that chafes your foot. Women should wear comfortable shoes for walking and for daily chores, saving their high heels for special occasions.

Treatment tips

It may be hard to tell whether you have bursitis or tendinitis-- but bursiris is usually characterized by a dull, persistent ache that increases with movement (in contrast to the sharp pain typical of tendinitis). If you do develop bursitis, try the following:

* Rest the part of your body that huns. If you suspect that one activity has caused the pain, stop it for a while.

* Take aspirin or ibuprofen. Acetaminophen is not as good for easing inflammation.

* Apply ice packs during the first two days to bring down swelling, then heat to ease pain and stimulate blood flow.

* Resume exercising only after you feel better, and start slowly with gentle activities.

Liniments and balms are no help for bursiris. Liniments don't penetrate deeply enough to treat bursitis; they mainly warm the skin and make it tingle, thus distracting attention from the pain beneath. Massage is likely to make matters worse. If bursiris pain is disabling or doesn't subside after three or four days, get medical advice.
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Publication:The University of California, Berkeley Wellness Letter
Date:Jun 1, 1993
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