Bursa – Bursitis

by Denise Müller, Grad. Sports Scientist

The human body contains over 150 fluid-filled sacs, known as bursae synoviales. These are located primarily in parts of the body that are under continuous stress, like joints, but also  in areas, where skin, tendons, or muscles come into direct contact with bone. A bursa serves as a damper between hard and soft structures, reducing pressure and friction impact.
Its structure resembles that of a joint capsule or a tendon sheath. It consists of an outer layer of connective tissue (stratum fibrosum) and an inner synovial layer (stratum synoviale). This synovial layer secretes the synovial fluid.

A bursitis (inflammation of the bursa) will generally affect one or more bursae at a time. The cause for a localised inflammation is usually excessive strain on the bursa , for example as the result of external trauma during a (sporting) accident, or bacterial infection. The area around the bursa is tender to the touch and swollen, appears reddened and warmer than the surrounding tissue. Bursitis of a deeper seated bursa will in most cases not present any externally visible symptoms. It simply manifests as pain.

In most cases, a simple solution will be the immobilisation of the affected area, as well as cooling and resting of the respective joint. In rare, severe, or chronic cases, the bursa may have to be surgically removed.

Once a bursitis has fully healed, special measures can be undertaken to prevent repeated inflammation.
Targeted stretching and strength exercises will fortify the muscles in the surrounding area, which in turn stabilises and protects the joints. Stress is reduced, and the surrounding tissue is more protected.
A bursa in a particular area with a tendency for problems due to repetitive stress as a result of work-related or athletic movement, can be helped with targeted rest periods between movements or strains, supported by stretching and massage exercises that stimulate blood flow. It is also advisable to support particularly high-stress areas (while kneeling or sitting) with air-filled cushions.