Tendonitis & Bursitis


Tendons are the connective tissue fibres that connect muscle to bone. Tendonitis is an inflammation of the tendon, and it most often occurs near joints such as the ankle, shoulder or elbow. Most commonly, tendonitis is an overuse injury, caused by microtrauma to the tendon by repetitive overloading.
Tendons are designed to withstand high loads, however they can become stressed if the load is too high, or the demand is too much. Micro trauma in the form of micro tears can cause an inflammatory reaction, which manifests as swelling, redness, restriction of movement and pain.

Healing time can take from 6 weeks up to indefinitely if not managed correctly.

Common tendons affected:
– Rotator Cuff: muscles surrounding the shoulder joint
– Biceps tendon
– Supraspinatus
– Achilles
– Biceps
– Adductors of the pelvis
– Patella tendon

A bursa is a fluid filled sac which allows for fluid movement and decreased friction between surfaces. They can be found where muscles glide over bones, and act to lubricate or cushion areas of high pressure between your muscles and bones close to your joints. Bursitis is the inflammation of this sac. It typically presents as a swollen, hot, red area close to a joint or tendon. It can be caused by traumatic injury, repetitive irritation or systemic disease.

Common bursas affected:
– Subacromial bursa
– Patella bursa
– Trochanteric bursa

Case: Supraspinatus Tendinopathy with Subacromial Bursitis

What is it?
Combination of irritation of the supraspinatus tendon, as well as inflammation of the bursa itself. The tendon and bursa both sit in the subacromial space, which is the space between the bony point tip of your shoulder and your shoulder joint itself (see where arrow is pointing at bursa in the picture).

tendonitis photo
The inflammation of these two can lead to shoulder impingement, which means the irritation of the tendon and bursa are encroaching on the subacromial space. Typical onset is gradual over weeks or months.
Symptoms include: pain on the tip of your shoulder, pain when lying on your affected shoulder, plus there may be some referral of pain down to your elbow or wrist. Aggravated by movements with your arms above your head such as washing your hair, or reaching up to the top cupboard.

How your osteopath can help..
Firstly getting a working diagnosis is crucial, that’s where you especially need us. Treatment is aimed at reducing inflammation assessing the cause, and preventing recurrence.
We will assess your posture, shoulder stability, rotator cuff strength, ergonomics and technique.
Initially the aim is to reduce inflammation and pain, so that you are able to lift and use your arm comfortably. Secondly, regaining full range of motion is important, which may take a few weeks. Your osteopath will help you regain range of motion with soft tissue techniques, joint mobilisation and some at home stretching and exercises.
When your shoulder joint is mobile, restoring scapular control and strength is the next priority, followed by functional return to sport/work exercises.  This whole process takes a lot of professional skill.  Gettting back to 100% will take massively less time if you get good advice and good treament.

To book a treatment with one of our Melbourne osteopaths, call 9663 5450, or use our online booking system.

Article written by Dr Sofie Rasmussen.