Bursa, Bursae, Bursitis! What is it?

various diagrams of feet showing where feet are most commonly affected by bursitis

Did you know your body has more than 140 bursae?

But what is a bursae?

Think of them as a tiny water filled balloon that’s wedged in between your bone and tissue structures.

Without them, our joints wouldn’t be able to move freely.  Their role is to provide lubrication to reduce friction and promote smooth movement of tendons over bones.

When a bursa becomes inflamed, it’s called bursitis.

Bursitis is something that we often see in the clinic.

Bursitis can cause pain, redness and swelling.  Pain can increase during activity and night. And you may also notice ‘stiffness’ in the joint near the bursa and some loss of movement.

What causes Bursitis?

Some of the main causes of bursitis are:

  • Poorly fitting shoes with inadequate support.  This can create pressure in the wrong places
  • Direct trauma such as falling, slipping, or car accidents
  • Bunions, corns, flat feet, abnormal joints, or any foot condition that places pressure incorrectly and cause you to alter your gait
  • Underlying conditions such as arthritis, tendonitis, or ligament damage

The most common cause of bursitis is repetitive movements which can cause irritation of the bursa.

These movements include high impact activities, such as jumping and running, which results in an increase in the amounts of shock the bursa absorbs.

Prolonged periods of walking and standing can also irritate the bursa, resulting in inflammation.

Wearing ill fitting footwear can apply direct pressure to the bursa. Shoes such as high heels increase pressure on the forefoot, and shoes that are too tight can also be a risk factor.

 

Bursa can become inflamed as a result of trauma to the area after a fall, accidents and sports and exercise related impact injuries.

Other causes can be attributed to prolonged pressure or pre-existing secondary conditions, such as rheumatoid arthritis or gout, where crystals can form in the bursa, causing irritation and swelling.

Foot structure and biomechanics are also a causative factor of bursitis.  This can include bunions, hammertoes, flat feet, high arches, reduced range of motion in joints, and overpronation. These factors can induce additional stress of bursa which can lead to bursitis.

Overpronation of the foot, which is commonly referred to as “flat feet”, is also a contributing factor to developing bursitis. Why? Flattening of the foot results in the heads of the metatarsals to rotate which causes “pinching” of the structures in between.

Over time, the friction causes the bursa to become inflamed and result in pain and irradiation.

Body weight can also be a causative factor for developing bursitis due to extra force and pressure being placed on bursa.

Other factors such as tendonitis and ligament damage can also increase the risk of developing bursitis.

What are symptoms of Bursitis?

Symptoms of bursitis include:

  • Localised swelling, pain, tenderness, warmth, and redness
  • Pain when walking barefoot or wearing tight socks
  • Pain when wearing tight shoes
  • Walking, running, and jumping motions may be especially painful
  • Range of motion in the joint near the affected bursa may be limited

How is Bursitis diagnosed?

As with any foot pathology, history taking is essential to determine any risk factors for the development of bursitis.

After a thorough history taking, we will begin a physical examination of the foot.

This examination will include palpating for pain, testing joint range of motion, muscle testing, and gait analysis.

Imaging may also be required, which can be in the form of x-rays, ultrasounds or MRIs. Ultrasounds and MRIs can help to determine the extent of the inflammation surrounding the injured tissue and an x-ray may be ordered to rule out any other pathologies.

Who is likely to suffer from Bursitis?

To put it simply, anyone and everyone can be diagnosed with bursitis.  However, there are some factors that contribute to its progression and presentation.

These include:

  • Age
  • Overuse
  • High impact sports activities
  • Foot mechanics
  • Poor stretching before exercise
  • Tight muscles
  • Inadequate footwear
  • Pre-existing conditions such as osteoarthritis

How is Bursitis treated?

Treatment of bursitis will depend on the cause of the bursitis and will be specifically tailored to you.

However, the aim of any treatment is to alleviate pain through the healing process.

There are several ways we can treat Bursitis, including:

  • Footwear modifications.  This is to ensure that shoes are not too tight and no unnecessary pressure is placed on the inflamed bursa, which can cause further irritation.
  • Padding and Strapping.  This can help to redistribute pressure and support the surrounding structures.
  • Strengthening Programs.  This is to help the surrounding support structures and improve the range of motion of the joints in the foot.
  • Rest.
  • Anti-inflammatory medication. This can help to reduce inflammation and alleviate pain.
  • Using custom or semi-custom devices. This can provide support to your foot and relive pressure.
  • Gentle mobolising exercises and stretching.
  • Injection therapy.

If you are suffering from Bursitis, or any pain or discomfort in your feet and lower limbs, you can book an appointment with one of our podiatrists.  We can help relieve your pain and assist in your recovery. Book your appointment by calling 03 9432 2689 or book online here.

 

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