Wednesday, November 27, 2013

Housemaid's Knee - Starts With a Bursa


A bursa is a sac-like membrane filled with fluid that lubricates joints. They are generally located between tendons and bones. "Bursitis" is the name for inflammation of these membranes. The most commonly plagued areas for bursitis are the hips, lower knees, elbows, shoulders and your heels.

The cause of bursitis can be arthritis, trauma, infection or strain. The role of a bursa is to provide a cushion between moving tissues and bones thus allowing friction-free movement. Sometimes the bursae can become a chronic problem if calcified deposits develop around them.

An inflamed bursa can form under the heel or in the back because a tendon is strained and this in turn prevents full range-of-motion encouraging swelling to occur. Bursitis in the heel is commonly caused by shoes that do not fit properly. Take the time and money to invest in shoes or sneakers that fit properly regardless if you are simply going for long walks in the neighborhood, standing on your feet all day, engaging in a strenuous activity, or participating in any sport.

Another form of bursitis affects the front of the knee caps and is called "pre-patella bursitis." When a bursa in the front of the knee becomes inflamed a large egg-like bump will form over the kneecap. You will not miss the bump because it will be inflamed and it will hurt if you press on it. Sometimes a physician will advise draining the extra fluid in the inflamed bursa. Draining a bursa can often have an after effect of even more extreme swelling. The swelling will diminish in a few days and the bursa should return to normal. Constant pressure on the front of the knee causes pre-patella bursitis, for example if you kneel most of the day while doing gardening you may develop mild to severe bursitis.

Other problems that can cause you to develop bursitis on the kneecap are taking a direct kick to the knee or falling and landing on your knee. Years ago this type of knee bursitis was often called "Housemaid's Knee." As the saying goes: "We've come a long way baby." To prevent so-called housemaid's knee follow these guidelines:

#1. Do not kneel on an injured knee,

#2. Do not put pressure on this knee,

#3. Do gentle stretching exercises such as using a Pilates Reformer with low resistance,

#4. Apply an ice bag to to the swollen area.

There are also many other fluid-filled sacs behind the knees which are interconnected with tendons and tissue to provide friction-free movement. If these become inflamed you will develop a swelling that protrudes at the back of the knee. This is usually diagnosed as "popliteal bursitis." Even though this form of bursitis might not be painful, it may limit your ability to move your knee. Popliteal bursitis may be due to a sports injury created by excess friction around the knee or it can be disease related. Your physician may recommend having a surgical procedure to remove the swollen sac. If there is no need for surgery, the best medicine is exercise that stretches your hamstring muscles and quadriceps. Gyrotonic® exercise is also beneficial to improve and prevent poptileal bursitis.

Overuse strains are common for the hip-flexors, especially for athletes. Your hip flexor muscle has a tendon that is attached to the thigh bone. If the bursa between them becomes inflamed, your hip area will become very painful.  The inflammation often results from one of the bursa hidden under the tendons, instead of between the tissues. Treatment would include:

#1. Apply an ice bag to the area,

#2. Rest, especially laying on your back to avoid pressure on the hip area,

#3.  Gentle stretching to regain flexibility; do this with a physical therapist or certified personal trainer to avoid further injury.

Shoulders are very over used and also sensitive to sports' injuries. Between the tendons and tissue in the shoulder, there are many large bursae to allow friction-free movement. They become inflamed when you exercise or play sports using the wrong form. Bursitis in the shoulders is extremely painful even with the slightest movement of your neck, back and shoulders. If you develop shoulder bursitis get it checked out by a physician because very often anti-inflammatory pills or injections are necessary to speed up the healing process.

You can also enhance the effectiveness of any medication, or help prevent bursitis from even developing, by using natural remedies and taking extra precautions. Here are some suggestions:

#1. Always stretch before and after exercising,

#2. Regularly take Vitamin C, Vitamin A, Vitamin E and zinc to keep your bursae healthy,

#3. Take Vitamin B-12, when needed, as it has been known to give quite rapid relief from bursitis,

#4. Take bromelain to help reduce inflammation,

#5. Get ultrasound treatments (performed by a physical therapist) to diminish calcium deposits,

#6. Avoid putting too much pressure on your knees by using padding or by standing up and moving frequently, otherwise...Housemaid's Knee!

#7. Use a padded floor mat if you have a job where you are required to stand for long periods of time,

#8. Commit to an exercise program, no matter what your age is. A personal trainer can help customize a program with a well balanced and symmetrical approach appropriate for your fitness level. The right exercise program provides increased strength and endurance, better balance, increased range-of-motion, better circulation and improved posture. All of these attributes help protect your tendons and bursae.

So now that you know more about how bursitis can be prevented and treated, pay attention to these little "sacs" that play a big role in your well being. Start your preventative exercise program today. 

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