Bursitis is an Acute or chronic inflammation in a bursa. Bursae are thin-walled sacs lined with synovial fluid and function to lubricate and ease the movement of the tendons and muscles over bony prominences. Causes of bursitis include trauma; systemic disease (such as arthritis or rheumatoid arthritis); gout; repetitive or excessive frictional force;

or infection. Most commonly, bursitis is seen in the shoulder, although many other joints can become inflamed:

olecranon, pre- or suprapatellar, trochanteric, ischial, anserine.

Unless treated, the bursitis tends to become chronic or consistently recur. Bursitis may cause splinting muscle spasms which further compress and irritate the bursa. Advanced disease can lead to a frozen shoulder from marked collagenous adhesion formation.

Bursitis Symptoms

• Acute: Pain; decreased range of motion; local tenderness on palpation; swelling and redness is visualized

if the bursa is superficial (e.g. olecranon and prepatellar).

• Chronic: Thickened bursa wall; formation of adhesion, calcareous deposits, muscle atrophy from not

using it; various degrees of pain, tenderness, swelling, muscle weakness; typically, the range of motion is

quite decreased.

• Shoulder: Bicipital tendinitis: tenderness over the bicipital groove and pain with elbow flexion; Subacromial bursitis: pain and tenderness locally and pain with all movements, especially rotation; Supraspinatus tendinitis: no rotational pain but pain when abduction reaches 40 degrees.

Nutrients Involved in Bursitis

Bromelain, vitamin B12, vitamin C, bioflavonoids, omega-3 fatty acids

Suggested Nutritional Supplementation for Bursitis

• Protrypsin - 5 caplets daily between meals on an empty stomach.

Select proteolytic enzymes.

• EZ-Flex - 3-9 tablets daily with meals.

Nutritional support for tendon, nerve, and muscle function.

• EPA-DHA 6:1 - 2 softgels 2-3 times daily with meals. (see EPA-DHA section in appendix) Essential fatty acids from cold water fish.

Bursitis Dietary Suggestions

• Anti-Inflammatory Diet

Bursitis Exercise Considerations

Range of motion exercise for shoulder.

To break adhesions: flex forearm to right angle, grasp wrist with one hand and point of elbow with other hand and elevate shoulder by pushing up on elbow, strongly supinate and pronate forearm, maintaining shoulder elevation, do this at various degrees of abduction, follow with heat.

Ice pack: for acute, keep on 5 minutes, remove for 1 minute, repeat 3 times.

Heat applications: to relieve pain, for 20 minutes followed by shower.

Wall-Walking Exercise:

1.     Face the wall at arm's length and lean into hands placed against wall.

2.     Starting slightly above the level of the waist, walk hand over hand as high as possible without pain.

3.     Repeat four times daily.