Bursitis

Bursae are a fluid-filled sacs that cushion the bones and tissues around joints and provide a smooth surface where muscles or tendons rub against bones. Bursitis happens when one or more bursae become irritated and swollen, usually through overuse or injury.

Bursitis is a common cause of hip pain, elbow pain, and shoulder pain. It can also affect other joints such as knees and feet.

While bursitis typically affects adults over the age of 40, it can also affect adolescent athletes.

Repeating the same motions over and over in sports and exercise can put pressure on the bursae around a joint, causing them to become inflamed and painful.

For instance, a baseball pitcher may develop bursitis in the shoulder or elbow of their pitching arm while a runner may develop bursitis in their knees or hips.

While uncommon, bursitis may occur with infections (septic bursitis) or inflammatory processes like gout or rheumatoid arthritis. In adults, this type of bursitis most often affects the elbow and knee.

Symptoms of bursitis are typically limited to the affected joint and may include:

• Pain
• Redness
• Swelling
• Stiffness and limited range of motion

Your doctor will ask you about pain, where it occurs (for instance, above, below, or directly on your joint), and how long you have been experiencing it. They may ask you what sports you play and how often you train and compete.

One or more of the following diagnostic tests may help your doctor confirm (or rule out) bursitis:

• An X-ray uses small doses of radiation to produce images of bones.
• Sports ultrasound uses sound waves to create images of muscles, ligaments, and joints as they are moving. This dynamic view of the joint helps clinicians gain insight into how the bones and tissues interact with each other as you play your sport or go about your daily life.
• Magnetic Resonance Imaging (MRI) uses a combination of large magnets, radio frequencies, and a computer to produce detailed images of organs and structures within the body.

The best treatment for overuse-related bursitis is time off from the activity causing the joint pain. With rest, most cases of bursitis get better quickly.

Anti-inflammatory medication like Advil and icing the area for 20 to 30 minutes at a time can reduce swelling and relieve pain.

If you have redness and swelling, or if your bursitis doesn’t go away after an initial period of rest, it’s important to make an appointment with a health care provider.

To reduce your risk of bursitis:

• Warm up with light exercises that increase circulation around the joint before every workout, practice, or game.
• Be sure to cool down and stretch after playing.
• Learn and practice proper technique. 
• Many sports injuries occur due to poor body positioning or using joints and muscles incorrectly. Many athletes who improve their technique find their performance improves as well.
• Play different sports throughout the year. Using different sets of muscles can help you get strong in a more balanced way.

As the largest and most experienced pediatric and young adult sports medicine practice in the country, the Sports Medicine Division at Boston Children's combines personalized care with innovative treatment for each athlete we treat.

Our Sports Medicine team consists of sports medicine physicians, orthopedic surgeons, physical therapists, podiatrists, athletic trainers, sports psychologists, dietitians, and many others who collaborate in every aspect of our patients’ care and their recovery.

Thanks to our Sports Ultrasound Clinic, we can directly observe bursae while a nearby joint is in motion and discuss advanced tests and treatments, including local injections, to help speed recovery from bursitis.

The Micheli Center for Sports Injury Prevention, part of the Sports Medicine Division, is dedicated to the prevention of sports injuries. Through research and clinical training, The Micheli Center offers practical strategies that help young athletes reduce their risk of injury while enhancing their sports performance. Our rehabilitation and strength training programs help injured athletes return to play stronger and healthier.

Whether injury prevention or recovery is your goal, we have the skills and dedication to help your child remain active in the sports they love.