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Physiotherapy Kensington, Notting Hill Gate, Shepherds Bush, Central London 020 7937 6444 / 07902 309 768

Tendonitis, bursitis

Tendonitis is inflammation of the tendon where a muscle narrows down to join a bone. A tendon is a flexible band of fibrous tissue that connects muscles to bones. It transmits the pull of the muscle to the bone to cause movement. They are found throughout the body, including the hands, wrists, elbows, shoulders, hips, knees, ankles, and feet. Tendons can be small, like those found in the hand, or large, like the Achilles tendon in the heel. Inflammation to the tendon (increased blood flow through the area with warmth, swelling, pain and loss of function) can be spelled tendonitis or tendinitis.

What is bursitis?

Bursitis is inflammation of a bursa, a small sac that acts as a cushion or pad between moving structures (bones, muscles, tendons or skin). If a muscle or tendon is pulling around a corner, or over a bone, then a bursa serves to protect it from fraying and stress. Irritation or inflammation of this small sac is called bursitis (itis means inflammation).

Pain in tendonitis or bursitis, commonly involving the shoulder, elbow, wrist, hip, knee and ankle, may be quite severe, often of sudden onset and usually made worse by movement. This inflammation of the soft tissue tendons and bursae located near joints will often be mistaken for arthritis.

Tendonitis and bursitis are inflammations of the soft tissue around muscles and bones, usually in the shoulder, elbow, wrist, hip, knee and ankle. The pain of bursitis or tendonitis can be severe and should be treated early by sport physiotherapist. Failure to rest the inflamed limb or the joint, temporarily, will usually result in longer-term, chronic problems.

People at risk of getting tendonitis and bursitis

Tendonitis can be caused by sport activities, training or trauma to a joint and injury, but is most often the result of a repetitive task like computer users.

For example, dentist, accountant, computer user, typist, musician and painting may develop a tendonitis or bursitis in the shoulder, elbow, wrist, hip, knee and ankle. The tennis game can strain the tendon on the outside of the elbow and cause tendonitis. "Tennis elbow"

People such as computer users, painters, musicians, and athletes who perform activities that require repetitive motions or place stress on joints are at higher risk for tendinitis and bursitis.

Tendonitis or bursitis may occur in individuals with diseases such as rheumatoid arthritis, gout psoriatic arthritis, thyroid disease and diabetes.

Diagnosis of tendonitis and bursitis

Diagnosis of tendonitis and bursitis require a medical history and careful physical examination by doctor or sport physiotherapist. On diagnoses and physical examination, there will often be tenderness along the involved tendon or its sheath (outer covering) or at one particular point within the tendon and pain when the muscle to which the tendon is attached is worked against resistance. X-rays do not show bursae or tendons, but may be useful in excluding other bone or joint problems. Blood tests, as well as MRI and diagnostic ultrasound which may be useful in the detection of these conditions, are generally not required.

Treatment of tendonitis and bursitis

Sport physiotherapist is the main professionals who does diagnoses and treat tendonitis and bursitis. Treatment of these two conditions is based on the underlying cause. In overuse or injury, reduction of the causing force or stress is mandatory. A computer user or dentist may need to review the ergonomic position that is used on a daily basis.

Failure to treat the tendonitis and bursitis on time will result in continuing symptoms and causing other complications like frozen shoulder. Splints or braces for the affected part are a means of achieving rest and reduction of stress on the part, especially in the hand and wrist area.

Treatments, particularly ice, may help to reduce inflammation and pain. Ultrasound is often of benefit and is applied by a sport physiotherapist.

In the lower limb, stressful weight bearing activities may need to be reduced on a temporary basis to allow the inflammation to lessen. The use of a cane in the opposite hand can assist a painful hip. Orthotics may be required to reduce the stress at the ankle or within the foot. An orthotic is placed between the foot and the shoe, to improve foot biomechanics and relieve pain or pressure.

The main symptoms of inflamed tendonitis and bursitis are redness, warmth and swelling. A potentially serious complication of tendonitis are frozen shoulder in shoulder joint and rupture of a tendon with the most common being a tear of the Achilles tendon in the lower calf, which may requires surgical intervention to repair.


Warming up and cooling down (stretching) prior to exercise will help to prevent these problems from occurring. Therefore, activities should be begun slowly prior to expending maximum effort.

Sport physiotherapist treatments include stretching and strengthening exercises to address any areas of muscle imbalance. In addition, sport physiotherapist may apply friction and ultrasound to reduce pain, swelling and inflammation. At work or when exercising, proper posture and body mechanics are important to prevent further complications.

It is important to complete a daily range of motion exercise prescribed by your sport physiotherapist to preserve mobility, particularly in the shoulder joint, as a tendonitis or bursitis in the shoulder can cause frozen shoulder. You can prevent frozen shoulder if the tendonitis or bursitis of shoulder joint, is addressed early on.

Some range of motion exercises for treatment of tendonitis, bursitis and frozen shoulder:

• Lie down on your back, clasp the fingers together and use the non-painful arm to assist the painful arm above the head to the fullest extent.
• Full shoulder movement will be bringing the upper arm up alongside the ear. Lower and repeat 5 times.
• In standing, walk with the fingers of arms up the wall, in front of you, to the highest tolerated position and then stretch the shoulder fully by holding it in this stretched position for 20 seconds and then lowering. Repeat 5 times.
Seeking sport physiotherapist treatment early will result in progress of the injury and prevent joint stiffness, frozen shoulder and chronic pain. The pain of bursitis or tendonitis can be severe and, just because it is not arthritis, does not mean it is less important.


• Rest the painful tendon from heavy activity and things that hurt.
• Ice the area for 10 - 15 minutes three times a day.
• Seek medical assistance GP, private doctor or sport physiotherapist.
• Avoid repetitive motion and overuse of an extremity.
•Warming up and cooling down (stretching) prior to exercise activity.

Rose Clinic Physiotherapy is registered with all major UK health Insurance Companies.

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Musculoskeletal conditions that our chartered physiotherapists treat: Low Back Pain, Disc degeneration, Pregnancy backaches, Arthritis, Whiplash, Sciatica Nerve Trapped, Headache, Pain, Stiffness, Tennis Elbow, Repetitive Strain Injury (RSI), Tendonitis, Osteoarthritis, Postural abnormality, Pre/Post Operation. Rehabilitation, ACL Rupture, Hip/Knee Replacements, Ligament Cartilage Tear, Shin Splints, Ankle Sprain, Muscular Tear, job related injuries, aging. London physiotherapy now covering Kensington W8, Chelsea SW3, SW10, Notting Hill Gate W11, Hammersmith W6, Shepherds Bush W12, South Kensington SW7, Cromwell road, Knightsbridge SW1, SW3, SW 10, W2 in association with Fitness First gym club for all physiotherapy services.