Shoulder Bursitis: How To Treat and Prevent

Bursitis in general means inflammation of the bursa, which is one of the layers of soft tissue that surrounds a joint. It can occur in almost any of your large joints. It is important to have a specific diagnosis of which bursa is inflamed.

Bursitis in the shoulder is technically diagnosed as subacromial bursitis. Shoulder pain can come from many sources, such as impingement syndrome, rotator cuff tendinitis, rotator cuff tear, frozen shoulder, muscle strain, Glenohumeral joint instability, various types of arthritis, and the list goes on. Therefore, it is not easy to develop a diagnosis unless you see an orthopedic/shoulder specialist and/or have an x-ray/MRI performed.

The first thing to know about treating bursitis (and most other inflammatory shoulder problems) is to identify and decrease the movements, positions and activities that exacerbate your symptoms. For example, you may need to stop sleeping on your right side for a few weeks-months. Or you may need to modify the position of your computer mouse. You may need to eliminate certain shoulder exercises in your workout routines. Switch your purse to the opposite shoulder or clean it out to make it lighter. Listen to your body in order to find out what aggravates your pain; then modify those things in order to function with less pain. This is called POSITIONAL AVOIDANCE.

Secondly, you may need MEDICATION. Consult your physician, who will likely prescribe an anti-inflammatory medicine. Your primary care physician will refer you as needed for imaging tests and/or specialist visits. It is important to comply with doctors' orders in order to know if the prescribed treatments are effective.

Any of your doctors (primary or specialist) may refer you for PHYSICAL THERAPY (or Occupational Therapy) if indicated.  Physical Therapy for your shoulder may include exercises, hands-on techniques, pain-relieving modalities, education, postural corrections and other interventions aimed at decreasing your pain and restoring full function of your shoulder.

ICE can also be an effective adjunct to your symptom-management routine. Put a bag of ice or frozen veggies in a T-shirt or pillowcase placed over the location of your pain. Do this for 10-15 minutes, >2x/day.

POSTURE plays a bigger role in shoulder pain that you may realize, so check this area to see how you measure up. Do you slump whenever you sit? What is your posture while working? Is there a posture you stay in for a long period of time each day that aggravates your shoulder pain? Upright posture places all your joints in proper alignment and maximizes their mobility. Try to avoid having your shoulders rounded forward. Sit or stand up tall, with your shoulders back (they should be lined up vertically with your ears).

Lastly, work to improve your BODY MECHANICS during all daily tasks. You should have an ergonomic work station. You may need to modify your computer chair, the placement of your keyboard/mouse, the amount of back support in your recliner chair, your lifting techniques, the placement of heavy objects in your home or garage, etc. The idea of body mechanics is to use your body to its advantage instead of straining your joints by doing difficult tasks incorrectly. Use large muscle groups to do harder work. Use proper lifting and reaching techniques. To prevent shoulder pain, avoid lifting heavy objects overhead. If you are carrying something heavy, hold it with both hands and keep it close to your body. Be sure your shoulders are relaxed (not shrugged up) while you are typing. Turn your thumbs up whenever you reach above shoulder height.

How To Avoid Holiday Weight Gain

With Thanksgiving this week, the season of holiday weight gain is heavy upon us. So how can you avoid gaining weight until the new year arrives? This is especially important if you have been losing weight this past year or are working hard to maintain the weight loss you have achieved.

1. Use your holiday time off to do some additional exercise. Don't just lounge before and after holiday meals but do some exercise or at least something active!
2. Limit your portions during larger holiday meals. Stick to 1 medium plateful and 1 small dessert.
3. Choose calories carefully. Be picky about which foods you really like and are willing to indulge on. Skip the others.
4. Limit your desserts. Try 1 slice of pie instead of 1 of each. Or have a small sliver of each, if you like to try the varieties.
5. Eat more vegetables and fewer carbs. And remember that veggies can taste good outside of casseroles and without bacon. They just need the right seasoning.
6. Stop eating when you are satisfied. Don't eat again until you are hungry.
7. Be sure your between-meal snacks are small and healthy. Choose the fruit or veggie tray instead of the cheese/pepperoni/crackers.
8. Drink more water and fewer calorie-filled beverages.
9. Remember that a healthy lifestyle does not have to stop during the holidays. Maintain the same healthy habits that you have been practicing.
10. Shop in stores instead of online.
11. Don't lie down if you can sit. Don't sit if you can stand. Don't stand if you can walk. Don't walk if you can run. Remember that some people are unable to do these things and they would give anything to be able to walk or run again. Don't take your mobility for granted.

IT Band Pain: How To Treat and Prevent

The IT Band (iliotibial band or ITB) is a band of muscle tissue that runs from the outside of your hip/pelvis down to the outside of your knee. It is not a very well-known muscle, so it can be easily neglected, especially by athletes. If it gets strained or injured, it usually causes pain on the outside or lateral part of the knee. This occurs most frequently among runners or athletes whose sport requires excessive running. You are at higher risk for IT band injury if you are new to running or if you are increasing your distances too quickly.

If you do any lower body flexibility exercise, which muscles do you stretch? Probably your hamstrings and calf muscles. Possibly your hip flexors, quads or various buttocks muscles. But have you ever stretched your IT band? It is not realistic to stretch every muscle group in the body daily, so first try to identify a few target areas. If you have IT band pain or have in the past, then be sure to include ITB stretching in your daily routine. The following stretch is one of the easiest ways to stretch your IT band regularly, as it requires no equipment and is done in standing.

The picture below demonstrates stretching of the right IT band. Hold the position for at least 20 seconds. Repeat 3-4 times. This should be done several times daily. You may need to stand next to a wall for arm support and to push into a deeper stretch (the wall would be on your right side for stretching your right ITB). If you are a runner or athlete, be sure to include this in your workout stretching routines. Warm up your legs for 3-5 minutes before stretching by doing some light cardio exercise. Be sure to stretch again after your workout, especially if you are recently having ITB pain.

Remember that prevention is easier than treatment! So in addition to stretching your IT bands, include sufficient warmups to your workouts, wear proper shoes, consult your physician before starting an exercise regimen, carefully progress your exercise intensity, and do not work out through an injury. If you have ITB Syndrome, you may also want to use ice, prescribed medications, massage, more ITB stretching, leg strengthening, and Physical Therapy. 

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