Q: Can you help me understand the difference between bursitis and tendonitis?
A: Bursitis is inflammation of a bursa, which is a fluid filled sac that helps decrease friction over the bone in order to protect ligament and soft tissue structures. There are many causes of bursitis such as a direct blow (acute trauma) or chronic trauma as seen with overuse injuries. There are certain inflammatory conditions such as gout and rheumatoid arthritis that can lead to bursitis also. There are eight major bursae around the knee and three major sites of bursitis around the hip. The hamstring, quadriceps and ligament complexes have connections to the bursae and help with cushioning and support. The classic signs of bursitis include a gradual onset of pain in the anatomic region that becomes proportional to activity level. Pain is present upon waking in the morning. Walking often aggravates pain. A limp is often noticed when pain is severe.
Tendonitis is inflammation around a tendon involving the tendon sheath-or covering around the tendon. A tendon, by definition, is a structure connecting muscle to bone. Tendonitis may occur anywhere in the body but is often seen in runners. For example, Achilles tendonitis may result from overpronation, recent change in shoe wear, sudden increase in training-especially with hill running. The Achilles' tendon is particularly vulnerable to injury because it belongs to a muscle tendon group that crosses two joints.
Runners may develop bursitis or tendonitis as a result biomechanical abnormalities (muscle imbalances, excessively flat feet, high arches etc.) or training errors (too much, too soon, too often).
Dr. Greg Coppola
Greg has run more than 10,000 miles and cared for thousands of athletes at the high school, collegiate and professional levels.
