Bursa is a term for fluid-filled sac, which forms from the subcutaneous ligaments in the areas of the mechanical burden. Especially in area where the ligaments or muscles are going through cartilage and bone base. There are two types of bursae, subcutaneous and synovial. Its function is to lower the pressure and friction in the given area, and ease the movement in the joint.

Human body has around 150 bursae. Divided into two types:

  • Synovial - are mainly located on the arms and legs, where the tendons are in contact with bone/cartilage base, or they are close to the joint capsule.
  • Subcutaneous - are mainly located between the skin and joint capsule, and where the skin is tightly surrounding the bone (for example. Front side of the knee joint - skin - patella, back side of the elbow).

The effect of long-term mechanical burdening, or even injured walls of the bursa, lead to painful inflammation. Typical areas are shoulder and knee joints, although it can also affect heels or sitting bones.


  • Blunt pain, stiffness
  • Restricted movement
  • Worsened pain during movement or pressure on the disabled area
  • Local edema and increased temperature, skin redness

Bursae in the area of the hips are located deep below the muscles, therefore we can’t see a visible redness. Painful area is on a lateral side of the thigh (above the bigger trochanter) in the place of connection of the thigh bone and hip joint.


  • Excessive burdening, overloading - repetitive impacts, leaning on the elbows, kneeling
  • Injuries
  • Infections (for example: Staphylococcus) arthritis, gout


Disabled bursa in the area of the shoulder joint is resulting from the above mention overloading - repetitive movements such as raising arms up, sudden swinging movement, but also injuries, falling on the shoulder, etc. At the same the the rotator cuff (muscles attached to the head of the arm bone, which lift up the arm in a 60 degree angle). Bursa in the shoulder could result in frozen shoulder.


You can find out more in our article which is focused on the student’s elbow.

More examples

Pain in the area of the sitting bones can be caused by long-term sitting (hard chair, or riding on a bicycle). On the other hand, standing for a long time or injuries, arthritis of the hips cause disability in this area of the body. Soft bulge on knee can be caused by long-term kneeling (cleaning floor, or kneeling on a pavement,...).


In acute stage we advise you to use cold compress, not moving with the affected limb and application of anti-inflammatory gels/creams. Surgical drainage can be applied in a developed stage. Doctor can also inject you corticoids.


With focused shock wave therapy we affect inflammations, edemas, and lower the pain. We end the session with application of kinesio tape to support lymphatic drainage process. After the pain is relieved, we start with physiotherapy, where we focus on strengthening the muscles in the area of the affected joint. We also teach our patients preventive measures, so that they could avoid any repetitive problems in a longer period of time.

FYZIOklinika physiotherapy Ltd., Prague, Czech Republic

Source: Dýlevský, Functional anatomy, Grada 2007, FYZIOklinika

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