Do I Need Surgery?
A Bursectomy is a Last Resort
Not every bursitis condition requires surgery.
It's generally understood by doctors and surgeons that surgery will introduce more scar tissue into your joint. This added scar tissue will be problematic, requiring visits to a physical therapist (PT) and often significant treatment post-surgery. If not dealt with properly, you could end up in worse condition than before the surgery! This is why surgery is only performed as a last resort.
If You Haven't Done So Yet, Get a Proper Diagnosis
Some serious cases of bursitis may be considered as Surgically Necessary (SN) and will require surgery. In cases of septic bursitis, which is very serious, you will most likely require antibiotic medications and very possibly - surgery. This is why it is important to get to a physician and find out what is really going on - this is known as getting a proper diagnosis. Getting a proper diagnosis would also determine if your pain is a side effect from another condition or disease (Lyme disease is one example). This is less common but nonetheless, very serious. So yes, it is important to get a proper diagnosis.
The Good News
Most cases of bursitis are not Surgically Necessary, and will heal on their own. This is why most doctors, physicians and orthopaedic specialists will recommend conservative treatment options for non-SN bursa injuries before considering surgery.
Some of the most effective conservative treatment methods used to try and avoid surgery for cases that are not Surgically Necessary are:
- Rest - This is important for initial healing; rest and elevation will help reduce pain, swelling and inflammation in the early stages of injury. This can be difficult when you have to carry on with daily activities, but resting and elevating the injury whenever you can is recommended. During your recovery modify or avoid the activities that caused your bursitis (and often tendinitis as well) until your pain and inflammation settles. However, too much rest can also be harmful to such injuries because joint immobility can actually cause stiffening. This is why rest should be used when reducing initial pain and swelling, but should not be considered for more long-term conservative treatment.
- Avoid Activities that Caused Your Injury - While resting your injury it's also important to avoid all activities that may have caused your injury in the first place and this definitely includes pretty much any type of sport or repetitive movements that might be undertaken when working. Continuing on with regular activities can increase the severity of your injury, turning a mild to moderate case of bursitis into a downward spiral of worsening damage and joint stiffness that may eventually severely impact your life. Also, trying to 'work around' your injury will eventually give rise to over-compensation injuries in other areas of your body.
- Use a Cold Compress or Ice Pack - Cold is very effective at reducing pain and inflammation - use at the onset of the injury and during flareups.
- Use Circulation Boost (T•Shellz Wrap®) - Once swelling has been reduced, you can use your own blood flow to maximize your rehabilitation. Improved blood flow to tissue in most cases will help improve recovery time while improving overall health of soft tissue in the area. Promoting blood flow and heat to the treatment area will help to minimize the growth of scar tissue, increase flexibility and reduce risk of worsening atrophy.
- Rehabilitative Stretching under supervision of a PT or doctor. The intent of this is to provide you with increased range of motion, pain relief and strengthening of the surrounding tissue of the joint. Doctors or surgeons typically won't perform a surgery until they feel that their patient has put effort into treating their injury with conservative treatment methods. This may include up to 4 to 6 months of visits to a PT clinic. If you haven't experienced any improvement in your condition during that time then surgery may be considered. Agressive PT approaches may focus on forced or manual manipulation of the leg - this means your physical therapists will be trying to move your leg past the point of comfort as they strive to increase range of motion and prevent further atrophy. This can be painful and end up making your injury worse if not done correctly. (reference: 1)
- Stretching - Stretching your joint in PT and at home will help you to regain your range of motion much faster than not stretching at all. Stretching in many ways is key maintaining good Range of Motion (ROM) in your joint, and stretching can be made much easier with use of a T•Shellz Wrap® before to warm up soft tissue, and a Cold Compress or Ice Pack treatment after to prevent any return of swelling and inflammation.
Restricted Movement Is Risky If It Goes On For Too Long
For acute (new or recent) Achilles tendon tears that have the ability to heal on their own - your doctor may even cast your foot in a toe pointed position (in something called a "hanging enquinus cast") or in a removable brace/splint. A removable splint can be very helpful to prepare you for PT sessions and mobility exercises.
Prolonged use of a cast, removable splint, or long-term rest (restricted movement) without proper exercise or stretching can make your Achilles tendon injury worse. If your Achilles tendon remains completely immobilized and at constant rest, the ends of the Achilles tendon (where it attaches to bone or other muscles) will begin to fill in with scar tissue as part of the healing process. You may also have on-going symptoms of pain, swelling and inflammation, and even poor blood flow circulation.
Lack of proper blood flow and growth of scar tissue will decrease the natural length of the tendon (atrophy) and tighten tissue, reducing the flexibility between your ankle and foot. Your ability to push off with your foot in certain activities such as running, jumping, or going up and down stairs all become compromised. You are also at an increased risk of re-rupture of the tendon, especially if the initial injury was large and required surgery in the first place.
What Happens When You Are Not Using Conservative Treatment Methods (as Outlined Above)
Painful soft tissue injuries such as bursitis and tendinitis are all injuries that cannot really be ignored. If you choose to ignore the injury, then this means you will still be be trying to do certain tasks (ie. using a fork, putting on your seat belt, etc) using soft tissue (strained and/or partially torn ligaments & tendons) that is already compromised. This means it will inevitably get worse.
Here is what to expect:
- Since the tissue is probably inflamed, lack of proper blood flow will drop your healing rate to a crawl.
- Continually straining the soft tissue (just by doing daily tasks such as cooking or driving) worsens the injury and will introduce more scar tissue.
- Increased scar tissue buildup will tighten the soft tissue in your joint, decreasing your already limited flexibility (reduced range of motion). After a week or more of limited flexibility in the joint, you may start to experience atrophy - a wasting away of soft tissue that inevitably weakens the joint.
Trying to use your joints once they have not been used for a week or more can easily introduce more scar tissue, cause pain, freeze you up again and happen again and again... As you can see this is a cycle that just gets worse and worse, eventually becoming a chronic (long term) injury. This is the cycle you need to stop or you will probably wind up having surgery once your injury becomes chronic. This is why you need to treat your injury with the T•Shellz Wrap® every single day, at least twice per day.
What Are the Two Biggest "Gotchas" When Treating Bursitis Using
Conservative Treatment Methods?
The Absence of Pain Does Not Mean Your Injury is Gone
After most of our clients use a Cold Compress or Ice Pack for a couple days, pain will typically drop very significantly. This where most people wrongly associate the pain with the injury, whereas in truth, almost all of the pain really came from the inflammation and swelling. Once the inflammation is gone, do not assume you are fully healed.
Time Is Not Your Friend
So you have used a Cold Compress or Ice Pack on your bursa and most of the pain is gone, but it's been a couple of months and the injury keeps flaring up. If this is you, then you probably know why this is happening now... the injury was never full healed. To really heal a bursa injury, you really need to rest until it is healed, and you don't need me to tell you this is a pain in the butt! This is why the T•Shellz Wrap® is such an important tool, as it introduces the concept of increased blood flow in the treatment area. Knowing that your body used blood flow to heal and repair tissue, know that enhanced blood flow gives your body the opportunity to boost its own healing cycle. In the majority of cases, we feel that this helps you get back on your feet more quickly, reducing the risk of re-injury.
When the swelling has gone down and the pain has reduced, this is the perfect time to use a blood flow inducing heat treatment such as the T•Shellz Wrap®. A treatment with a T•Shellz Wrap® will substantially increase blood-flow to the treatment area - it literally supercharges your body's ability to repair damaged tissue. We also highly recommend that our clients treat themselves with this wrap first thing in the morning before getting out of bed. This is important, as heat is known to increase elasticity, extensibility and flexibility (longer and more pliable.. less likely to strain) in soft tissue. Combined with light stretching, we feel this will not only help combat atrophy, it will also decrease the chance of re-straining this tissue at their most vulnerable time - after a long period of inactivity.
Why Your Bursitis Won't Heal
If our body is designed to heal our own injuries, why does it take so long to heal?
When we have an injured ligament, muscle, tendon or bursa, this means the tissue is damaged. Your body responds to this damage with healing right away. During this healing process the injured tissue spasms. These spasms are contractions, and are meant to hold the tissue still to prevent any further injury.
Swelling and inflammation is your body's way of:
- Creating localized pain to tell you something is wrong there and to stop moving it, and
- Sending blood to the area to start healing. Healing at this point will also expand the blood vessels in the injured tissue - they enlarge and swell causing you pain. This pain is a signal for you to lessen activity that would put anymore undue stress on your bursa.
However, there is a significant problem with swelling and inflammation with respect to healing rate. Once soft tissue is inflamed, blood-flow is restricted. The body heals itself by sending nutrients through the blood to the injured tissue, and if the injured tissue is swollen, the blood-flow is greatly decreased.
Decreased blood-flow to injured tissue, prevents the damaged tissue from healing as fast as it would if the area wasn't swollen.
The other issue is that swelling is also very painful. With many conditions, once you get rid of the inflammation, a lot of the pain will disappear as well.
Once the Pain is Gone, We Think Our Soft Tissue Injury is Healed.
So we start using it more and more for common tasks, and then "boom" we get a sharp pain and then it starts all over. When this happens, the injury was never fully healed - and now it is worse! More scar tissue grows in the new tissue micro-tears and well, lets talk about scar tissue.
Scar Tissue - We Need It For Kick-Starting Soft Tissue Repair
But After That It is Nasty Stuff
Tendons, ligaments, muscle and other soft tissue are all meant to be durable and flexible, ready to work and move extreme forces in everyday activities. When I say extreme force, I mean try to imagine the amount of force that your legs puts on your hip, even when you are just walking, let alone running or jumping. Much of this force is handled by the bursa - a pad that allows tendons to slide over bony areas so they don't tear.
Scar tissue grows in damaged tissue when it tries to heal; little tiny band-aids that overlap each other to bind tiny tissue tears together. With this added scar tissue, muscles & tendons & ligaments become rigid, less flexible and unable to handle the forces that it once could. From this, there is added pressure on the bursa, which can easily become inflamed once there is other inflamed soft tissue in the vicinity (tendons, muscles) If you're suffering with scar tissue now you may feel the effects with stiffness, tightness, weakness and pain in your joint. So much pain that you don't want to move it!
On-going issues with scar tissue can result in soft tissue tears and increase chances of strain to nearby tendons or ligaments (as they are now handling higher forces due to overcompensation).
Scar tissue is one of the MAIN reasons why a chronic injury has not healed and your Range of Motion (ROM) is reduced from what it once was.
Scar tissue will form fast to deal with a soft tissue injury, and this scar tissue will also attach to everything in the area, including the surrounding healthy tissue as well. This can result in a fusing together of soft tissue that shouldn't be fused together, causing extreme pain when you try to move your joint - it is literally ripping scar tissue. This is why PT is often painful - the therapist stretches the joint, forcing the scar tissue bonds to break so you can regain your range of motion.
Scar tissue is a significant problem - even for bursitis sufferers - causing your injury to become chronic, and taking months or even YEARS to completely heal!
You can help reduce the nasty effects of scar tissue and minimize further injury to your joint bursae/muscles/tendons/ligaments by adding a heat based treatment to the area before undergoing significant activity.
When applied before activity or work, the T•Shellz Wrap® will help relax and lengthen tissue in the application area, temporarily improving range of motion of the injured joint. Gently warmed soft tissue is more extensible and flexible - meaning there is a reduced risk of further injury when these tissues are stressed during activity.
Overall, continued treatment with a TShellz Wrap is intended to maintain good health in your soft tissue and significantly reduce your risk of re-injury.
Using a T•Shellz Wrap® will not expose you to the risk of causing further harm to soft tissue like you can when using rigorous exercise. The T•Shellz Wrap® accomplishes the goal of enhanced blood flow without the need for intensive exercise and as such reduces your risk of re-injury.
Use a T•Shellz Wrap®:
- After swelling and inflammation have been reduced with cold compression.
- BEFORE getting out of bed in the morning. BEFORE going to bed at night.
- BEFORE exercise, workouts or activity of any kind to increase elasticity of tissue in the area which in turn reduces your risk of further injury/re-injury.
- Anytime you feel your bursa site may have stiffened up, is tight and your mobility is reduced causing you more pain.
- Anytime you have sore or aching tissue as long as there is not substantial swelling.
- AFTER surgery (once the skin wound has healed over and swelling has reduced - basically at least 6 weeks after the surgery) to boost blood circulation, helping surgically repaired tissues recover for long-term health and minimize scar tissue growth at the surgery location.
- Anytime BEFORE you feel you might undertake activity that will put significant strain on the injury area.
- Any other situation where you need to increase blood flow to relax your tissue, relieve pain, prevent re-injury and enhance flexibility in the area.
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Minimize Your Chance of Bursa Surgery with these Effective Conservative Treatment Options
If your doctor thinks you might be able to avoid surgery by using conservative treatments, you can join our many customers who have had great success treating themselves with the powerful T•Shellz Wraps® that we offer through AidMyBursa.
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We also encourage your to Call Our Office at 1-866-237-9608 (toll free continental NA) where we can answer any questions you have and/or take your order via phone.
If Surgery is Required
Ok, well the good news is that enhanced blood flow is also very effective for post-surgery recovery. To learn more about how to get started with recovery after surgery, click here.
The Next Step Is Up To You!
Living with pain is never easy as it affects your entire lifestyle. Living with pain during or after an intensive surgery and lengthy rehabilitation period can be even harder! What is more important than taking your best shot at trying to heal your bursitis before signing up for surgery?
Doctors and Surgeons are always improving the technologies used in surgery, and results from surgery now are much more positive than they were in the past. However, all surgeries introduce scar tissue, and recovery from some surgeries can be disappointing. If you do wind up getting surgery, know that rehabilitation at-home while attending regular PT clinic or doctor appointments is vital for your overall recovery. It is especially vital to critical joints that consistently handle extreme forces (body weight). Consistent exercise and conservative treatment on a daily basis during your rehabilitation while working with your doctor, surgeon or PT is key - and this is why you should seriously consider utilizing a blood circulatory enhancer such as the T•Shellz Wrap® at home once your physician approves.
AidMyBursa stands out in this regard as our goal is to help you keep your body healthy for the long-term in a cost effective manner. This might mean fixing bursitis without needing surgery. If you couldn't avoid surgery, then we feel our tools can also be quite effective during your post surgery recovery period..
We strongly believe that we can help you, and we have thousands of happy clients to back this claim. You are welcome to try our products for a 60 day period.. If you are committed to following the treatments outlined in the product instructions we are very confident that our TShellz Wraps will aid you immensely. If you do not receive the benefits that countless of our other customers have experienced after 6 weeks - call us. We will send you return instructions and provide you with a full product refund once receiving the product back.
Our online shop accepts Visa & Mastercard as well as a Paypal Payment option.
We also encourage your to Call Our Office at 1-866-237-9608 (toll free continental NA) where we can answer any product related questions you have and/or take your order via phone.
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If any question or concern arises, call us or simply send us an email at any time (we check our emails constantly all throughout the day and night.. even on holidays!). We will respond as soon as possible.
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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!