Do I Have Bursitis OR Tendinopathy? How To Treat Both

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We often get asked what the difference between bursitis and tendinopathy are. In truth both are similar in their characteristics, but not exactly the same. On one end of the spectrum, they are both undergoing an inflammatory process yet the tissues are very different. This is not medical advice and we highly recommend you reach out to your primary care provider first.

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A bursa is a closed, fluid-filled sac that works as a cushion and gliding surface to reduce friction between tissues of the body. The major bursae (this is the plural of bursa) are located next to the tendons near the large joints, such as in the shoulders, elbows, hips, and knees.

Johns Hopkins Medicine

Most commonly in the clinic I have seen hip, knee, and elbow bursitis commonly due to trauma or overuse.


The infamous tendinopathy formerly known as tendonitis.

Tissue that attaches muscle to other body parts, usually bones. Tendons are the connective tissues that transmit the mechanical force of muscle contraction to bones.

Encyclopedia Britannica

Some of the major tendons we see in clinic with tendinopathy are your patellar tendon (Knee cap), Tennis elbow, Tendon attachment at the hamstrings, Achilles tendon, etc.

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How do you get Bursitis or Tendinopathy?

Most commonly I see these two from overuse. Many times the patient has performed too much activity without the appropriate training or body adaptation. Other times, an athlete who is training properly may be fatigued to the point that the soft tissue cannot handle the load. With bursitis, you can have trauma to the bursa sac from trauma, creating an inflammatory component.

Is inflammation good or bad?

Inflammation often gets a bad reputation from pharmaceutical companies touting their prescriptions to dampen it down. Inflammation also commonly goes concurrently with autoimmune disorders, poor nutrition, alcohol, high BMI, etc. In truth, we need inflammation to repair our bodies and it is absolutely a healthy and essential component to healing. When chronic inflammation is present, this can have negative effects on the healing process.

How to tell the difference between Bursitis vs. Tendinopathy


  • Pain with rest
  • Passive or Active range of motion are limited due to pain (Not in a capsular pattern)
  • Obvious trauma leading up to it (Falling/ hitting/ infection)
  • Potential Overuse
  • Tenderness/ Swelling


  • Normally pain not as obvious during rest
  • Passive or Active range of motion are limited due to pain
  • Painful with muscle activation
  • Potential Trauma leading up to it
  • Often overuse
  • Tenderness/ Swelling
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How to treat?

Both are similar in their treatment although tendinopathy may take longer to fully return to normal due to lack of blood supply.

  • Thermal agents (ice/ thermotherapy/ cryotherapy)
  • Implementation of flexibility exercises (Careful with tendonitis)
  • Implementation of manual therapy if appropriate (Massage, things that will allow exercise or temporary relief).
  • Progressive resistance: Eccentric movements
  • Heavy resistance training (Tendonitis only)
  • Education and activity modifications (Especially with sport/ exercise this is a big one)

How long does it take to heal?

It depends… It depends on the grade of tendinopathy/ bursitis, activity you are returning to, age, diet, stress, sleep health, current/ past activity, injuries, etc. We can expect the range from 2 – 24 weeks on average especially if it is already in a chronic stage.

In Conclusion

I highly recommend seeing your local physical therapist for a musculoskeletal disorder like the ones mentioned above. They are the experts in this realm and most states allow for visits without your primary care providers referral. Go outside, be kind to others, and smile.

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