I have had a recent influx of patients suffering with knee bursitis. So, I thought it was about time I wrote about the current problems we are seeing.

Knee bursitis can cause pain above, on or below your patella (kneecap). The knee consists of up to 11 bursae. The bursae most commonly subjected to inflammation are the prepatellar bursa, infrapatellar bursa, pes anserinus bursa and suprapatellar bursa.

The prepatellar bursa lies just above the knee cap between the skin and the knee cap. Prepatellar bursitis has historically been referred to as “housemaid’s knee”, which is derived from being a condition that was commonly associated with individuals whose work necessitated kneeling for extended periods of time. Prepatellar bursitis is common in professions such as carpet layers, gardeners, roofers and plumbers.

The infrapatellar bursa essentially consists of two bursae, one of which sits superficially between the patella tendon (below the kneecap) and the skin and the second referred to as the deep infrapatellar bursa is sandwiched between the patella tendon and tibia bone (shin). It can occur conjunctively with a condition called “Jumper’s Knee”, which involves repetitive strain and irritation to the patella tendon, often from jumping activities.

The third most common knee bursitis, pes anserinus, occurs in the lower, inside part of the knee in close proximity to the upper aspect of the shin bone (tibia). It usually affects middle-aged women and overweight individuals.

Suprapatellar bursitis occurs above the kneecap. The suprapatellar bursa extends superiorly from beneath the patella under the quadriceps muscle. It is vulnerable to injury from both acute trauma and repeated microtrauma. Acute injuries are from direct trauma to the bursa via falls directly onto the knee, as well as from overuse injuries, including running on soft or uneven surfaces, or from jobs that require crawling on the knees, such as carpet laying.

What is a Bursa?

Bursae are thin, lubricated cushions located at points of friction between a bone and the surrounding soft tissue, such as skin, muscles, ligaments and tendons. A bursa lies between a bone and opposing surface (e.g. skin) like a tiny water balloon with only a few drops of fluid in it, wedged between two surfaces.

Physiotherapy and how it can help!

Many patients with knee bursitis start to feel better within a few weeks of the injury. Here, our physiotherapy team will aim to:

Reduce pain and inflammation, this is achieved with the application of electrical modalities, ice, therapeutic taping and education regarding activity modification.

  • Normalise your knee joint range of motion.
  • Strengthen your knee muscles: quadriceps and hamstrings.
  • Strengthen your lower limb: calves, hip and pelvis muscles.
  • Normalise your muscle lengths.
  • Improve your proprioception, agility and balance.
  • Improve your technique and function eg walking, running, squatting, hopping and landing.

Minimise your chance of re-aggravation.

Anti-inflammatories or NSAIDs are also used in combination with physiotherapy to help alleviate the pain and swelling. If the bursa becomes infected or if your symptoms persist for a prolonged period your doctor may recommend that the bursa be aspirated. Alternatively, your doctor may also recommend an injection of a glucocorticoid steroid that is mixed with a local anesthetic. If infection occurs, you may require antibiotics.

The Game Ready machine that we have here at our Physiotherapy and Sports injury Clinic(s) will assist in rapidly reducing the inflammation. Recent clients with bursitis will confirm that our equipment, along with our friendly and knowledgeable staff has been very effective in dealing with their injuries.

If you require further information then please do not hesitate to contact us!