Knee bursitis is one of the most common bursitis conditions; it can be painful when moving the knee, when kneeling, or even when at rest. The condition can also be painless, with only visible swelling present. Knee bursitis can have many causes. The most common is trauma, whether from a direct hit, or the result of activities that require crawling or kneeling on hard surfaces for long periods of time, such as laying carpet or tile, or scrubbing floors. Our physical therapists at Progressive Physical Therapy have vast experience with this condition and help our patients reduce their pain, swelling, stiffness, and any associated weakness in the knee or leg.

What is knee bursitis?

Knee bursitis (also called prepatellar or infrapatellar bursitis) occurs when one or more of the many bursae (fluid-filled sacs) becomes damaged, irritated, or inflamed. Normally, a bursa acts as a cushion or friction-reducer between 2 body parts, such as between bone and skin, or bone and ligament or tendon. Bursae on the front of the knee serve as cushions between the knee cap and skin, and between the patellar tendon and tibia bone. Prolonged pressure or traumatic blows can injure a bursa, and repetitive motions can cause irritating friction on it, leading to the development of bursitis. In fact, “itis” means “inflammation.” When the bursa is injured, it can swell and become painful.

Knee bursitis can be caused by:

  • Repetitive motions, including certain sports, such as running
  • Prolonged kneeling, as when cleaning floors, installing flooring, or praying in a kneeling position
  • Prolonged crawling, such as when laying carpet or flooring, or scrubbing floors
  • Direct trauma, such as being hit or falling on the knee
  • Knee surgery or knee joint replacement
  • Infection
  • Autoimmune conditions

How Does it Feel?

With knee bursitis, you may experience:

  • Swelling on the front of the knee
  • Redness on the front of the knee
  • Pain when you push with your fingers on the front of the knee
  • Pain when kneeling
  • Stiffness in the knee joint, or difficulty straightening or bending the knee

How can a physical therapist help?

Your physical therapist at Progressive Physical Therapy will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments that you can do at home. Physical therapy will help you return to your normal lifestyle and activities. The time it takes to heal the condition varies, but results can be achieved in two to eight weeks or less, when a proper swelling management, stretching, and strengthening program is implemented.

During the first 24 to 48 hours following your diagnosis, your physical therapist may advise you to:

  • Apply light compression to the area by wrapping the knee a specific way using a compressive wrap.
  • Rest the area by avoiding any activity that causes pressure or pain in the knee.
  • Apply ice packs to the area for 15 to 20 minutes every 2 hours.
  • Consult with a physician for further services, such as medication or diagnostic tests.

Your physical therapist will work with you to:

Reduce Pain and Swelling. If repetitive activities have caused the knee bursitis, your physical therapist will help you understand how to avoid or modify the activities to allow healing to begin. Your physical therapist may use different types of treatments and electrothermal modalities (machines that use heat, light, or sound to reduce swelling and pain) to control and reduce your pain and swelling.

Improve Motion. Your physical therapist will choose specific activities and treatments to help restore normal movement in the knee and leg. These might begin with “passive” motions that the therapist performs for you to gently move your knee joint, and progress to active exercises and stretches that you do yourself.

Improve Flexibility. Your physical therapist will determine if any of your leg muscles are tight, start helping you to stretch them, and teaching you how to stretch them on your own.

Improve Strength. If your physical therapist finds any weak or injured leg muscles, your therapist will choose and teach you the correct exercises and equipment to steadily restore your strength and agility.

Improve Endurance. Restoring your leg’s muscular endurance is important after an injury. Your physical therapist will develop a program of activities to help you regain the endurance that you had before the injury, so you can return to doing the things you like to do.

Improve Balance. Regaining your sense of balance is important after an injury. Your physical therapist will teach you exercises to improve your balance skills.

Restore Agility. Speed and accuracy of leg movement is important in athletics. Your physical therapist will help you regain these skills in preparation for a return to sports activities.

Learn a Home Program. Your physical therapist will teach you strengthening and stretching exercises to perform at home. These exercises will be specific for your needs; if you do them as prescribed by your physical therapist, you can speed your recovery.

Return to Activities. Your physical therapist will discuss your activity goals with you and use them to set your work, sport, and home-life recovery goals. Your treatment program will help you reach your goals in the safest, fastest, and most effective way possible. Your physical therapist will teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals.

Speed Recovery Time. Your physical therapist is trained and experienced in choosing the best treatments and exercises to help you safely heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

If Surgery Is Necessary

Surgery is not commonly required for knee bursitis. But if surgery is needed, you will follow a recovery program over several weeks, guided by your physical therapist. Your physical therapist will help you minimize swelling and pain, regain motion and strength, and return to normal activities in the safest and speediest manner possible.

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