Knee Bursitis

Knee bursitis, an inflammation of the tiny fluid-filled sacs called bursae near your knee joint, can cause significant pain and discomfort. These bursae act as cushions to reduce friction between tissues of the body, but when they become inflamed, you experience debilitating pain.

Knee pain, swelling, or stiffness can impact daily activities and quality of life. An experienced physiotherapist can treat this condition. At Suarez Physical Therapy in Las Vegas, our experienced physical therapists are here to provide comprehensive knee bursitis care. We specialize in diagnosing and treating knee bursitis. Contact our clinic for treatment and return to living your life fully.

An Overview of Knee Bursitis

A 2018 research article explains that knee bursitis is a condition characterized by inflammation of the bursae around the knee joint. Bursae are tiny, fluid-filled sacs that act as cushions to reduce friction and pressure between the bones, tendons, muscles, and skin near your joints.

When the bursae become irritated or inflamed, they can cause knee bursitis, which causes pain and restricts movement. Different types of knee bursitis affect specific bursae around the knee, leading to varied symptoms and causes.

Various types of bursitis include:

Prepatellar Bursitis

Prepatellar bursitis is a common condition affecting the fluid-filled sac (bursa) in front of your kneecap. It's often caused by frequent kneeling on hard surfaces, direct trauma to the knee, or even infection.

Swelling, pain, tenderness, redness, and warmth around the kneecap are all telltale signs of prepatellar bursitis. Limited knee movement due to pain and swelling can also occur. Diagnosis typically involves a physical examination and may include imaging tests or fluid aspiration from the bursa to confirm the cause and rule out other issues.

Treatment for prepatellar bursitis depends on the severity and cause. Common approaches include resting your knee and avoiding activities that aggravate it, applying ice therapy to reduce swelling and pain, taking medications to manage inflammation, and physical therapy to strengthen the muscles around your knee and improve flexibility.

Occasionally, aspiration to remove excess fluid or corticosteroid injections might be necessary. Surgery is rarely needed but may be considered for chronic bursitis that doesn't respond to other treatments.

Infrapatellar Bursitis

Infrapatellar bursitis affects the bursae just below your kneecap. This area has two main bursae: one between the kneecap tendon and your skin (superficial) and another between the tendon and the top of your shinbone (deep).

Like prepatellar bursitis, kneeling on hard surfaces is a common cause, especially for those who work in occupations like carpet laying or cleaning. Repetitive stress from activities like running and jumping can also inflame the bursae in athletes. A direct blow to the front of the knee or underlying conditions like rheumatoid arthritis can also contribute to infrapatellar bursitis.

Pain and tenderness below the kneecap, often extending along the tendon, are significant symptoms. Swelling and a noticeable lump in the area are common and can limit your knee's range of motion. Stiffness, particularly after being still, and redness with warmth (especially in cases of infection) are other potential signs. Difficulty bending your knee for activities like walking or jumping can also occur due to the inflammation.

Accurate diagnosis is critical to determining the right treatment. Doctors typically perform a physical exam to assess the location and severity of pain and swelling. X-rays help rule out other issues, while MRI and ultrasound provide detailed images to confirm bursitis. If infection is suspected, a fluid sample from the bursa may be analyzed to identify the culprit and guide antibiotic treatment.

Treatment focuses on reducing inflammation, relieving pain, and preventing future problems. Rest and modifying activities aggravating the condition, like kneeling or running, are crucial. Ice therapy helps reduce inflammation and numb pain, while medications like ibuprofen or naproxen can manage pain and inflammation. Physical therapy with targeted exercises strengthens the muscles around the knee and improves flexibility, taking stress off the patellar tendon. Techniques like ultrasound and electrical stimulation may also manage pain and inflammation.

Corticosteroid injections directly into the bursa can provide significant relief for persistent pain and inflammation. In cases of swelling, aspirating fluid from the bursa can ease pressure and pain and potentially aid diagnosis if infection is a concern. Surgery is rarely needed but may be considered as a last resort for chronic bursitis that doesn't respond to other treatments.

Infrapatellar bursitis can be disruptive, but recovery is possible with proper diagnosis and treatment. By understanding the causes, symptoms, and treatment options, you can effectively manage the condition and regain your normal activities pain-free.

Pes Anserine Bursitis

Pes anserine bursitis affects a bursa on the inner side of your knee, just below the joint. This bursa, called the "goose's foot" because of the tendons that connect there, can become inflamed from overuse, especially in runners or overweight people. Other factors like osteoarthritis, improper training, or previous injuries can also contribute.

The main symptom is pain on your knee's inner side, tenderness, swelling, and stiffness. Activities like climbing stairs or walking can worsen the pain. In rare cases, the area may be red and warm.

Doctors diagnose the condition through a physical exam and sometimes imaging tests. Treatment focuses on reducing inflammation and pain through rest, ice therapy, medication, and physical therapy. Injections or aspiration may sometimes be necessary, and surgery is a last resort.

Suprapatellar Bursitis

Suprapatellar bursitis targets the bursa right above your kneecap, acting as a cushion between the quadriceps tendon and the thigh bone (femur). This bursa gets inflamed due to various reasons.

Repetitive activities like running, jumping, or cycling can irritate the bursa. A direct hit to the knee from a fall or accident can also cause inflammation. In rare cases, bacteria entering the bursa through a wound can lead to infection. People with underlying conditions like rheumatoid arthritis are more susceptible to inflammation throughout their bodies.

Pain and tenderness are the telltale signs, usually felt above the kneecap and possibly spreading along the quadriceps tendon. Swelling in the area creates a noticeable lump and restricts knee movement. Stiffness is another common symptom, especially after being still for a while. In cases of infection, the skin over the bursa might appear red and warm. Activities like walking, running, or climbing stairs become difficult due to pain and swelling.

An accurate diagnosis is key. Doctors typically perform a physical exam to assess pain location and severity. X-rays, MRIs, or ultrasound scans help rule out other knee problems. If infection is suspected, a fluid sample from the bursa is analyzed to identify the culprit and guide antibiotic treatment.

Treatment focuses on reducing inflammation, relieving pain, and preventing future issues. Rest and modifying activities that aggravate the condition are crucial. Applying ice packs to the area helps reduce inflammation and numb pain. Medications like ibuprofen or naproxen manage pain and inflammation. Physical therapy with targeted exercises strengthens the muscles around the knee and improves flexibility, taking stress off the bursa. Corticosteroid injections directly into the bursa can provide significant relief for persistent pain.

In severe cases of swelling, aspirating fluid from the bursa can relieve pressure and pain. Surgery is rarely needed but may be considered as a last resort for chronic bursitis. Suprapatellar bursitis can be disruptive, but recovery is possible with proper diagnosis and treatment.

What Does Knee Bursitis Feel?

Knee bursitis manifests through various symptoms that can vary in intensity based on the specific bursa affected and the underlying cause. As explained above, each type of knee bursitis can have additional particular symptoms based on the location of the inflamed bursa.

General symptoms are and are not limited to:

• Pain. Pain associated with knee bursitis is often localized to the affected knee area. It can be sharp or dull and worsens with activity or pressure. For example, prepatellar bursitis typically causes pain in the front of the knee, while pes anserine bursitis results in pain on the inner side of the knee below the joint.

• Swelling. The affected area may appear visibly swollen due to the accumulation of excess fluid in the bursa. This swelling can create a noticeable lump, often tender to the touch.

• Tenderness. This tenderness is usually concentrated in the specific area of the knee where the bursa is located, such as above, below, or around the kneecap.

• Stiffness. Stiffness in the knee joint is common, particularly after periods of inactivity, such as upon waking up in the morning or after sitting for an extended period. This stiffness can make it difficult to move the knee fully and comfortably.

• Warmth and redness. In cases of infection or severe inflammation, the skin over the affected bursa may become warm to the touch and appear red. This warmth and redness indicate an inflammatory response and may be accompanied by fever and chills in the case of infection.

• Limited range of motion. The pain, swelling, and stiffness associated with knee bursitis can significantly limit the knee’s range of motion. Simple activities such as walking, climbing stairs, or bending the knee can become challenging and painful.

Knee Bursitis Causes

The most common cause of bursitis is inflammation of one or more bursae around the knee joint. Research shows that 1 in 10,000 patients suffer elbow and knee bursitis every year.

Excessive kneeling is the leading cause of knee bursitis. Some professions, such as gardeners, roofers, installers, and carpenters, are prone to it. Credible research also shows that sitting for long hours can cause it.

Other common causes of bursitis include the following:

Repetitive Motion and Overuse

Activities that involve repetitive motion or frequent knee pressure can lead to bursitis. This is particularly common in jobs or sports that require extensive kneeling, squatting, or jumping. For example, carpenters, plumbers, gardeners, and athletes are at higher risk due to the constant knee strain.

Direct Trauma

A sudden injury or impact to the knee can cause acute bursitis. This can occur from a fall, a direct blow to the knee during sports, or an accident. The trauma can lead to immediate bursa inflammation, which in turn leads to pain and swelling.

Prolonged Pressure

Prolonged pressure on the knee, such as kneeling on hard surfaces for extended periods, can irritate and inflame the bursa. This is commonly seen in professions requiring sustained kneeling, leading to prepatellar bursitis, often called "housemaid's knee."

Infection or Septic Bursitis

An infection in the bursa, known as septic bursitis, can occur if bacteria enter through a cut, scrape, or puncture wound near the knee. This type of bursitis is less common but more serious, requiring prompt medical treatment with antibiotics. People with compromised immune systems or chronic illnesses like diabetes are more susceptible to septic bursitis.

Underlying Medical Conditions

Conditions such as rheumatoid arthritis, gout, and osteoarthritis can contribute to the development of knee bursitis, which can lead to chronic bursa inflammation.

Rheumatoid arthritis, an autoimmune disorder, causes widespread joint inflammation, including the bursae around the knee, making them more susceptible to bursitis. Gout, the buildup of uric acid crystals in the joints, can also lead to bursitis, particularly in the knees. Also, osteoarthritis, a degenerative joint disease, can cause inflammation and irritation of the bursae, particularly in older adults.

Biomechanical Factors

Abnormal gait or improper movement patterns can place additional stress on the knee joint and surrounding structures. For example, individuals with flat feet, leg length discrepancies, or misaligned knees may experience increased friction and pressure on the bursae, leading to bursitis.

Obesity

Excess body weight stresses the knee joints, increasing the risk of bursitis. Obesity can exacerbate the wear and tear on the knee structures, leading to inflammation and pain.

Previous Knee Injuries

A history of knee injuries, such as ligament tears, meniscal damage, or fractures, can increase the risk of developing bursitis. Previous injuries can alter the mechanics of the knee, leading to increased stress on the bursae.

Knee Bursitis Diagnosis

Accurate diagnosis of knee bursitis helps with effective treatment and recovery. Your physical therapist gathers information through a detailed medical history and physical exam, then uses tests to rule out other suspects.

First, they ask about the following:

• When did the pain start? What makes it worse or better?

• Have you injured your knee before? Do you have any ongoing health conditions like arthritis?

• What kind of work do you do, and what are your hobbies? Kneeling a lot or jumping sports can put stress on your knee bursae.

Next, they perform a thorough knee inspection. The doctor will look for swelling, redness, or any unusual shape of your knee. A lump over a specific area might indicate bursitis. By gently pressing on your knee, they can pinpoint the source of pain and tenderness, helping to identify the affected bursa.

Your therapist can also check how well your knee can bend and straighten, comparing it to a healthy knee to see if anything is limited. They might ask you to squat, walk, or do specific movements to see how the pain affects your daily activities.

Sometimes, your physician could recommend more tests to confirm the cause and type of bursitis. X-rays can help rule out fractures or arthritis that can cause similar pain. Ultrasounds are like real-time pictures of your soft tissues, showing fluid buildup and inflammation in the bursa. Another method, MRI scans, reveal not just bones but also muscles, tendons, and bursae. This helps identify other possible problems, like ligament tears that might mimic bursitis symptoms.

If there is a lot of swelling, a small sample is needed for further investigation. Your physician will use a needle aspiration to withdraw fluid from the bursa. This fluid is then analyzed for signs of infection, gout crystals, or anything abnormal. Blood tests might be done to check for wider inflammation or underlying conditions depending on the analysis.

Seeking Help of a Physical Therapist

Physical therapy focuses on reducing pain, improving function, and preventing recurrence. A personalized and comprehensive approach ensures optimal recovery and long-term knee health.

Pain Management and Inflammation Reduction

The therapist will advise on appropriate rest and activity modification to avoid aggravating the condition. This may include resting and avoiding activities that put excessive stress on the knee, such as kneeling, squatting, or jumping.

Another pain management approach is applying ice packs to the affected area, which can help reduce inflammation and numb the pain. Your therapist could recommend the frequency and duration of ice application. Your physical therapist may also use ultrasound, electrical stimulation, or laser therapy to reduce pain and inflammation. These techniques promote healing and reduce discomfort.

Therapeutic Exercises

Stretching and strengthening exercises are the key therapeutic exercises. Gentle stretching exercises improve flexibility and reduce stiffness. The therapist will focus on stretching the muscles around the knee, including the quadriceps, hamstrings, and calves. Strengthening the muscles around the knee provides better support and reduces stress on the bursa. Strengthening exercises may include leg lifts, squats, lunges, and resistance band exercises. Emphasis is placed on strengthening the quadriceps, hamstrings, glutes, and hip muscles.

Other range-of-motion exercises aim to restore the knee's full range of motion, helping to improve function and reduce stiffness. The therapist will guide the patient through specific movements to enhance flexibility and mobility.

Manual Therapy

Manual therapy involves soft tissue and joint mobilization, where hands-on techniques such as massage, myofascial release, and trigger point therapy help relieve muscle tension and improve blood flow to the affected area. Gentle manipulation of the knee joint improves mobility and reduces pain. This technique helps address any joint restrictions and promote proper alignment.

Find a Suarez Physical Therapist Near Me

Knee bursitis is a painful and disruptive condition. This article has explained the types, symptoms, causes, and ideal treatment approaches. A qualified physical therapist can offer personalized and comprehensive care tailored to your needs.

Whether you are dealing with acute symptoms or looking to prevent knee bursitis, your physical therapist can guide you through effective treatment options. These could include therapeutic exercises and manual therapy, lifestyle modifications, and preventive measures.

At Suarez Physical Therapy in Las Vegas, our experienced team is dedicated to helping you achieve optimal knee health and well-being. Call us at 702-368-6778 to schedule an appointment and have your knee bursitis healed.