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Prepatellar bursitis

What is it?

This is inflammation of the small sac of fluid at the front of the knee (bursa) it is often caused by repetitive or prolong period of kneeling. The bursa is present to prevent friction. If this becomes inflamed it can be painful. It can also be caused by a one off injury or by an infection.

Location of prepatella bursa and muscles of the knee

1 Quadriceps (front of the thigh)

2 Hamstrings (back of the thigh)

3 Gastrocnemius (back of the calf)

Blue arrow – Prepatellar bursa

What are the common symptoms?

Pain and swelling usually occurs at the front of the knee, over the knee cap.

There can be a restriction in movement of the knee. You may also have difficulty walking and kneeling.

How to manage it?

The good news is this will usually settle with self-management. If there is an infection causing the bursitis this will need to be treated as soon as possible. If you have any heat or redness around the knee, please speak with your GP immediately.

  • Modification or avoidance of activities which worsen symptoms (such as prolonged kneeling or pressure over the knee)
  • Resting the knee
  • Application of ice (see below)
  • Compression
  • Elevation

Pain relief

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

Ibuprofen

Paracetamol

Other medicines can help to reduce inflammation, swelling and pain. You should discuss this with your GP if the simple pain relief advice does not help or if you are needing to take ibuprofen for more than 10 days.

Ice

Some people find using ice helpful on the painful area.

For ice therapy use a damp cloth containing an icepack (or bag of frozen peas) over the top of the painful area to help numb the pain. Leave it on for up to 20 minutes and use up to 3 times a day.

  • You should be cautious using these treatments if you have altered skin sensation or circulatory problems.
  • Check the skin regularly during and after the ice pack application
  • Stop if there is excessive pain, numbness or tingling
  • Do not put ice directly on to the skin as this may cause a burn

As the pain and swelling improves, gradually re-introduce any normal day-to-day activities that you have been avoiding, returning to full activity.

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