Prepatellar Bursitis

Explanation of Diagnosis

Prepatellar bursitis is inflammation or irritation of the bursa in front of the kneecap. This small fluid-filled sac helps reduce friction where the skin and soft tissues move over the kneecap. It most often happens after repeated kneeling, direct impact, or prolonged pressure on the front of the knee. Common symptoms include tenderness, swelling at the front of the knee, and pain when you kneel or press on the area. If you notice rapidly worsening redness, significant warmth, fever, or drainage, you should get urgent medical care, because infection must be ruled out.

Specific Work Modifications

• Use knee pads with a thick gel or foam cushion when kneeling, and avoid direct contact with hard floors.
• Whenever possible, shift to a kneeling stool or use a standing task height so your knee is not bearing pressure.
• Take short “pressure breaks” every 15 to 30 minutes to reduce continuous irritation.
• Reposition tools and work surfaces so you do less deep bending and repeated reaching that forces your knee forward.
• Avoid tasks that require sustained squatting or repeated kneeling; rotate duties if you can.
• If the area is very tender, keep the knee protected with a padded bandage or wrap during the day to limit friction.

Specific Activity Modifications

• Avoid kneeling on the affected knee, including during stretching, floor work, or cleaning tasks.
• Temporarily reduce or avoid deep squats, lunges, and exercises that keep the front of the knee under pressure.
• Choose low-impact options such as walking on even surfaces, cycling with minimal resistance, or swimming.
• Use a supportive seat and avoid sitting with your knee bent for long periods if it increases swelling.
• If stair climbing increases pain, shorten your step, slow down, and take breaks as needed.
• Do not “test” the knee by pressing directly on the swollen area; let it calm down before returning to pressure activities.

Recommended Supplements

• Omega-3 fish oil 1,000 mg daily with food may help support normal inflammatory balance.
• Curcumin (turmeric extract) 500 mg once or twice daily may help some people with inflammation-related discomfort.
• Vitamin C 500 mg daily can support normal connective tissue maintenance during recovery.

Recommended Nutrition and Hydration

Diet Recommendations

• Aim for a balanced diet with adequate protein (such as eggs, fish, poultry, beans, Greek yogurt, or tofu) to support tissue repair.
• Include colorful fruits and vegetables daily for antioxidant support (for example berries, citrus, leafy greens, and peppers).
• Choose healthy fats such as olive oil, nuts, and fatty fish to support overall inflammation control.
• Limit alcohol and highly processed foods, which can make inflammation harder to manage for some people.
• If weight is a factor, gradual weight reduction can reduce load on the knee over time.

Hydration Tips

• Drink enough fluids to keep urine pale yellow, especially if you are more active or in warm environments.
• Take a water bottle with you during the day and sip regularly rather than “catching up” all at once.

Home Exercise Prescription

Perform these exercises 1 to 3 times per day, only within a comfortable, pain-minimizing range.

1. Quad sets: Sit or lie down with your leg straight, tighten the thigh muscle to press the knee gently toward the bed, hold 5 seconds, repeat 10 times.
2. Heel slides: Lie on your back and slowly slide your heel toward your body and back out, keeping motion gentle, repeat 10 times.
3. Straight leg raise: With the knee straight, tighten the thigh and lift the leg about 8 to 12 inches, hold 1 to 2 seconds, repeat 8 to 10 times.
4. Gentle hamstring stretch: Sit with one leg bent and the other straight, reach toward the straight-leg foot until you feel a mild stretch, hold 20 to 30 seconds, repeat 2 times each side.
5. Calf stretch against a wall: Keep the sore side behind you, knee straight, lean forward until you feel stretch in the calf, hold 20 to 30 seconds, repeat 2 times each side.
6. Short arc knee motion (light range): Lie down and use a small range of knee flexion and extension that does not increase front-of-knee tenderness, repeat 10 times.

Helpful Books

• "The Sports Medicine Patient Advisor" written by American Academy of Orthopaedic Surgeons (AAOS)
• "Pain Relief Without Surgery" written by Michael S. Grodin
• "Heal Your Hands and Knees" written by Nicole Dorsey
• "Choosing Healthier Habits" written by Harvard Health Publishing