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Common Conditions

Swelling (Housemaid’s Knee)

25/09/2020

Knee bursitis is inflammation of a small sac of fluid called a bursa. There are a number in the knee joint and their function is to lubricate movement between tendons and bone. The most common is Housemaid’s Knee. Housemaid’s Knee also known as Prepatellar Bursitis or knee bursitis is a swelling of the bursa or small sack of fluid at the front of the patella (kneecap). It can be acute or chronic where it occurs gradually over time.

Acute prepatellar bursitis can be caused by a direct blow or fall on the knee. This ruptures blood vessels which bleed into the bursa causing swelling and triggering an inflammation reaction in the walls of the bursa. Subsequently, the walls may then thicken, causing tenderness that may remain even after the swelling has reduced. Acute knee bursitis can also be triggered by an infection as a result of a surface injury, such as a skin wound over the kneecap. In this case, bacteria may spread into the fluid within the prepatellar bursa causing infection. Chronic bursitis is a longer-term problem which may recur over a period of time. Repeated damage to the knee for example from kneeling or work that involves a lot of pressure on the kneecap thickens the walls of the bursa causing irritation.

Symptoms of Housemaid’s knee include pain and tenderness at the front of the kneecap and just below it. The kneecap or patella may be swollen and warm to the touch. Movements such as kneeling may be painful. If the injury becomes chronic, then there may be a visible tender lump floating underneath the skin on the patella.

Physical therapy can help with the treatment of Housemaid’s knee. The goal of treatment is to regain mobility and range of motion of the knee. Treatment will include manual therapy, therapeutic ultrasound therapy and ice therapy to help decrease pain and inflammation of the prepatellar bursa. Specific stretching and strengthening exercises will be prescribed by your therapist to aid in reattaining range of motion and strengthen muscles of the knee to support, stabilize and decrease the stresses placed on the prepatellar bursa and tendons of the knee joint. Functional training will also be taught to avoid recurrence of pain especially when doing daily activities. If in doubt, seek professional advice.