Knee bursitis involves inflammation of a bursa, a small, fluid-filled sac that cushions and reduces friction between bones, tendons, and muscles. When a bursa becomes irritated, it produces excess fluid, leading to swelling and pain. The most commonly affected bursa is the prepatellar bursa, located directly in front of the kneecap. Physical activity is often possible and even beneficial when managed correctly.
Activity and Inflammation Management
Exercising with knee bursitis requires a careful, symptom-guided approach. The general rule is that if an activity causes an increase in pain or swelling, it must be stopped or significantly reduced. Continuing to push through pain will likely worsen the inflammation.
During an acute flare-up, temporary rest from irritating activities is necessary to allow the inflammation to subside. This initial management often involves applying the RICE principle: Rest, Ice, Compression, and Elevation. Applying ice helps reduce local swelling and pain.
Light compression assists with managing the swelling. Activity modification aims to maintain mobility and strength without aggravating the inflamed sac. A complete stop to all movement is generally not advised unless the pain is severe, as this can lead to stiffness and muscle weakening.
Safe Movement and Strengthening Exercises
Once the initial acute pain has settled, incorporating gentle, low-impact movements is beneficial for recovery and joint health. The focus should be on exercises that strengthen the muscles supporting the knee, like the quadriceps and hamstrings, without applying direct pressure or excessive friction to the bursa. Proper form is important to ensure the knee tracks correctly and avoids instability.
Specific exercises can be performed while lying down to avoid weight-bearing stress on the knee. Quad sets involve tightening the thigh muscles by pressing the back of the knee down onto a towel or the floor and holding the contraction for several seconds. Heel slides are another beneficial exercise, performed by lying on the back and gently sliding the heel of the affected leg toward the buttocks, bending the knee only as far as is comfortable and pain-free.
Low-impact cardio activities are excellent alternatives to running or jumping, which put high stress on the joint. Swimming, especially flutter kicks, and cycling on a stationary bike with low resistance allow for controlled range of motion without direct impact. Stretching the muscles surrounding the knee, such as the hamstrings and calves, also promotes flexibility and reduces tension that might contribute to bursal irritation.
Immediate Red Flags and When to Seek Medical Help
Be aware of symptoms suggesting the condition is more severe than simple inflammation, requiring immediate medical attention. One complication is septic bursitis, an infection of the bursa. If this occurs, stop exercising immediately and consult a doctor.
Signs of infection include fever and chills, suggesting the infection has become systemic. Locally, the skin over the bursa may become intensely red, feel significantly warmer to the touch, and the pain may be disproportionate to the injury. Swollen glands near the affected area also indicate septic bursitis.
A medical professional can differentiate between non-infectious and septic bursitis, often by testing a fluid sample from the bursa. Treatment for septic bursitis typically involves antibiotics and sometimes draining the infected fluid. Ignoring these red flags can lead to the infection spreading, making prompt medical intervention necessary.