Knee numbness and pain when kneeling are common complaints. These sensations often arise from direct pressure on the knee joint or underlying conditions. Understanding the causes helps in management and relief.
The Mechanics of Knee Numbness and Pain
Kneeling places direct mechanical pressure on the knee, compressing tissues, including nerves, soft tissues, and bones. This compression can lead to discomfort, tingling, and sometimes sharp pain. Symptoms worsen the longer one kneels and typically resolve once the position is changed.
The knee joint contains various structures affected by kneeling. Bursae, small fluid-filled sacs, act as cushions to reduce friction between bones, tendons, and muscles. When these bursae or other soft tissues like tendons become irritated or inflamed from pressure, they can swell and cause pain and numbness. Nerves located superficially around the knee can also be compressed, leading to numbness or tingling.
Common Underlying Conditions
Several medical conditions can contribute to knee numbness and pain when kneeling.
Prepatellar bursitis, often called “housemaid’s knee” or “carpenter’s knee,” involves inflammation of the bursa directly in front of the kneecap. This condition commonly results from frequent or prolonged kneeling, which irritates the bursa, causing it to produce excess fluid and swell. Symptoms include visible swelling, tenderness, and pain at the front of the knee, worsening with pressure or bending.
Infrapatellar bursitis, also known as “pastor’s knee” or “clergyman’s knee,” affects the bursa just below the kneecap. Like prepatellar bursitis, it can be triggered by repetitive kneeling or direct trauma. Symptoms include pain, swelling, and redness just below the kneecap, and bending the knee increases discomfort. This condition can be associated with patellar tendonitis, an inflammation of the tendon connecting the kneecap to the shin bone.
Patellofemoral pain syndrome (PFPS), also known as “runner’s knee,” is characterized by pain around or behind the kneecap. Kneeling can intensify this pain by increasing pressure and friction on inflamed knee components. This syndrome can stem from overuse, muscle imbalances, or misalignment of the kneecap. The pain is described as a dull ache, but it can feel sharp or stabbing during activities like squatting or going up or down stairs.
Nerve entrapment, such as saphenous nerve entrapment, can cause numbness, tingling, or burning sensations around the inner knee. The saphenous nerve is a sensory nerve that can become compressed or irritated as it travels down the inner thigh and knee. Pain from saphenous nerve entrapment may worsen with activities like squatting, going up or down stairs, or kneeling.
When to Seek Medical Guidance
While temporary knee numbness and pain from kneeling can often be managed at home, some symptoms indicate a need for medical evaluation. Seek guidance if the pain is severe or persistent, lasting more than 48 hours despite self-care measures.
Seek immediate medical attention for severe and sudden knee pain, an inability to bear weight on the affected leg, or a popping sound heard at the time of injury. Significant or sudden swelling, particularly if accompanied by warmth, redness, or signs of infection like fever or chills, warrants consultation. Altered sensation, such as persistent numbness or tingling in the knee or lower leg, also suggests nerve involvement and needs evaluation.
Relief and Prevention Strategies
Practical strategies can help alleviate knee numbness and pain when kneeling and prevent recurrence. For acute symptoms, the RICE protocol—Rest, Ice, Compression, and Elevation—is effective. Resting the knee avoids aggravating activities. Applying ice for 15-20 minutes several times a day helps reduce pain and swelling. Compression with an elastic bandage can limit fluid buildup, and elevating the leg above heart level promotes fluid drainage.
Using knee pads or a thick foam cushion provides direct padding and reduces pressure on the kneecap during kneeling. Modifying activities, such as taking frequent breaks or squatting instead of prolonged kneeling, can also minimize stress on the knee. Maintaining a healthy weight reduces the overall load on the knee joints, which can lessen discomfort.
Regular stretching and strengthening exercises for the muscles surrounding the knee, including quadriceps, hamstrings, and glutes, can improve flexibility and stability. Exercises like half squats, wall squats, and leg lifts help support the knee joint and alleviate pressure. Warm-up exercises before activity and proper footwear also contribute to knee health and injury prevention.