Welcome to Cambie Physiotherapy and Health Clinic's patient resource about Prepatellar Bursitis.
Prepatellar bursitis is the inflammation of a small sac of fluid located in front of the kneecap. This inflammation can cause many problems in the knee.
This guide will help you understand:
how prepatellar bursitis develops
why the condition causes problems
what can be done for your pain
Hear from some of our patients who we treated for Knee Pain
“
I am having a very pleasant experience at Cambie Physiotherapy Clinic . Mr. Tarunbeer Kang, my physiotherapist, is extremely professional and knowledgeable! He helped me to understand my injury and... ”
“ I am having a very pleasant experience at Cambie Physiotherapy Clinic . Mr. Tarunbeer Kang, my physiotherapist, is extremely professional and knowledgeable! He helped me to understand my injury and provided best care. Also, he could constantly adjust the treatment plan based on the condition of my injured knee and leg. Now my leg and knee feel much better.
Besides, Ms. Amanjot and Ms.Amandeep and other staffs in the clinic are very nice and friendly. They are always ready for my appointments, greet warmly to the clients, and help me do the physiotherapy.
I would highly recommend. ”
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I have a car accident resulted in lots of knee pain and can't bend my knee joints. I came to cambie physio, luckily I met Hardeep Mann, she figured out I have arthritis and plantar femoral syndrome... ”
“ I have a car accident resulted in lots of knee pain and can't bend my knee joints. I came to cambie physio, luckily I met Hardeep Mann, she figured out I have arthritis and plantar femoral syndrome right away and start treating me right away, I recover quickly and able to move around freely without pain. I am a nure and I have experience working with trauma patients before. I can tell Hardeep is very knowledgeable and patience, she helps me to go through this difficult time. The office ladies are very helpful for set up appointments and arranging the right person to see me. I will highly recommend this place and see Hardeep ”
“
This clinic has been amazing in helping my knee recover from some muscle issues. After a few weeks I was able to start making proper use of it again in BJJ. I will continue using this clinic in the... ”
“ This clinic has been amazing in helping my knee recover from some muscle issues. After a few weeks I was able to start making proper use of it again in BJJ. I will continue using this clinic in the future should I have any further injuries
I highly recommend coming here if you need physio. The staff and therapy are top notch! ”
“
Dr. Tarunbeer Kangaroo is very patient and nice person. He takes care of your issue and try his best to help you out. I got a knee pain recently, and after few session, I feel much more better. The... ”
“ Dr. Tarunbeer Kangaroo is very patient and nice person. He takes care of your issue and try his best to help you out. I got a knee pain recently, and after few session, I feel much more better. The place is also easy to access as well. ”
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INCREDIBLE! I got there with a lot of pain in my knee due a calcification and tendinopathy in the Patelar tendon in the left knee, was struggling for over a year with the injury visited lots of... ”
“ INCREDIBLE! I got there with a lot of pain in my knee due a calcification and tendinopathy in the Patelar tendon in the left knee, was struggling for over a year with the injury visited lots of physios and Doctors and no one could help me, but when I got here physio Hardep Kaur told me she will do everything to help me with my knee, and she explained everything to me about the treatment and procedures because she want it to help me to go back to my activity which is being a professional badminton player, We start with shock wave therapy and manual treatment, after 6 sessions I am almost pain free and my knee feeling amazing good I started doing my activity a couple of days ago and I can only say THANK YOU for everything because I’m Feeling incredible good with no pain patients and doing what I love again without pain thanks to Cambie Physiotherapy at no5 road and thanks to my physio Hardeep kaur for helping me and being so nice to me,taking care of my health and being incredible human caring about the patients, now cambie physiotherapy and Hardeep Kaur Mann will be my place forever Thanks you so much ”
“
INCREDIBLE! I got there with a lot of pain in my knee due a calcification and tendinopathy in the Patelar tendon in the left knee, was struggling for over a year with the injury visited lots of... ”
“ INCREDIBLE! I got there with a lot of pain in my knee due a calcification and tendinopathy in the Patelar tendon in the left knee, was struggling for over a year with the injury visited lots of physios and Doctors and no one could help me, but when I got here physio Hardep Kaur told me she will do everything to help me with my knee, and she explained everything to me about the treatment and procedures because she want it to help me to go back to my activity which is being a professional badminton player,
We start with shock wave therapy and manual treatment, after 6 sessions I am almost pain free and my knee feeling amazing good I started doing my activity a couple of days ago and I can only say THANK YOU for everything because I’m
Feeling incredible good with no pain patients and doing what I love again without pain thanks to Cambie Physiotherapy at no5 road and thanks to my physio Hardeep kaur for helping me and being so nice to me,taking care of my health and being incredible human caring about the patients, now cambie physiotherapy and Hardeep Kaur Mann will be my place forever
Thanks you so much ”
“
Friendly staff!! injured my knee and they’ve helped a lot!!! very knowledgeable. I’ve been seeing Tarunbeer Kang and he’s very helpful and professional!!! 100% recommend ”
“ Friendly staff!! injured my knee and they’ve helped a lot!!! very knowledgeable. I’ve been seeing Tarunbeer Kang and he’s very helpful and professional!!! 100% recommend ”
“
I have been visiting the clinic, Richmond location, for the last few weeks. Very professional and friendly staff. Dr. Tarunbeer Kang is very knowledgeable and competent. His recommendations was very... ”
“ I have been visiting the clinic, Richmond location, for the last few weeks. Very professional and friendly staff. Dr. Tarunbeer Kang is very knowledgeable and competent. His recommendations was very helpful Aman made me feel comfortable during treatments. Direct billing is very convenient.. Very flexible hours. My knee injury is getting much better. Thank you! ”
“
I have been visiting the clinic, Richmond location, for the last few weeks.
Very professional and friendly staff.
Dr. Tarunbeer Kang is very knowledgeable and competent. His recommendations was very... ”
“ I have been visiting the clinic, Richmond location, for the last few weeks.
Very professional and friendly staff.
Dr. Tarunbeer Kang is very knowledgeable and competent. His recommendations was very helpful
Aman made me feel comfortable during treatments.
Direct billing is very convenient..
Very flexible hours.
My knee injury is getting much better.
Thank you! ”
“
Tarunbeer and his team are very knowledgeable, friendly people and Tarunbeer helped me in easing my knee pain The place is very clean with easy access and plenty of parking and have extended hours ”
“ Tarunbeer and his team are very knowledgeable, friendly people and Tarunbeer helped me in easing my knee pain The place is very clean with easy access and plenty of parking and have extended hours ”
“
If you are in any sort of joint pain, NAVJOT is the person to go to. I have had a bad knee pain for the past 3 years and few visits, exercise and correct treatment later I am literally out of pain.... ”
“ If you are in any sort of joint pain, NAVJOT is the person to go to. I have had a bad knee pain for the past 3 years and few visits, exercise and correct treatment later I am literally out of pain. Reasonable charge and in-depth knowledge. Navjot had a perfect plan for my recovery and perfect assessment of my pain. Thank you Navjot :) One of the best physiotherapist I met! ”
“
Great service all around. Tarunbeer Kang really takes the time to listens and suggests everything that might help with great expertise. My knee injury is recovering well ”
“ Great service all around. Tarunbeer Kang really takes the time to listens and suggests everything that might help with great expertise. My knee injury is recovering well ”
“
Excellent clinic. Very professional and friendly staff from minute one. My physiotherapist Hardeep was attentive and I felt safe trusting his guidance. Asked lots of questions and did through testing... ”
“ Excellent clinic. Very professional and friendly staff from minute one. My physiotherapist Hardeep was attentive and I felt safe trusting his guidance. Asked lots of questions and did through testing paid attention to my answers and questions. My LCL knee problem has been getting better now. I recommend this Physio clinic. ”
“
Tarunbeer and his team are very knowledgeable, friendly people and Tarunbeer helped me in easing my knee pain
The place is very clean with easy access and plenty of parking and have extended hours ”
“ Tarunbeer and his team are very knowledgeable, friendly people and Tarunbeer helped me in easing my knee pain
The place is very clean with easy access and plenty of parking and have extended hours ”
Where is the prepatellar bursa, and what does it do?
A bursa is a sac made of thin, slippery tissue. Bursae occur in the body wherever skin, muscles, or tendons need to slide over bone. Bursae are lubricated with a small amount of fluid inside that helps reduce friction from the sliding parts.
The prepatellar bursa is located between the front of the kneecap (called the patella) and the overlying skin. This bursa allows the kneecap to slide freely underneath the skin as we bend and straighten our knees.
Bursitis is the inflammation of a bursa. The prepatellar bursa can become irritated and inflamed in a number of ways.
In some cases, a direct blow or a fall onto the knee can damage the bursa. This usually causes bleeding into the bursa sac, because the blood vessels in the tissues that make up the bursa are damaged and torn. In the skin, this would simply form a bruise, but in a bursa blood may actually fill the bursa sac. This causes the bursa to swell up like a rubber balloon filled with water.
The blood in the bursa is thought to cause an inflammatory reaction. The walls of the bursa may thicken and remain thickened and tender even after the blood has been absorbed by the body. This thickening and swelling of the bursa is referred to as prepatellar bursitis.
Prepatellar bursitis can also occur over a longer period of time. People who work on their knees, such as carpet layers and plumbers, can repeatedly injure the bursa. This repeated injury can lead to irritation and thickening of the bursa over time. The chronic irritation leads to prepatellar bursitis in the end.
The prepatellar bursa can also become infected. This may occur without any warning, or it may be caused by a small injury and infection of the skin over the bursa that spreads down into the bursa. In this case, instead of blood or inflammatory fluid in the bursa, pus fills it. The area around the bursa becomes hot, red, and very tender.
Prepatellar Bursa Infection
Symptoms
What does prepatellar bursitis feel like?
Prepatellar bursitis causes pain and swelling in the area in front of the kneecap and just below. It may be very difficult to kneel down and put the knee on the floor due to the tenderness and swelling. If the condition has been present for some time, small lumps may be felt underneath the skin over the kneecap. Sometimes these lumps feel as though something is floating around in front of the kneecap, and they can be very tender. These lumps are usually the thickened folds of bursa tissue that have formed in response to chronic inflammation.
The bursa sac may swell and fill with fluid at times. This is usually related to your activity level, and more activity usually causes more swelling. In people who rest on their knees a lot, such as carpet layers, the bursa can grow very thick, almost like a kneepad in front of the knee.
Finally, if the bursa becomes infected, the front of the knee becomes swollen and very tender and warm to the touch around the bursa. You may run a fever and feel chills. An abscess, or area of pus, may form on the front of the knee. If the infection is not treated quickly, the abscess may even begin to drain, meaning the pus begins to seep out.
Diagnosis
How do health care providers identify the condition?
When you visit Cambie Physiotherapy and Health Clinic, our physiotherapist will take a history and do a physical exam. The diagnosis of prepatellar bursitis is usually obvious from the physical examination. In cases where the knee swells immediately after a fall or other injury to the kneecap, X-rays may be necessary to make sure that the kneecap isn't fractured. Chronic bursitis is usually easy to diagnose without any special tests.
Some patients may be referred to a doctor for further diagnosis. Once your diagnostic examination is complete, the physiotherapists at Cambie Physiotherapy and Health Clinic have treatment options that will help speed your recovery, so that you can more quickly return to your active lifestyle.
Cambie Physiotherapy and Health Clinic provides physiotherapist services in Richmond.
Our Treatment
Non-surgical Rehabilitation
When you visit Cambie Physiotherapy and Health Clinic, our treatment usually starts by trying to control the inflammation. Our physiotherapist may suggest the use of heat, ice, and ultrasound to help calm pain and swelling. We may also suggest specialized stretching and strengthening exercises used in combination with a knee brace, taping of the patella, or shoe inserts. We use these exercises and aids to improve muscle balance and joint alignment of the hip and lower limb, easing pressure and problems in the bursa.
Our therapy sessions sometimes include iontophoresis, which uses a mild electrical current to push anti-inflammatory medicine to the sore area. This treatment is especially helpful for patients who can't tolerate injections.
Chronic prepatellar bursitis will usually improve over a period of time from weeks to months. The fluid-filled sac is not necessarily a problem, and if it does not cause pain, it is not always a cause for alarm or treatment. The sac of fluid may come and go with variation in activity. This is normal.
Post-surgical Rehabilitation
If surgery is required, you and your physiotherapist will come up with a plan for your rehabilitation. Initially you will have a period of rest, which may involve using crutches. Then we will begin a careful and gradual exercise program.
At Cambie Physiotherapy and Health Clinic, our goal is to help speed your recovery so that you can more quickly return to your everyday activities. When your recovery is well under way, regular visits to our office will end. Although we will continue to be a resource, you will be in charge of doing your exercises as part of an ongoing home program.
Cambie Physiotherapy and Health Clinic provides services for physiotherapy in Richmond.
Physician Review
In cases where the knee swells immediately after a fall or other injury to the kneecap, X-rays may be necessary to make sure that the kneecap isn't fractured. Chronic bursitis is usually easy to diagnose without any special tests.
If your doctor is uncertain whether or not the bursa is infected, a needle may be inserted into the bursa and the fluid removed. This fluid will be sent to a lab for tests to determine whether infection is present, and if so, what type of bacteria is causing the infection and what antibiotic will work best to cure the infection.
View animation of draining the prepatellar bursa:
If an infection is found to be causing the prepatellar bursitis, the bursa will need to be drained with a needle, perhaps several times over the first few days. You will be placed on antibiotics for several days. If the infection is slow to heal, the bursa may have to be drained surgically. To drain the bursa surgically, a small incision is made in the skin, and the bursa is opened. The skin and bursa are kept open by inserting a drain tube into the bursa for several days. This allows the pus to drain and helps the antibiotics clear up the infection.
Prepatellar bursitis that is caused by an injury will usually go away on its own. The body will absorb the blood in the bursa over several weeks, and the bursa should return to normal. If swelling in the bursa is causing a slow recovery, a needle may be inserted to drain the blood and speed up the process. There is a slight risk of infection in putting a needle into the bursa.
Chronic prepatellar bursitis is sometimes a real nuisance. The swelling and tenderness gets in the way of kneeling and causes pain. For people who need to kneel, this creates a hardship both in their occupation and recreational activities. Patients with prepatellar bursitis may benefit from two to four weeks of physiotherapy.
Surgery
Surgery is sometimes necessary to remove a thickened bursa that has not improved with any other treatment. Surgical removal is usually done because the swollen bursa is restricting your activity.
To remove the prepatellar bursa, an incision is made over the top of the knee (either straight up and down or across the knee). Since the bursa is in front of the patella, the knee joint is never entered. The thickened bursa sac is removed, and the skin is repaired with stitches. You may need to stay off your feet for several days to allow the wound to begin to heal and to prevent bleeding into the area where the bursa was removed.
Some types of bursae will probably grow back after surgery, because the skin needs to slide over the kneecap smoothly. The body will form another bursa as a response to the movement of the patella against the skin during the healing phase. If all goes well, the bursa that returns after surgery will not be thick and painful, but more like a normal bursa.
Bursitis is the inflammation of a bursa. The prepatellar bursa can become irritated and inflamed in a number of ways.
