A soft, puffy swelling at the front of your knee, sometimes after a weekend of gardening, laying a floor or scrubbing the bathroom. Kneeling becomes uncomfortable, and the swelling can be a bit alarming to look at. Knee bursitis is common, and with a few changes to how you kneel, it usually settles well.

What knee bursitis is

A bursa is a small, fluid-filled sac that acts like a cushion between bone and skin, helping them glide smoothly. You have one just in front of your kneecap, and another just below it.

Knee bursitis means one of these bursae has become irritated and filled with extra fluid. It most often happens after a lot of kneeling, like gardening, cleaning, tiling or some types of work. It can also follow a knock or fall onto the front of the knee.

You might notice:

• A soft, rounded swelling at the front of the knee.
• Tenderness when you press on it or kneel.
• Some stiffness when you bend your knee fully.

The joint itself is usually fine, and you can often bend and straighten your knee without much trouble.

Why it usually settles

Knee bursitis usually settles when the pressure on the front of the knee is reduced. The extra fluid gradually reabsorbs, and the swelling goes down. It can take a few weeks to settle fully, and the swelling can come back if you return to lots of kneeling too quickly. If you have been given advice by your GP or a physiotherapist, keep following that.

Easing pressure on the knee

The most helpful step is taking pressure off the front of your knee for a while. Some ideas:

• Avoid kneeling directly on the sore knee where you can.
• If you need to get down to the floor, try squatting, sitting or half-kneeling on your other knee instead.
• Use a wrapped cold pack for 10 to 15 minutes at a time to ease swelling and discomfort.
• Rest your leg up on a cushion when sitting, to help the swelling settle.

Kneeling more comfortably

When you do need to kneel, small changes can protect your knee:

• Use a thick kneeling pad, cushion or folded towel.
• Try gardening or knee pads with plenty of padding, especially for longer jobs.
• Take regular breaks to stand up and stretch your legs.
• Swap between kneeling, squatting and sitting on a low stool.
• Break bigger jobs into shorter sessions.

For work that involves a lot of kneeling, it may help to talk to your employer about knee protection or varying your tasks.

Keeping your knee moving

Gentle movement helps your knee stay supple while the swelling settles. Something to try a few times a day:

• Sitting on a chair, slowly straighten your knee, hold for a few seconds, then lower.
• Lying on your back, slowly slide your heel towards your bottom, then back out.

Keep within a comfortable range. If you would like a guided stretch, VIDA has short videos you can follow at your own pace.

Keeping your legs strong

Strong thigh muscles help support your knee, and staying active helps it recover. Something to try a few times a week, as long as it does not press on the sore area:

• Sit to stand. Rise from a chair without using your hands, then lower slowly.
• Bridges. Lie on your back with your knees bent, lift your hips, then lower slowly.
• Heel raises. Rise onto your toes, pause, then lower slowly.

If you would like to follow along, VIDA has short videos of sit to stands, bridges and heel raises you can use at your own pace.

Walking, cycling and swimming are good ways to stay active while your knee settles.

Looking after the skin

If the skin over your knee is broken, scratched or grazed, keeping it clean and covered can help prevent infection, especially if you are kneeling on soil or rough surfaces.

When to get it checked

If your knee becomes hot, red and increasingly painful, especially if you feel feverish or unwell, it is worth speaking to your GP straight away.

Your VIDA pain check-in can help you notice how your knee settles over time.

What to take away

• Knee bursitis is common and usually settles when pressure is reduced.
• Avoid kneeling on the sore knee where you can.
• Use thick padding and take breaks when you do need to kneel.
• Keep your knee moving gently and your legs strong.
• Keep any cuts or grazes on your knee clean and covered.

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