Housemaids Knee: Prepatellar Bursitis
He runs a biomechanical assessment clinic, advises on footwear and custom orthotics.
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What is Housemaids Knee?
Housemaids Knee is a painful condition involving the anterior part of the knee resulting from an inflammation of the pre-patellar bursa. It is often referred to as “carpenter’s knee” or “prepatellar bursitis”. Depending on the severity of the pathology, a lump may be visible on top of your kneecap as a result of swelling.
What is the function of the Prepatellar Bursa?
Think of a bursa as a small anatomical pouch that contains fluid: the aim of this structure is to reduce friction between bones, ligaments, and tendons during movement. The patellar bursa, better known as “pre-patellar bursa”, is very superficial and located between the knee cap and the skin. This allows the knee cap to move smoothly as we bend and straighten our knees.
Housemaid’s Knee Symptoms?
Typically, patellar bursitis is a result of acute trauma to the knee or a progressive mechanical overuse. It is prevalent in people kneeling down often to meet the demands of their job, such as carpenters, gardeners, and mechanics. Although uncommon, patellar bursitis may also come as a result of infection, due to the superficial nature of the bursa.
If an inspection of your knee reveals a recent skin cut along with a red, hot, and swollen knee, you should contact your GP to start an antibiotic treatment as soon as possible. Other possible causes of pre-patellar bursitis are rheumatic conditions, such as gout and rheumatoid arthritis.
What other structures can cause anterior knee pain?
The most common cause of anterior knee pain is patellofemoral joint syndrome. This is a common condition affecting young active individuals but may be diagnosed in sedentary people as well. This is generally less related to prolonged kneeling down, but more to repetitive activities such as running or prolonged sitting. When pain is located below the knee cap, patellar tendinopathy should be considered, a frequent condition involving the patellar tendon that is aggravated by jumping and hopping.
Treatment of Housemaids Knee
Patellar bursitis generally has a favorable prognosis and heals within 4-6 weeks with conservative management. For people involved in jobs requiring kneeling down, a knee pad may be required to reduce irritation of the bursa. Anti-inflammatories medication such as Ibuprofen and Naproxen may also be appropriate to reduce pain and swelling. In case conservative management fails to address your symptoms, aspiration of the fluid inside the bursa may be considered along with a corticosteroid injection.
Exercises for Housemaids Knee
After the initial inflammatory phase has settled, a light exercise program may commence, with the aim of restoring quadriceps, glutei, and hamstring strength. Examples of these are:
- Straight leg raise exercise
- Lateral leg raise
- Clam exercise with a resistance band
- Bridges and single-leg bridges
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