Knee bursitis shows up as pain on the front part of the knee. It can happen above the kneecap,
right on the front of the kneecap, below the kneecap, and just inside on the inner
part of the knee. If treated correctly, knee bursitis gets better 100%. And as
long as you treat the underlying root problem, it should improve enough to get back to being
physically active again, without worrying that knee bursitis will be coming back.
But if left untreated, knee bursitis can progress to worse knee problems, like cartilage damage,
osteoarthritis, meniscus tears in the knee, and those knee problems can eventually lead
to a knee surgery. But since you're watching this video, today, you're going to prevent
yourself from ever reaching that point. Now neither side is can be debilitating,
and the pain can be very severe. It might even leave you unable to walk normally sit
comfortably. sleep well at night, even kneel or just bend your knee without worrying that
it's going to get worse and worse. In this video, I'm going to explain everything that
you need to know to diagnose yourself and begin to treat your knee bursitis pain.
I'll also tell you the difference between knee bursitis and other knee conditions that mask as
knee bursitis. And these are knee problems that even other health care professionals
frequently misdiagnosed your patients with so make sure to watch the whole video all the way
through so that you don't miss any of that. Now, what is knee bursitis? Well, let's start
by explaining what a bursa is. A bursa is a fluid filled sac that is between two different parts of
the body, in order to reduce friction, think of it as a water balloon. And if you get a water balloon
like this, and you rub it on both sides, it kind of rolls between your hands. That's the idea.
Now it's not as big as a water balloon, or as round as a water balloon, they're flat, and
they're stuck between tendons and bones or tendons and other tendons and ligaments. And you have four
of them inside your knee joints. Here's a knee joint that you're looking at the right knee.
There's a kneecap right there. This is the quad tendon up here and
then it turns into the patellar ligament down here and you have three bursa that are right
in this space, you have one that's behind the quad tendon here, the quadricep muscle tendon,
and its job is to keep there from being too much friction from the quad muscle tendon and the thigh
bone. That one's called the Supra patellar Bursa. Then you have another bursa that's right on the
front of the kneecap right here. And that's called the prepatellar bursa and that versus protecting
the front of the kneecap and the tissues right over it. Then there's the infrapatellar Bursa,
which is below the kneecap right in this space right here. And it's protecting all
those tissues from rubbing together. And then you have a fourth major one that can cause problems.
It's called a pes anserine Bursa. And it's going to be down in this region on
the inner part of the knee. The irritation and inflammation in any of these bursa is a sign
that you're over pressurizing the bursa, that bursa is becoming inflamed, and it's
telling you that there's too much pressure on me, I can't take this right now. And it's just
a matter of time before something else becomes injured in addition to the bursa and an injury.
And another thing like cartilage, a ligament or tendon can have more severe consequences
than bursitis. And to give you a preview of the root problem that is causing knee
bursitis is there's usually too much pressure on the front of the knee and on the inside
of the knee and that's overloading the bursa. It's also overloading the tendons, the ligaments,
all the other things that are here on the front of the knee. And it's just that your bursa is the
first one to complain. It's the first one they get irritated. Some people are more prone to bursitis
other people end up getting similar problems like tendinitis. And there's other problems that happen
on the front of the knee like Contra, Malaysia, patella, and patellofemoral pain syndrome.
Let me tell you about knee bursitis versus patellofemoral pain syndrome.
These two conditions along with Kandra, Malaysia, patella, and tendinitis on the front of the knee,
they all share the same root problem, the problem that I was just explaining where there's
way too much pressure on the front of the knee. And that's because of a muscle imbalance where the
quad muscles, the muscles that are on the front of the thigh, they run right here and they attach
to the kneecap, those muscles are over dominant, they're too strong, and they're causing way too
much pressure on the tissues on the things, the structures that are on the front of the knee here.
The main difference between the two though is that in bursitis, there is very severe
inflammation of the bursa and it's usually very visible. If you look at your knee, you'll have a
bump like a fluid filled little bubble that's right in the front of the kneecap if it's at
prepatellar bursitis. Or right above the kneecap if it says super patellar bursitis infrapatellar
bursitis happens right below the knee. That one's a little bit harder to see but you
can get bursitis right there that's visible. And then you have the peasant serene bursitis it's on
the inside part of the knee kind of lower corner of the knee on the inside. patellofemoral pain
syndrome, there usually isn't a spot that's very swollen, it's just pain in the front of the knee,
there's nothing visible on the X ray. And usually the doctor, if they do any sort
of tests with their hands, which they don't always do, they won't find anything wrong with the tests,
like they're like, your ligaments will be fine, your knee cartilage would be okay,
and your meniscus wouldn't be torn, but there's still pain somewhere in the front
of the knee. And so the doctor will usually diagnose that as patellofemoral pain syndrome.
Both can cause severe pain with walking, inability to kneel, or sometimes even be
able to bend your knee all the way. And the pain can be severe, it might even keep you up at night,
or wake you up from sleeping. It's even common for both of these conditions to happen at
the same time, or to happen at different times, but look a little bit differently.
In other words, people will get bursitis at one point, and then months or years later,
they'll get patellofemoral pain syndrome, but without the bursitis aspect of it. And even
if you see multiple doctors, like if you're getting a second opinion, or a third opinion,
it can get quite confusing when a doc one doctor will tell you oh, this is bursitis.
And another one might say this is patellofemoral pain syndrome. And you might even have somebody
else a physical therapist say no, this is tendinitis. It can all look very similar.
But what you need to understand is that all of those conditions that I've just talked
about have the same root problem, therefore they should be treated pretty much the same.
There's slight differences in what to do to relieve pain initially, like if you've got a big
swollen Bursa, well, you don't want to be poking on it. And you might do some short term pain
relieving things to it, like put some ice on it. So I'll talk a little bit more about in a moment.
But to fix the long term problem of bursitis in the knee, or patellofemoral pain syndrome,
even Kandra Malaysia Patellar tendinitis in the front of the knee, you need to look at that
muscle imbalance that I've been talking about those quad muscles on the front of the thigh,
they're likely to dominance too strong relative to muscles in the back of the hip,
usually the glutes, and there could also be problems in the foot muscles down below the knee.
And let's talk about how to diagnose knee bursitis. The number one obvious thing
that you're going to find is that swelling that I'm talking about, I mean, it could look like a
pretty big bubble right above the kneecap, right above the cap here or in front of the kneecap.
If you're looking directly at the front of your knee, it can get swollen right down here, which
that often gets mistaken for a meniscus problem. There's also a fat pad that everybody has in
their neither that's used as cushioning for the way the knee moves, that can get
irritated too. And then that pes anserine bursitis, you'll have that swelling that's
on the inner part of the knee. But it's pretty distinct. Like you can usually trace a little
circle around it with a pin. And it's a distinct circular, oval shaped structure that swollen.
That is one of the most defining features of bursitis. Now it's going to get worse as you
get more active. And then usually is set off by some increase in physical activity. Like if
you started a new exercise plan, if you began to run and you hadn't been running recently,
or if you increased your activity, like maybe you were you already exercising or running or
doing some sort of physical activity, it could be chores housework yard work.
But then you upped it a certain level, then you can develop bursitis at that point.
Another sign is that it gets better when you rest. If you take a few days off, the swelling
tends to decrease, the pain improves, and you tend to feel better. And this usually affects
people in their 20s 30s and 40s. But I have seen this affect people in their teenage years.
And all the way it's old age people in their 70s 80s 90s and beyond. If you do go see a doctor,
the X rays will look normal. And usually, your MRI will look completely normal as well,
they may be able to see the inflammation or the swelling in your bursa and on an MRI,
but it's not always visible. Now let's talk about the common treatments that you'll run into.
If you go see the doctor for your knee bursitis the first thing they're going
to tell you is to rest to stop doing that activity that made it flare up.
Or if you weren't really doing a whole lot if you're tend to be more of a sedentary person,
then they're going to tell you just take it easy rest sit on the couch for a bit lay in bed. And
that should generally get your pain to calm down. But it's not a good long term plan that's only in
the short term. And doctors will always tell you that they won't tell you how long to bed
rest will just say here's the pain medication go rest. We'll see you in a month. And they
just assume that you know when you're going to get active again, I seen the knee tends to help right
over the spot where you feel like it's swollen. And the reason why the ice tends to be quite
effective is because the bursar right close to the skin and so if you put the ice the
cold can penetrate white quite quickly. And the reason why the ice can be effective is
because the bursts are close to the skin. And so the cold from the ice can penetrate
pretty easily into where the burst is at. Now the cold is not solving the long term
problem. It's just buying us some on short term pain relief, and hopefully allowing you to not
take pain medications, you can use an ice pack that you can buy at like a Walgreens CVS Walmart
grocery stores often have them, where you can just get a bag of ice cubes a plastic bag, fill it up
with ice cubes from your freezer, and that will work just fine to your doctor might tell you to
just take over the counter pain medications like your Tylenol, ibuprofen, those types of things.
And that can help reduce the pain, it doesn't take it away permanently, or even get rid of the
pain completely, it might just take the edge off to make it more tolerable. And if you're
still running into bursitis problems, even though you've tried resting icing and taking over the
counter pain medications, your doctor might then give you prescription strength pain medication,
which is definitely more powerful. But it comes with some more side
effects potentially. But you might need that amount of pain relief in order to function
to do your normal everyday activities. If it continues to get worse, despite the over the
counter pain medications and the prescription string pain medications, they might recommend
doing an injection on your Bursa, which will give you like a cortisone or a steroid shot basically.
And that's an anti inflammatory medication. It also has pain relieving effects. And that
can usually buy you a longer amount of time with pain relief and reduce
inflammation. Now injections for bursitis aren't that common. They do happen though.
And if it still doesn't help you out getting an injection, they even less common, they'll refer
you out to a surgeon and surgeons rarely ever do this. But there are surgeries for bursitis.
It's called a burst ectomy, and they'll take out a chunk of the bursa or in some cases,
the whole Bursa. And apparently sometimes it grows back sometimes it doesn't. I would
think that mechanically speaking as far as the way the joints supposed to work,
it is not a good idea to remove a bursa. But sometimes surgeons get it at their wit's end,
and patients are asking them for pain relief. And that's a procedure that surgeons are trained in
doing a vasectomy. So they'll do it for you. But I don't think it's the best long term plan, you need
to look at fixing the muscle imbalance because that's the root problem, you have an excellent
chance at allowing that bursa to calm down so that it's not getting inflamed on you all the time.
Now, hopefully before you've gone to a surgeon or have gotten injections or even prescription
string pain medications, your doctor would have sent you to physical therapy. This is
a more common treatment that's done for people with bursitis problems. And in physical therapy,
you do need to be careful because most physical therapists are trained in helping
people after they've had a surgery of some sort. And they don't always understand what to do for
somebody who has not had a surgery. Like if you're dealing with bursitis, chances are you probably
haven't had any type of knee surgery yet. And even if you had an old knee surgery, like maybe you
had an ACL repair when you were younger, the knee bursitis problem now is not because of a surgery.
So you don't want to go see somebody who's a specialist in helping people
right after surgery. And the reason for that is because they usually will have you do the
same exercises that people that have just gotten out of surgery are doing maybe a little bit more
advanced. But they're not thinking in terms of preventing the problem from coming back
and treating the root muscle imbalance. Physical therapists that work with people
after surgery tend to help people get better bending in their knee and to be able to walk
better. And chances are you can already walk you probably know how to walk decently well.
And you can bend pretty well, you just need to get those bad forces off your bursa so that they
can calm down and allow you to get back to doing all the things that you love to do.
So you want to make sure you find a therapist who specializes in helping people avoid surgery,
and even one who is very experienced in treating knee bursitis problems. Now understanding the
root problem of knee bursitis. Let me explain it thoroughly here so that you can understand
it and begin to treat it yourself. In the bursitis. You've got the quad muscles as
the muscles on the front of the thigh. They attach up to the hip here and on the
front of the thigh bone on the back of the thigh bone as well. And they come down and
connect to the kneecap. There's a bursa right here above the kneecap, one in front of the kneecap,
one below the kneecap, and then one on the inner part of the knee right here. Any of those bursa
can get overloaded if these quad muscles are too short because they're too strong.
And in order to shut down the quad muscles and not make them work so much that they can
lengthen and take pressure off the bursa and the front of the knee. You usually need to get
better glute strength. When the butt muscles back here, the glutes work better. It tends
to allow the quad muscles to relax and not have to dominate all the leg motions and that
takes the pressure off the knee joint here. This is why when you become more active,
if you don't have good glute strength up here, your body just starts to reflexively
use the strongest muscle in the area which is going to be the quads, but that might cause
that excessive pressure on your bursa so glute exercises tends to be the best place to start.
I've linked to videos that focus on glute exercises is to help knee problems down in
the description below. They've also got some other playlists that might be of interest
for you down in the description too. I've also got a program called the 28 day knee
health and wellness boost program. And that program exhaustively takes you through all
the exercises that you need to be doing to fix this muscle imbalance that causes knee bursitis.
You can learn more about it in the link in the description below. I hope this video was helpful
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