In this article you will learn what knee bursitis is and what its causes may be, as well as its diagnostic methods and the appropriate treatment that can be carried out from physiotherapy.
What is a bursitis?
Bursitis is an inflammation of a structure called the bursa serosal. It is a small closed bag that contains synovial fluid and serves to lubricate the joints, and facilitate the movement of tendons and ligaments, when the bag is inflamed it will increase the production of synovial fluids; but, in some cases, the damaged blood vessels inside the bursa cause the blood to spill, accumulating and forming a hematoma, this is the case of hemorrhagic bursitis.
Bursa and bursitis – What is inflammation of the bursa, causes and treatment
I explain in this video what the synovial bag is and what bursitis or inflammation of the synovial bag is. I also show you what its causes are, its symptoms, and the proposed treatment in physiotherapy or rehabilitation.
Types of bursae of the knee
There are five bursae around the knee:
- The prepatellar bursa is located in front of the anterior aspect of the patella and is very prone to inflammation.
- The goose foot bursitis is on the inner surface of the knee. The tendons are the gracilis, sartorius, and semitendinosus.
- Superficial infrapatellar bursa, is the bursa that is in front of the patellar tendon.
- Deep infrapatellar lies between the patellar tendon and the infrapatellar body fat.
- The semimembranosus bursa which is located on the medial side of the knee, at a level higher than that of the pes cue.
Causes of knee bursitis
Basically the causes are usually the following:
- Overload or friction due to repetition of movement
- For some chemicals
- From a septic infection
Knee bursitis can be caused by continuous pressure, by excess tension in the tendon which causes inflammation, by repetitive stress or microtrauma; due to prolonged repetition of certain gestures and movements. In general, workers who must stay in a kneeling position for a long time, such as installers and carpenters, often suffer from knee bursitis.
In contact sports such as rugby, soccer, martial arts are at risk of developing the disease, even volleyball players can be affected as a result of constant jumps or falls on the knee, it is also very common in runners or in “running”.
In addition to the causes of knee bursitis, there are several factors that increase the risk of knee bursitis, such as:
- Chondromalacia patella
- Misalignment at the patellofemoral joint (biomechanical deficit)
- Poor execution of movements in functional activities
- Rheumatic diseases such as rheumatoid arthritis and gout
- Metabolic diseases such as diabetes
How are patellar tendon injuries treated?
We have two types of injuries at the level of the patellar tendon. The first injury is patellar tendinitis and the second injury is patellar tendon rupture. The rupture of the patellar tendon occurs acutely and is easily detected because it produces a snapping sound and a very strong pain that can knock the person down. After this pain the knee swells and knee extension is impossible.
Symptoms of knee bursitis
- Symptoms of knee bursitis are pain, lameness, stiffness, and functional limitation or impotence.
- The patient complains of very intense pain, as if they were stab wounds.
- The signs are caused by inflammation of the synovial fluid . The swelling can be very bulky and resembles a ball or lump on the front of the knee.
- A hemorrhagic bursitis is characterized by a visible bruise. If you press on the bag or make movements of flexion and extension of the knee, it will exacerbate the symptoms.
- Septic bursitis also causes fever. Usually there is a wound from which the infection started, if the inflammation is accompanied by infection, the knee is red and hot.
Diagnosis of knee bursitis
In general, the clinical examination for bursitis of the knee is observation, palpation and the appearance of pain, in addition to the history, are sufficient to reach the doctor and be diagnosed with bursitis in the knee (with the examination is sufficient) .
If the doctor feels it is helpful to investigate to make sure there are no fractures, he or she may require an X- ray to make sure there are no fractures or other bone disorders. But, we must know that the x-ray will not be used to diagnose bursitis or any soft tissue injury.
So, the confirmation of a knee bursitis is through musculoskeletal ultrasound, which can show the soft tissues: muscles, tendons, ligaments, bags, etc. Your doctor may also prescribe lab tests that can be analyzed and that the fluid inside the bag.
Treatment of knee bursitis
The treatment of knee bursitis varies depending on the area and the patient suffering from bursitis. In any case, when bursitis occurs, cold or ice is applied as soon as possible to prevent aggravation of the inflammation. For cryotherapy, ice is kept for 20 minutes; three times a day, no need to have it more.
If the bursitis is hemorrhagic, traumatic or inflammatory due to overload; Treatment will consist of rest with cryotherapy.
The treatments are:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Local cortisone infiltration after aspiration of fluid from the bursa
- Laser therapy and physical or manual therapy
- If conservative treatment of bursitis is not enough, surgical removal of the bursa is possible.
- Surgical treatment of bursitis consists of incision in the skin above the bursa and removal of the bursa; the operation is performed under local anesthesia, the patient is hospitalized for one night
- In the case of the treatment of septic bursitis, it consists in the resolution of the infection with antibiotics.
How to avoid recurrence of bursitis?
Prevention is achieved by avoiding situations that can cause bursitis such as leaning on the knees. If you really need this position for your work, it is better to lean on a soft surface such as a pillow. In sports and work activities that involve a repetitive movement of constant knee flexion and extension for a long time, it is best to reduce it to a minimum. An example of this can be repeated jumps, squats with poor execution repeatedly, in any case you should contact a physiotherapist, who will recommend what you should not do according to your activity.
3 things you should know about trochanteritis or trochanteric bursitis
Knee bursitis causes functional disability since gait is altered. In the first instance, the treatment will be to reduce inflammation, in addition to pain control with the application of physical agents such as cold or ultrasound.
Subsequently, the physiotherapist should indicate mobilization exercises and for strengthening the muscles of the thigh and leg, proprioceptive exercises for the knee joint, inadequate postures in the workplace or in daily life that predispose to knee bursitis .
There is no specific prevention method for inflammation of these bursae or synovial bursae. However, there are various techniques to correct movement, stretching and others so that a bursa that is receiving too much friction from other tissues can be released, and thus reduce the risk of inflammation.
- Bursitis is the inflammation of the bursa and this be hemorrhagic, septic or inflammatory.
- The main cause of knee bursitis is the repetition of flexo extension movements, such as jumping.
- Symptoms of bursitis are pain, inflammation, functional limitation
- The diagnosis is through an ultrasound; the doctor may order an analysis of the fluid to check for blood or infection
- The treatment of bursitis consists especially in controlling inflammation and pain.
- In this article you will learn what knee bursitis is and what its causes may be, its diagnostic methods and the appropriate treatment that can be carried out from physiotherapy