Suprapatellar Bursitis: Top Causes, Symptoms, and Treatment Options

If you've ever felt a persistent, uncomfortable swelling just above your kneecap that makes even simple movements uncomfortable, you might have more than just a simple ache from overuse, it could be suprapatellar bursitis - a common yet often overlooked cause of knee pain.

Whether you're an athlete pushing your limits or someone who spends long hours kneeling or squatting, this inflammation can really hinder your daily routine.  Understanding the causes, symptoms, and treatment options is essential for effective management and recovery.

What is Suprapatellar Bursitis?

Suprapatellar Bursitis is inflammation of the suprapatellar bursa; a small fluid-filled sac located above the kneecap (patella). The bursa acts as a cushion between the quadriceps tendon and the femur, helping to reduce friction during movement, and when it becomes inflamed, it can lead to that classic swollen, stiff, and painful feeling. 

Symptoms of Suprapatellar Bursitis

Symptoms of suprapatellar bursitis can vary in intensity but generally include:

Knee Swelling

The most common sign is swelling just above the kneecap - the area may feel tender and warm to the touch. 

Pain

Knee pain, especially when moving or bending the knee. The pain may worsen with activity and decrease with rest.

Stiffness

The knee may feel stiff or difficult to move, particularly first thing in the morning or after long periods of inactivity.

Limited Range of Motion

Fully extending or bending the knee may be challenging due to the pain and swelling. 

Causes of Suprapatellar Bursitis

Several factors can contribute to the development of suprapatellar bursitis. The most common causes include:

Overuse or Repetitive Motion

Repetitive movements that stress the knee joint can irritate the suprapatellar bursa, leading to inflammation. Activities like running, jumping, or frequent kneeling are common culprits. People who engage in sports, particularly runners, or those with jobs requiring repeated knee bending (e.g., gardeners and carpenters) are at higher risk.

Direct Trauma or Injury

An injury to the knee or a sudden blow, such as falling directly onto the kneecap, can cause acute bursitis. Trauma may lead to inflammation by damaging the tissues surrounding the bursa, which can cause a build-up of fluid (swelling). 

Arthritis

Conditions like rheumatoid arthritis or osteoarthritis can lead to bursitis by creating chronic inflammation in the joints. Arthritis can irritate the suprapatellar bursa, causing it to become swollen and painful.

Infection (Septic Bursitis)

Sometimes the bursa can become infected, leading to septic bursitis. This may occur if bacteria enter the bursa through a cut, scrape, or nearby infection. Septic bursitis requires immediate medical attention and often involves a fever, redness, and warmth in the affected area.

Poor Biomechanics or Muscle Imbalance

Weak muscles or improper body mechanics can place excess strain on the knee joint, increasing the likelihood of bursitis. For example, improper running form or overloading the quadriceps muscle can contribute to increased pressure on the bursa.

Prevention Tips

You can make small adjustments to daily activities and exercise routines to help prevent suprapatellar bursitis:

Use Knee Pads

Use protective knee pads to reduce stress on the knee joint if you have to kneel frequently.

Strengthen and Stretch

Regular exercises to strengthen the muscles around the knee (especially the quadriceps and hamstrings) and stretching to improve flexibility can help reduce the risk of bursitis.

Practice Good Posture and Form

Whether running, squatting, or lifting, ensure you’re using proper biomechanics to avoid unnecessary strain on your knees.

Treatment Options for Suprapatellar Bursitis

There are many treatment options depending on the severity of the condition and whether the inflammation is due to infection. Common treatment options include:

Rest and Activity Modification

The first step in managing bursitis is to rest the affected knee and avoid activities that aggravate the condition, such as squatting, kneeling, or running. Allowing time for the inflammation to subside can help reduce symptoms.

Ice and Compression

Applying ice packs to the swollen area for 15 - 20 minutes several times a day can help decrease swelling and relieve pain. Compression bandages or knee braces can also provide support and minimize fluid accumulation.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Over-the-counter medications like ibuprofen or paracetamol can reduce pain and inflammation.

Physical Therapy

Strengthening the muscles around the knee, particularly the quadriceps, can help prevent future flare-ups by reducing strain on the bursa. A physical therapist can guide patients through exercises that improve knee strength, flexibility and stability.

Aspiration

In cases of severe swelling, draining excess fluid from the bursa (aspiration) using a needle maybe recommended. This procedure provides relief from pressure and reduces pain.

Corticosteroid Injections

For chronic or severe cases, a corticosteroid injection can be used.  It is a potent anti-inflammatory and is very effective at reducing the pain and swelling associated with the condition.  The steroid is combined with a local anaesthetic to ensure the procedure is relatively pain-free, and is carried out using ultrasound guidance to ensure the needle is placed in the correct place to get maximal pain relief. 

Prolozone Injections

Another option is a prolozone injection; a mixture of ozone gas and nutrients that are injected into the affected area.  Together these therapies promote healing and tissue regeneration, providing relief from pain and improving mobility.

Antibiotics (for Septic Bursitis)

If the bursitis is caused by an infection, antibiotics are necessary to treat the bacterial source.

Surgery

In rare, severe cases where the bursitis does not respond to conservative treatments, surgical removal of the bursa may be necessary. However, this is typically considered a last resort.

If you experience knee pain, swelling, or stiffness that doesn’t improve with rest or home treatments, consult a healthcare provider.  The Leigh Injection Clinic offer both steroid injections and prolozone injections to treat many different MSK related pains – including Suprapatellar Bursitis.  For more information please take a look at the website.

The Leigh Injection Clinic are based on the coast in Leigh on Sea, Essex – perfect for patients in Essex, Kent, London, and surrounding areas. 

https://www.leighinjectionclinic.co.uk/prolozone-and-prolotherapy-injections-essex-london

https://www.nhs.uk/conditions/bursitis/

https://www.healthline.com/health/suprapatellar-bursitis#exercises-and-prevention

https://gpnotebook.com/en-GB/pages/musculoskeletal-medicine/suprapatellar-bursitis