Knee Pain Kneeling

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Knee Pain Kneeling: Common causes, symptoms and treatment options for knee pain when kneeling

Knee pain kneeling is a common problem and can really affect daily activities. You might get knee pain as soon as you kneel down, after kneeling for a while, when you get up from kneeling, or later on after having kneeled for a while.

Your knee may just feel a bit sore or you might get a burning, stabbing, stinging or sharp pain when kneeling. 

Here, we look at the most common causes of knee pain kneeling, help you work out which one is causing your pain and then look at what you can do to get rid of it.

What Causes Knee Pain Kneeling?

There are a number of things that can cause knee pain when kneeling, and it’s usually due to inflammation or an injury.

The most common causes of knee pain kneeling are:

1. Knee Bursitis

Knee Bursitis - a common cause of Knee Pain When Kneeling

Bursitis is probably the most common cause of knee pain when kneeling. Bursa are small fluid filled sacs that help to reduce friction between bones and soft-tissues. Repeated pressure or friction on a bursa can cause it to swell and become inflamed, known as bursitis.

Any pressure over an inflamed bursa will be painful so it’s no surprise that bursitis is one of the leading causes of knee pain from kneeling. In fact, frequent prolonged kneeling is one of the main causes of bursitis so it quickly becomes a vicious cycle.

With knee bursitis, there is typically a sharp pain in the knee when you first kneel down as the bursa is squashed, and then a prolonged dull achy pain as you kneel. Many people find that the sharp knee pain returns as you get up from kneeling as the squashed bursa re-inflates and swells.

There are three types of knee bursitis that frequently cause knee pain kneeling:

  • Prepatellar Bursitis: Commonly known as housemaids knee Prepatellar knee bursitis typically affects people who spend a lot of time bent forwards on their knees. Housemaids Knee is a frequent problem for tradesmen who spend a lot of time working on their knees such as carpet layers and roofers. The prepatellar bursa is located right in front of the kneecap so when it gets inflamed there is swelling at the front of the knee and around the kneecap. 

  • Infrapatellar Bursitis: Commonly known as Clergyman’s Knee. Infrapatellar bursitis tends to strike people who spend lots of time kneeling more upright or resting back on their heels rather than leaning forwards. This is due to the position of the infrapatellar bursa which sits below the kneecap on the front of the skin

  • Semimembranosus Bursitis: Commonly known as a Bakers Cyst. Semimembranosus bursitis is the most common reason for the back of the knee to hurt when kneeling. The semimembranosus bursa sits at the back of the knee between the hamstring and calf muscles. Whilst kneeling itself doesn’t typically cause a Bakers Cyst to form, you will certainly know that you have one when you kneel down, particularly if you sit back on your heels which squashes the bursa.

Find Out More: Knee Bursitis Treatment

2. Knee Arthritis

People with knee arthritis often complain of knee pain kneeling. With arthritis, there is degeneration of the knee joint bones and cartilage so the bones end up rubbing against each other with can be really sore. 

If you are over 60 and get pain deep inside the knee joint when you kneel, there’s a good chance there is some arthritis in the knee joint. If your knee pain kneeling is more at the front of the knee, you may have kneecap arthritis. 

With arthritis, it tends to be a gnawing, achy knee pain kneeling which may persist for a while once you are upright. The best way to reduce the pain is to walk around for a few minutes, as movement helps to lubricate the knee.

Find Out More: Knee Arthritis

3. Patellar Tendonitis

Knee Pain When Kneeling: Patellar Tendonitis. Find out about the causes, symptoms and treatment options

If you get pain just below the kneecap when you kneel down, it might that you are suffering from patellar tendonitis, aka Jumpers Knee. 

Patellar tendonitis is where there is inflammation of the patellar tendon. It causes pain and tenderness in the dip below the kneecap, between the patella and the small lump on the front of the shin bone, known as the tibial tuberosity. 

Whilst kneeling doesn’t cause patellar tendonitis, it tends to be repetitive sporting activities like jumping and kicking that do, if the patellar tendon is inflamed, it will be extremely tender to touch and result in a sharp pain in the knee when kneeling. Pain while kneeling from patella tendonitis settles quickly when you get up rather than there being knee pain after kneeling.

Find Out More: Jumpers Knee Symptoms & Treatment

4. Osgood Schlatters

Common Causes of Knee Pain Kneeling: Osgood Schlatters

Osgood Schlatters Disease is the leading cause of knee pain when kneeling in children and adolescents.

Symptoms of Osgood Schlatters are usually linked with growth spurts where the knee bones grow at a faster rate than the muscles and tendons, placing them under a lot of tension. The resultant damage to the tibial tuberosity on the front of the shin makes the area very tender.

People with Osgood Schlatters often complain of sharp knee pain when they kneel down. If you are between 9 and 16 years of age and get knee pain when kneeling, chances are it’s Osgood Schlatters.

Find out More: Osgood Schlatters Causes & Treatment

Frequently Asked Questions

Why Does My Knee Burn When I Kneel On It?
If you get burning knee pain when kneeling, chances are something is getting squashed inside or around the joint. The most likely culprit is knee bursitis.

Another possibility is Gout Knee which causes burning pain in the knee but the pain isn’t usually linked with kneeling. If the burning pain persists after kneeling, it could be due to nerve damage in the knee, lower back or thigh.

How Do I Know If My Knee Pain Is Serious?
If you get knee pain when you kneel that settles quickly once you are up chances are it is nothing serious.

The things to watch out for are when knee pain kneeling is associated with locking, instability, severe pain at night or that affects your mobility, major knee swelling, unexplained weight loss and the symptoms of a DVT (calf pain, redness, warmth & swelling)

Why Does My Knee Sting When I Kneel On It?
The most likely cause of stinging knee pain when kneeling is Housemaid’s Knee. Other possibilities are nerve pain, often associated with other symptoms such as tingling or numbness, or a meniscus tear, commonly caused by twisting awkwardly or a fall, with resultant knee locking and swelling

What Causes Sharp Pain On Outside of Knee When Kneeling?
If your knee pain kneeling is on the outer side of your knee, it is most likely linked with the iliotibial band (ITB). The ITB is a thick band that runs down the outer thigh attaching to the outer knee.

Inflammation of either the ITB itself, known as iliotibial band syndrome, or the underlying iliotibial bursa can result in a sharp pain on the outer knee when kneeling. ITB problems most commonly affect runners.

Knee Pain Kneeling After A Fall? 
If you had a fall and landed on the front of your knee, chances are you’ll notice knee pain when you kneel down. You may simply have bruised the bone in which case the pain should settle within a few weeks.

If the pain is severe or is limiting your mobility, you may have a patella fracture or have dislocated your kneecap.

What Causes Sharp Pain In Knee or Kneecap When Kneeling?
Sharp pain in and around the knee when kneeling can be caused by a number of things:

  • If you are over 60 years old, it may well be due to arthritis
  • If you are under 20, Osgood Schlatters is a likely cause
  • If you’ve injured the knee by twisting awkwardly, it’s most likely a meniscus tear
  • If there is a localised pocket of swelling, similar to a small water balloon, it’s most likely knee bursitis.
  • If the sharp pain is in your kneecap, it could be runners knee or and underlying kneecap injury

What Are The Best Knee Pads For Kneeling?
If you get knee pain kneeling but need to be on your knees frequently, then knee pads can really help. In terms of which knee pads are best for kneeling, it really depends what you are using them for.

You might only need a light pair for gardening, but if you work in construction you are going to need some pretty heavy-duty knee pads. Visit the knee pads section for help choosing the right ones for you.

How Can I Get Rid Of Knee Pain Kneeling?
The first step to getting rid of knee pain when kneeling is to find out what is causing the pain in the first place. The best way to get an accurate knee pain diagnosis is to see your doctor.

It may simply be a case or resting the knee and avoiding kneeling in the short term, you may be given exercises to do to strengthen the knee or you may be advised to wear knee pads

  1. Knee Pain Guide
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  5. Knee Pain When Kneeling

Page Last Updated: 09/24/19
Next Review Due: 09/24/21



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References

1. Safety & Health At Work Journal. Occupational Exposure to Knee Loading and the Risk of Osteoarthritis of the Knee: A Systematic Review and a Dose-Response Meta-Analysis. J. Verbeek, C. Mischke, R. Robinson, S. Ijaz,1 P. Kuijer, A. Kievit, A. Ojajärvi and K. Neuvonen. June 2017

2. The Journal of Rheumatology. Occupation-related squatting, kneeling, and heavy lifting and the knee joint: a magnetic resonance imaging-based study in men. Amin S, Goggins J, Niu J, Guermazi A, Grigoryan M, Hunter DJ, Genant HK, Felson DT. August 2008

3. Livestrong.com. Knee Pain While Kneeling Down. P. Quinene


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