Prepatellar Bursitis Treatment

Author: Chloe Wilson - BSc(Hons) Physiotherapy

Prepatellar bursitis, also known as Housemaid's knee, is a common cause of front knee pain.  It tends to affect people who spend long periods kneeling e.g. tradesmen such as roofers and carpet layers. 

Housemaid's knee develops when there is inflammation of the prepatellar bursa – a fluid filled sac that acts as a cushion between the quads tendon and the knee bones.

There are a number of housemaid's knee treatment options, but the best way to cure it and prevent it coming back in the future is stretches.

Tight quads often cause and aggravate the condition as they place extra pressure on the bursa. Any time you move your knee, more friction occurs at the bursa, which leads to inflammation, swelling and pain below the knee. Stretching is the first step to fixing this problem. 

Here we will concentrate on the best stretches you can do, but if you want to know more about other treatment options include corticosteroid injections and medication, see the housemaid's knee overview for more information.

 Exercises for Prepatellar Bursitis

Prepatellar bursitis presents with swelling infront of the knee cap

If your muscles are tight, stretching is going to be a vital part of your prepatellar bursitis treatment. There are a number of different ways of stretching the quads muscles.

Here you will find my favourite two which are simple yet effective. Use the one that works best for you – you don’t need to do both, just one will do!  To stretch effectively, you want to hold the stretch for thirty seconds and repeats it three times, once or twice a day. 

1) Standing Quads Stretch

Starting Position: Stand on one foot, holding the back of a chair for balance. Bend the leg to be stretch behind you

Stretches are a vital part of Housemaids knee treatment.  Approved use by

Action: Pull your heel towards your bottom until you feel a strong stretch in the front of your thigh. Hold for 30 secs.

Repetition: Repeat 3 times, 2x daily, or before and after exercise

Note: Keep your upper body up straight – don’t lean forwards or it reduces the stretch

Progression: To stretch further, carry out the exercise as described but also push the pelvis forwards and take the knee backwards

2) Quads Stretch Lying

Starting Position: Lie on your tummy with a towel around your ankle

Here is a simple way to stretch your quads lying dow

Action: Pull your foot towards your bottom until you feel a stretch in the front of your thigh. Hold for 30 secs.

Repetition: Repeat 3 times, 2x daily, or before and after exercise

Progression: 1) Prop yourself up on your elbows and carry out the exercise as described above
2) Place a pillow/rolled up towel under your knee and carryout the exercise as described above. Can combine with progression one to stretch further

How To Get The Best Results

To get the best results from stretches for prepatellar bursitis, the stretch should feel strong, i.e. rather uncomfortable.  However, you should only feel it down the front of the thigh, not anywhere else and it should stop as soon as you release the stretch.  With each exercise, you want to feel the stretch in the middle of the thigh, not at the knee.

For more tips on the best ways to stretch as well as how to stretch the other leg muscles, see the knee stretches guide.

Other Treatment Options

Stretching is just one part of prepatellar bursitis treatment.  There are a number of other things that can help.  For example, if you spend long periods kneeling, it can help to wear gel knee pads to reduce the friction on the bursa. 

Other things that can help reduce the pain associated with housemaids knee include ice, medication and injections.  Find out more in the prepatellar bursitis overview.

Go to Housemaids Knee Overview or Exercise Guide

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