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If you’re dealing with the ache and swelling of knee bursitis, you’re not alone – and you’re not stuck with the pain forever. Knee bursitis can make simple movements like kneeling or climbing stairs a challenge. The good news is that with the right approach, you can find relief. In this guide, we’ll walk you through what knee bursitis is, why it hurts, and most importantly, how to help it heal. You’ll learn about proven treatments (from quick at-home tips to cutting-edge therapies) and simple exercises to ease your discomfort. Our goal is to give you clarity and hope – so you can get back to the activities you love without that nagging knee pain.
Living with knee bursitis can be frustrating. You might feel a sharp twinge when you bend down, or notice a swollen bump on your knee that makes it hard to kneel. Maybe you’ve tried resting or even cortisone shots, only to have the pain come back. We understand how discouraging this cycle can be. This guide is written with empathy and expertise – as if you’re sitting down with a friendly clinician who explains things in plain language. We’ll cover knee bursitis symptoms, why it happens, and what the latest research says about healing it. Most importantly, we’ll discuss both clinic treatments (like advanced shockwave therapy) and self-care strategies so you can take control of your knee pain. Let’s dive in and start your journey toward fast pain relief and lasting recovery.
Knee bursitis is a condition where one or more of the bursae in your knee become inflamed. Bursae are small fluid-filled sacs that act as cushions between bones, tendons, and skin. When they’re working normally, bursae reduce friction in the joint. But repetitive stress or irritation can cause a bursa to produce too much fluid and swell up – that’s bursitis (literally, “bursa inflammation”). In the knee, there are several bursae, and any of them can get irritated. The most common types are:
Prepatellar bursitis – inflammation of the bursa in front of the kneecap (patella). This is also known as “housemaid’s knee” and often happens from constant kneeling or a direct blow to the knee. You might notice a tender, squishy swelling right over the kneecap.
Pes anserine bursitis – inflammation of the bursa on the inner side of the knee, just below the joint. The pes anserine bursa lies between the shinbone and the tendons of three hamstring muscles. When it’s inflamed, you feel pain about 2-3 inches below the inner knee. This type often affects runners or people with knee osteoarthritis, and it’s more common in women and older adults.
Infrapatellar bursitis – involves the bursae just below the kneecap (sometimes called “clergyman’s knee”). These can get irritated from activities like jumping or prolonged kneeling.
Suprapatellar bursitis – swelling of the bursa above the kneecap (often related to knee joint effusion or arthritis).
Symptoms: No matter the type, knee bursitis usually causes localized pain and swelling. You might see a visible bump or swelling over the kneecap or inner knee. The area can be tender and warm to the touch. Pain typically worsens with activity or pressure (for example, kneeling on a prepatellar bursitis is quite painful). Unlike deep joint pain from arthritis, bursitis pain is more superficial and pinpoint. If the bursa is infected (septic bursitis), there may be redness, and you might have fever or chills – that scenario needs prompt medical care.
Prepatellar bursitis causes visible swelling at the front of the knee. In “housemaid’s knee,” the bursa in front of the kneecap fills with excess fluid (right image), compared to a normal knee (left). This swelling can make kneeling and bending the knee painful.
Causes: Knee bursitis usually develops from either repetitive friction or direct pressure. Prepatellar bursitis often stems from jobs or hobbies involving frequent kneeling – plumbers, carpet layers, and gardeners are at higher risk. A sudden fall or impact on the knee can also inflame the bursa. Pes anserine bursitis frequently occurs in athletes (runners, for example) due to overuse, or in people with underlying knee osteoarthritis which alters knee mechanics. Being overweight can increase stress on the knee and contribute to bursitis in the pes anserine area. Sometimes bursitis is linked to inflammatory conditions like rheumatoid arthritis or gout– crystals or systemic inflammation can irritate the bursa. In rare cases, an infection can enter a bursa (for instance, through a cut or scrape on the knee) and cause septic bursitis, which typically makes the knee red, hot, and very swollen.
Why the pain persists: Bursitis pain often continues when the underlying cause isn’t addressed. Think of bursitis as your body’s way of saying something is rubbing or stressing the area too much. If you only treat the symptoms (like draining the fluid or taking pain pills) but keep aggravating the bursa, the swelling can return. For example, someone may get a cortisone injection that quickly relieves the pain, but if they go back to kneeling on hard surfaces without protection, the bursitis often flares up again. Sometimes, the bursitis is actually a symptom of a larger issue – a knee that’s under extra strain because of problems elsewhere. The knee is a hinge between your hip and ankle; if those joints aren’t moving well or your muscles are imbalanced, the knee can suffer excess friction and stress. As Unpain Clinic founder Uran Berisha explains, the pain in your knee is often a symptom of dysfunction elsewhere – commonly the hips, ankles, or lower back – and until those imbalances are corrected, the knee bursa keeps getting irritated. This is why simply resting or repeatedly draining a bursa might not provide a long-term solution if, say, tight hamstrings or flat feet are continually putting pressure on that knee. In short, to break the cycle of “feel better, then bursitis comes back,” it’s crucial to identify why the bursa became inflamed in the first place.
It’s always reassuring to know there’s scientific evidence behind treatments. So, what does research say about knee bursitis and the best ways to manage it? Here’s a summary of key findings and recommendations, backed by studies:
Many cases resolve with conservative care: The first line of treatment for non-infected knee bursitis is usually conservative management – things like rest, ice, compression, elevation (the classic RICE), and anti-inflammatory medications. These measures can reduce swelling and pain. In fact, most acute bursitis cases improve within a few weeks with activity modification and conservative care. For example, a guideline from the American Academy of Orthopaedic Surgeons suggests avoiding activities that worsen symptoms and using ice several times a day to reduce knee bursitis swelling. Over-the-counter NSAIDs (like ibuprofen or naproxen) can help relieve pain and inflammation. The evidence here is mostly consensus and clinical experience – since these steps are low-risk, they’re universally recommended.
Cortisone injections can provide fast relief: For more stubborn bursitis, a common medical approach is an injection of corticosteroid into the bursa. Steroid injections deliver a powerful anti-inflammatory effect and often relieve pain within days. Research supports their effectiveness, at least in the short term. A 2023 randomized study on pes anserine (inner knee) bursitis found that a single steroid injection significantly reduced pain and improved function at 1 and 8 weeks compared to other treatments. In fact, in this study, the cortisone shot outperformed platelet-rich plasma (PRP) and even shockwave therapy in the early weeks. By 8 weeks, patients who received the steroid had the greatest pain relief and ability to move. This isn’t too surprising – steroids are potent reducers of inflammation. However, there’s a catch: the relief may be temporary, and repeated steroid injections can have downsides (they can weaken soft tissues over time, and there’s a limit to how often you should get them). So while a cortisone shot can be a fast pain-reliever – essentially a “quick fix” – it doesn’t address whatever caused the bursitis. You’ll want to use that window of pain relief to work on rehab (rather than just returning to the aggravating activity immediately).
Shockwave therapy is a promising option: Extracorporeal shockwave therapy (ESWT) is a newer, non-invasive treatment that uses acoustic waves to stimulate healing. It’s been studied mostly for tendon problems and plantar fasciitis, but research is extending to bursitis as well. How does shockwave help? It appears to promote tissue regeneration, improve blood flow, and modulate inflammation in chronic soft-tissue conditions. In the context of knee bursitis, especially chronic cases that haven’t responded to rest, shockwave offers a way to “jump-start” the healing process. A small randomized trial on pes anserine bursitis showed that shockwave therapy significantly improved pain, function, and mobility over a few weeks of treatment. Both low-energy and mid-energy shockwave protocols reduced patients’ pain and improved their walking ability, with mid-energy showing a slightly faster pain reduction. Another clinical study (180 patients with chronic pes anserine bursitis) compared shockwave to injections and found that shockwave did help, though the steroid injection group improved a bit more in the early weeks. The takeaway: shockwave can be an effective, non-surgical treatment for knee bursitis, especially if you prefer to avoid injections or if traditional therapy isn’t giving results. It may not provide overnight relief like a steroid, but it can strengthen the tissues and address the problem long-term rather than just numbing it. In fact, experts note that unlike cortisone (which might weaken tissue), shockwaves actually encourage repair and strengthening of the area.
Other therapies under investigation: Researchers have also explored treatments like Platelet-Rich Plasma (PRP) injections for knee bursitis. PRP involves injecting concentrated platelets (from your own blood) to promote healing. The evidence is mixed – the 2023 study mentioned earlier found PRP was less effective than steroid or shockwave in the short term. Some patients improved with PRP, but not as much or as fast. There’s also interest in treatments like prolotherapy (injections of dextrose solution) or neural prolotherapy for chronic bursitis, though high-quality studies are limited. For example, one study on chronic pes anserine bursitis indicated that a series of dextrose injections yielded similar outcomes to steroid injections over a longer term, suggesting it’s another option if steroids aren’t advisable. However, these alternatives need more research.
Exercise and physical therapy matter: While not a high-tech treatment, therapeutic exercise is one of the most important aspects of managing knee bursitis, especially pes anserine bursitis. Strengthening the muscles around your knee and improving flexibility can reduce the abnormal strain on the bursa. For instance, if weak hip muscles or tight hamstrings led to your bursitis, targeted exercises can correct those issues and prevent recurrence. There aren’t large RCTs solely on “exercises for knee bursitis,” but extrapolating from knee osteoarthritis research: strengthening the quadriceps and hips often alleviates knee pain and improves function. Clinically, physical therapists observe that patients who engage in a consistent rehab program (strengthening, stretching, and gradually returning to activity) tend to have better long-term outcomes than those who only get passive treatments. So, while a shot or shockwave can reduce pain, combining those treatments with exercise is key. In fact, one study on chronic knee pain showed that adding shockwave therapy to a rehab exercise program led to greater pain reduction and mobility gains than exercise alone. Movement is medicine – as long as it’s the right kind of movement.
In summary, research suggests that knee bursitis is very treatable. About 1 in 5 people with knee arthritis may experience bursitis, but simple measures often help. Steroid injections and shockwave therapy are two evidence-backed options for quicker relief, each with pros and cons. Exercises and holistic therapy address the root causes, which is crucial for preventing flare-ups. Our approach at Unpain Clinic is to take these research insights and combine therapies for the best results – which leads us to how we treat knee bursitis at our clinic.
At Unpain Clinic, our philosophy is “treat the root cause, not just the symptoms.” When it comes to knee bursitis (or any knee pain), this means we don’t just focus on deflating the bursa and calling it a day – we want to know why that bursa got inflamed. Our clinicians perform a thorough whole-body assessment to identify any contributing factors: are your hip muscles weak? Is your ankle stiff? Do you have scar tissue from a past injury altering your movement? By addressing these factors, we aim for lasting relief, not just a temporary fix.
Here are the main treatment modalities we offer for knee bursitis and how they work together:
Shockwave therapy is one of our cornerstone treatments for knee bursitis and other chronic soft tissue injuries. It involves sending high-energy sound waves into the affected area. Don’t let the term “high-energy” scare you – this is a non-invasive treatment done with a handheld device applied to your skin. Shockwave therapy essentially jump-starts your body’s healing processes. It stimulates blood flow, breaks down adhesions or calcifications, and encourages the formation of new, healthy tissue fibers. In simpler terms, it helps the body repair itself.
In knee bursitis, especially if you’ve had the issue for a while, the body’s natural healing may have stalled. Shockwaves send a wake-up call to the cells in and around the bursa. For example, with a pes anserine bursitis, we might use focused shockwave on the irritated bursa and the nearby tendons to reduce inflammation and pain. For a prepatellar bursitis, we can target the swollen bursal sac and any thickened tissue around it. Sessions are relatively quick (about 5-10 minutes of actual treatment time to the knee) and performed once a week in a typical plan. Most patients tolerate shockwave therapy well – you feel a tapping or percussive sensation. It can be slightly uncomfortable on very tender spots, but we adjust the intensity to keep it within your tolerance. And the discomfort, if any, lasts only during the treatment pulses and immediately eases when we stop. Many patients describe it as a “deep tissue massage” type of feeling.
Importantly, shockwave isn’t just about pain relief in the moment; it’s about healing. Studies have shown shockwave can stimulate regeneration of tissues and reduce pain in chronic conditions without the downsides of steroids or surgery. Unlike a cortisone injection – which might make you feel better today but could weaken tissues if overused – shockwave therapy actually strengthens the area by prompting collagen rebuilding. We often explain to patients: shockwave uses sound waves to regenerate soft tissue, improve blood flow, and trigger your body’s natural healing response. This is why shockwave is a great tool for knee bursitis, particularly chronic cases that haven’t healed with rest. Plus, shockwave can address any accompanying tendon or muscle issues (for instance, if your bursitis is linked with a bit of patellar tendinitis or IT band tightness, we can use radial shockwave over the thigh muscles to relieve that tension too).
To complement shockwave, we often add EMTT – a therapy you may not have heard of yet, because it’s quite new. EMTT stands for Extracorporeal Magnetotransduction Therapy. It’s a form of pulsed electromagnetic field therapy. In an EMTT session, you lie comfortably while a loop or paddle emits high-frequency magnetic pulses around your knee. You don’t feel much – maybe a gentle warmth or nothing at all – but at the cellular level, important things are happening. EMTT appears to reduce inflammation and modulate pain signals by affecting ion channels and cell membranes. In plain language, EMTT helps calm down overactive nerves and jump-start tissue repair from another angle, using electromagnetic energy instead of sound energy.
EMTT is especially useful for very irritable bursitis or arthritic knees where there’s a lot of diffuse inflammation. For example, if a patient’s knee is extremely sensitive to touch (even light pressure hurts), we might begin with EMTT to gently desensitize the area. It’s painless and can cover a broader region of the knee joint at once. We often pair shockwave + EMTT in the same session because they complement each other. Shockwave provides a mechanical stimulus to the tissues, and EMTT provides an electromagnetic stimulus that penetrates the entire knee area. This one-two punch addresses both the local tissue healing and the overall joint inflammation/pain modulation. Early clinical experiences have been positive – our team finds that combining these therapies can accelerate pain relief and improve mobility more than either alone. (And yes, EMTT is safe; it’s Health Canada and FDA approved for musculoskeletal pain. We just avoid it in people with electronic implants like pacemakers, due to the magnetic field).
Chronic pain conditions like bursitis can sometimes lead to the nervous system becoming overly sensitive – a concept called “central sensitization.” If your knee has been hurting for months, your nerves might start warning “pain” even with less provocation than before. That’s where neuromodulation comes in. Neuromodulation refers to therapies that alter nerve activity to reset the pain signals. At Unpain Clinic, our neuromodulation approaches may include specialized electrical nerve stimulation, low-level laser therapy, or even acupuncture-type needling aimed at calming nerve fibers. For instance, we might use a gentle frequency-specific microcurrent device around your knee or a technique like Scrambler Therapy (which is a form of electronic nerve stimulation that “scrambles” pain signals). These modern neuromodulation treatments are usually painless – patients often feel a soothing or warm sensation.
The aim is to desensitize overactive pain fibers so that normal movement isn’t constantly triggering a pain alarm. Think of it as turning down the volume on an overly loud alarm system. Many patients report that after neuromodulation sessions, their knee feels “lighter” or the pain is significantly reduced for hours or days. This can “buy a window” during which they can do strengthening exercises with much less discomfort, which in turn leads to long-term improvement. We might also include nerve gliding exercises (often called “nerve flossing”) if we suspect a nearby nerve is irritated or stuck – for example, flossing the saphenous nerve in an inner-knee bursitis case. Additionally, simply teaching your nervous system that movement is safe again is a form of neuromodulation: we do this with graded exposure, meaning we gradually reintroduce knee activities in a tolerable way so your brain relearns that bending your knee or climbing stairs doesn’t have to hurt. In summary, neuromodulation in our clinic could be high-tech (using devices) or exercise-based, but it’s all about calming that pain response.
No holistic treatment plan would be complete without hands-on care and exercise. Our physiotherapists and chiropractors are skilled in manual therapy techniques that can relieve pressure on the knee. For example, if you have tight quads or IT band contributing to a bursitis, we may do soft tissue release or myofascial techniques on those areas. Gentle joint mobilizations to the patella or the knee joint can improve its glide and reduce friction on the bursa. Sometimes a tilted pelvis or foot imbalance can be identified – in such cases, manual therapy to the hip or ankle (or even orthotics for the feet) might be part of the plan. The key is that we look at how your whole body is moving.
Therapeutic exercises are then prescribed to reinforce these improvements. Depending on the case, your exercise program may include: stretching exercises (e.g., hamstring and calf stretches if they’re tight and pulling on that pes anserine area), strengthening exercises (quads, glutes, and core are common targets, since stronger muscles help absorb shock and stabilize the knee), and balance or coordination drills. We tailor these to your ability and pain level – early on, it might be simple things like quad sets (gentle tightening of the thigh muscle) or straight-leg raises, then progressing to squats or step-downs as tolerated. Research consistently shows that exercise therapy is the gold standard for long-term improvement in knee pain and function. Even for bursitis, exercise helps by improving joint support and distributing forces more evenly across the knee.
One thing that sets our clinic apart is that we combine these therapies in an integrated way. For instance, a typical session for chronic knee bursitis at Unpain Clinic might involve: some EMTT to calm the knee, followed by targeted shockwave on the most affected tissues, then manual therapy to improve mobility, and finally supervised exercises to reinforce new movement patterns. By addressing the muscular, skeletal, and neurological factors together, we’re not leaving any stone unturned. This comprehensive approach often succeeds where “cookie-cutter” treatments fail. As an example, we’ve seen patients who had long-standing knee pain (including bursitis) improve significantly when we not only treated the knee, but also strengthened their hips and core and used neuromodulation to reduce nerve hypersensitivity. Instead of chasing pain symptoms, we focus on the whole system – the result is not just a reduction in bursitis swelling, but better movement and confidence overall.
Lastly, education is a big part of our treatment. We’ll teach you what movements or habits to avoid while you heal (for example, how to kneel properly with cushioning, or correct a movement that’s aggravating your knee). We empower you with knowledge about your condition – as the saying goes, “knowledge is power,” and knowing why your knee hurts can be a huge relief in itself. Many patients tell us they finally understand their body after our thorough initial assessment (more on that in the FAQ/CTA at the end).
Sometimes it helps to hear how all of this comes together in real life. Let’s share a brief example (with details changed for privacy):
Meet Jane (not her real name), a 52-year-old avid gardener who came to us with a stubborn prepatellar bursitis. Jane had developed swelling over her right kneecap (“housemaid’s knee”) after many summer days of gardening on hands and knees. She tried resting for a couple of weeks and wore a knee pad when she remembered, but each time she knelt down to weed, the swelling puffed right back up. The bursitis had become chronic and painful – it hurt for her to press her knee while climbing stairs or even to kneel in church. She had one cortisone injection from her family doctor, which helped for a month, but then the pain returned when she resumed activities. Frustrated, Jane visited Unpain Clinic looking for a long-term solution.
Assessment findings: In her initial assessment, we found that Jane’s right knee was indeed very tender and swollen at the kneecap. But we also discovered something interesting: her right hip was extremely stiff, and she had weakness in her right gluteal muscles. Because her hip was so inflexible, every time she squatted or knelt, her knee was absorbing extra stress. This likely set the stage for the bursitis. Additionally, Jane had some scar tissue in her quad muscle from an old thigh injury, which might have altered her kneecap movement slightly.
Treatment plan: We created a multi-modal plan for Jane:
Shockwave Therapy & EMTT: Once a week, we applied focused shockwave directly over her prepatellar bursa and the quadriceps tendon above it to stimulate healing. We followed this with 10 minutes of EMTT around the knee to further reduce inflammation and pain (Jane said she barely felt the EMTT – just a bit of warmth). After two sessions, her knee swelling was visibly reduced and she reported less tenderness.
Manual Therapy: Our therapist performed gentle mobilizations of her patella (kneecap) to ensure it glided better. We also did soft tissue release on her quads and IT band, which were notably tight.
Neuromodulation: Because Jane’s pain had been persistent for months, we included a couple of sessions of a soothing electrical stimulation (a form of neuromodulation) around her knee. She described these sessions as relaxing; afterwards her knee felt calmer and she noticed she could bend it with less pain. This likely helped “reset” her pain perception, making the exercises more comfortable.
Targeted Exercise: We taught Jane specific exercises to strengthen her glutes and core – like bridging exercises and side-lying leg lifts – to offload the knee. We also gave her quad sets and straight-leg raises to gently strengthen her thigh without irritating the bursa. Importantly, we showed her how to stretch her hip flexors and hamstrings to improve her hip mobility. Within a couple of weeks, Jane’s squat movement looked much better aligned, meaning less pressure on the front of the knee.
Results: After about 4-5 weeks, Jane’s knee bursitis had dramatically improved. The swelling was gone and she could kneel on a cushion to do light gardening again (we advised moderation and using knee pads consistently). She was delighted that she could return to her favorite hobby without the familiar painful lump on her knee. What amazed her most was that addressing her hip and thigh issues made such a difference – something no one had looked at before. By fixing the root causes (weak glutes, tight tissues) and using shockwave and EMTT to heal the bursa, we not only got rid of her current bursitis, but also helped protect her knee from future flare-ups. Jane’s story is just one example – every patient is unique, but the common theme is that a comprehensive approach can succeed even if isolated treatments (like just an injection, or just rest) have failed. Seeing patients like Jane regain their mobility and confidence is exactly why we combine advanced technology with hands-on care at Unpain Clinic.
(Note: Results can vary from person to person – Jane’s experience is illustrative. Always consult a healthcare provider for personalized advice.)
While professional treatments can accelerate healing, what you do at home also plays a huge role in recovering from knee bursitis. Here are some safe, simple things you can do on your own to relieve pain and support your knee – all backed by common medical advice and our clinical experience:
1. Rest and Protect the Knee: In the acute phase of bursitis (especially if your knee is very swollen or painful), avoiding aggravating activities is crucial. This means no prolonged kneeling, deep squatting, or high-impact exercises for a while. You don’t have to be bed-bound – just use common sense and listen to your knee. If you must kneel, use a thick foam kneeling pad or knee pads to cushion the knee. Modify activities: for instance, do push-ups against a wall instead of on the floor (to avoid kneeling), or switch from running to gentle cycling for cardio temporarily. Giving the bursa time to calm down can prevent a minor inflammation from becoming a chronic issue.
2. Ice and Compression: To tackle swelling and pain, ice is your friend. Apply an ice pack or a bag of frozen peas wrapped in a cloth to the tender area for about 15-20 minutes at a time, several times a day (e.g. after activity and in the evening). Ice helps reduce the bursal fluid and numbs pain signals. Compression can also help with swelling – consider wearing a compression sleeve or a snug elastic bandage around the knee (not too tight, and avoid directly compressing a very large bursitis bulge). Many people find that a soft knee sleeve provides comfort and mild support during daily activities. It’s not a cure, but it can prevent excess fluid accumulation and serve as a reminder to be gentle with the knee. When resting, elevate your leg on a pillow so your knee is above heart level; this aids swelling reduction as well.
3. Topical and OTC Relief: Over-the-counter anti-inflammatory creams or gels can be applied to the knee to help with pain. Products containing NSAIDs (like diclofenac gel) have evidence for relieving joint and soft tissue pain with minimal systemic side effects. You can gently rub a thin layer over the painful area 3-4 times a day. Additionally, oral NSAIDs such as ibuprofen or naproxen, as recommended by your doctor or pharmacist, can reduce inflammation. Always follow dosing instructions and be mindful of stomach sensitivity or other contraindications. Note: If you have any medical conditions or are on other medications, check with a healthcare provider before using these.
4. Gentle Stretching: Keeping the surrounding muscles flexible will reduce tension on the knee. Two areas to focus on are the hamstrings and quadriceps:
Hamstring stretch: Sit on the floor with the affected leg extended and the other leg bent. Gently reach toward your toes on the extended leg (you should feel a stretch in the back of your thigh). Hold 20-30 seconds, no bouncing, and breathe. Improved hamstring flexibility can ease pes anserine bursitis pain by reducing pull on the inner knee.
Quadriceps stretch: Stand holding onto a support, bend your knee and grab your ankle (of the affected side), then pull your heel toward your buttock. You’ll feel a stretch in the front of the thigh. Hold 20-30 seconds. If kneeling is uncomfortable, you can do a similar quad stretch lying on your side or use a strap to gently pull the foot. Stretching the quad may relieve pressure on a prepatellar bursa and improve patellar mobility.
Do these stretches 2-3 times a day if possible. They should feel a mild pull, not sharp pain. Flexibility gains will help your overall knee mechanics.
5. Strengthening Exercises: Once initial pain has subsided a bit, start light strengthening to support the knee:
Quadriceps strengthening: A simple exercise is the straight leg raise. Lie on your back, leg straight, and slowly lift the leg about 12 inches, then lower. Do 10-15 repetitions for 2-3 sets. This strengthens the quads without bending the knee. If that’s easy, you can add a small ankle weight or do mini-squats (only bend ~30 degrees) keeping pain-free range.
Glute activation: Try bridges – lying on your back with knees bent, lift your hips off the floor by squeezing your buttocks, hold 2 seconds, lower down. Strong glutes take pressure off the front of the knee by improving alignment. Do 10 reps for 2-3 sets.
Hip abductor strengthening: Do side-lying leg lifts or clamshells with a resistance band to strengthen the outer hip muscles (gluteus medius). These help stabilize the knee during walking and running, which can prevent bursitis recurrence.
Aim to do these exercises about 3 times a week, on non-consecutive days. Muscle strength won’t improve overnight, but over a few weeks you’ll likely notice better knee stability and less pain with movement. Remember: pain is your guide – slight discomfort or muscle burn is okay, but sharp pain in the bursa area means back off or modify the exercise.
6. Gradual Return to Activity: As your symptoms improve, ease back into your normal activities. Increase intensity or duration bit by bit. For example, if you took a break from jogging due to bursitis, start with brisk walking, then short jog intervals. Or if you’re returning to gardening, limit kneeling time initially and take breaks. This gradual approach prevents sudden overload on a healing bursa. It’s also a good idea to continue using protective gear (knee pads, proper footwear) and to incorporate warm-ups before activity. A warm-up might be 5 minutes of easy cycling or a brisk walk to get blood flowing to the knee.
7. Listen to Your Body and Monitor Progress: Pay attention to any warning signs of bursitis flaring up: increased swelling, redness, or warmth in the knee, or pain that’s worsening. A little soreness after exercise can be normal, but it should fade by the next day. If you notice swelling coming back, it might mean you did a bit too much – scale back and use ice. Keeping a small journal of what activities or exercises you do and how your knee feels can help identify patterns. For instance, you might find that whenever you skip your stretching routine for a few days, your knee feels tighter – a clue that stretching is helping.
8. Know when to seek help: If your knee bursitis doesn’t improve after 2-3 weeks of consistent self-care, or if it’s getting worse (especially if you suspect infection – e.g. the knee is very red or you have a fever), it’s important to see a healthcare provider. Sometimes aspiration (draining fluid) or a guided injection is needed. And as we’ve discussed, persistent or recurrent bursitis might be a sign of underlying issues that a professional can pinpoint. Don’t view seeking help as a failure – think of it as adding more tools (like physiotherapy or specialized treatments) to your recovery toolkit.
By following these at-home guidelines, you’re stacking the deck in your favor. Many of our patients find that a combination of these self-care strategies significantly speeds up their recovery and complements the in-clinic treatments. For example, doing your home exercises and icing regularly can make your shockwave therapy sessions even more effective by keeping swelling down and muscles responsive. Always remember, healing is a process – but with patience and the right care, knee bursitis can be beaten and you can get back to pain-free living.
The typical symptoms include pain around the affected area of the knee (front of the knee for prepatellar bursitis, inner knee for pes anserine bursitis), noticeable swelling or a bulge, and tenderness to touch. You might feel an ache when moving the knee and sharp pain if you press on the swollen bursa or kneel down. The skin over the area may feel warm. Unlike deep joint pain from arthritis, bursitis pain is usually more localized and external. If the bursa is infected, additional symptoms like redness of the skin, fever, or chills can occur. In non-infected bursitis, you typically won’t have fever, but you will have that bothersome swelling and pain with activity.
Recovery time can vary based on the severity and cause. For acute knee bursitis (for example, after a one-time injury or a short period of overuse), it may improve within a few weeks with proper rest and treatment. Many people see significant improvement in 2 to 4 weeks of conservative care. Chronic bursitis or bursitis related to underlying conditions (like arthritis) might take longer – possibly 6 to 8 weeks or more – because you need to address those contributing factors. If you receive treatments like a cortisone injection, you might feel relief in a couple of days, but that doesn’t necessarily mean the bursitis is fully healed (the steroid is reducing inflammation quickly, but the tissue still needs to repair). Shockwave therapy protocols for chronic bursitis typically involve 3-6 sessions over a few weeks, and patients often notice steady improvement over that period. The key is to continue gentle exercises and avoid aggravation even after pain subsides, to ensure the bursa heals completely. Always follow up with your healthcare provider – they can give you a more specific timeline based on your progress. And remember, everyone heals at their own pace, so patience is important.
You can (and should) do gentle exercises with knee bursitis, but you need to be smart about it. Complete immobilization isn’t usually recommended except in very acute cases or if advised by a doctor – too much rest can lead to muscle weakness and joint stiffness. The trick is to avoid movements that directly aggravate the bursa (like deep knee bends, running, or kneeling on a hard surface) while still keeping the leg muscles active. Low-impact activities are generally safe: for example, try cycling on a stationary bike with low resistance, or swimming, as they put minimal stress on the knee while keeping it moving. Engage in range-of-motion exercises (like gently bending and straightening the knee when lying down) to prevent stiffness. Strengthening the surrounding muscles (quads, hamstrings, hips) is beneficial, but start with isometric exercises or very low load. If any exercise causes a spike in pain or noticeable swelling after, scale it back. Often in therapy we say: it’s okay to feel a mild discomfort (like 2-3 out of 10 pain) during exercise, but not sharp pain, and your knee should not be more swollen or painful the next day. If it is, you overdid it. So, yes, you can exercise – just focus on gentle, controlled movements and gradually build up intensity as your tolerance improves. Exercise actually promotes blood flow and healing, so moderate activity is helpful, not harmful, in bursitis recovery.
A knee brace or sleeve can be a useful tool in managing knee bursitis, but it’s not a cure on its own. For prepatellar bursitis, a cushioned knee pad or a neoprene sleeve can protect the bursa from further friction (for instance, if you absolutely have to kneel, a padded brace is much better than kneeling on a hard surface). Compression from a sleeve may also limit how much the bursa can swell, providing some comfort. Many patients report that wearing a simple compression sleeve makes the knee feel more supported during daily activities – it’s warm and gives a gentle pressure that can reduce the ache. In pes anserine bursitis, a wrap or sleeve around the upper tibia area might reduce excessive movement and provide proprioceptive feedback (reminding you to move carefully). Scientific evidence on braces for bursitis specifically is sparse, but by extrapolation from knee arthritis and patellofemoral pain research, braces and sleeves tend to give short-term relief and confidence. They don’t fix the underlying issue, but they can make you more comfortable while you heal. One caution: avoid any brace that is too tight over the bursa as it might irritate it – for example, a tight strap directly over a prepatellar bursitis could worsen pain. Generally, choose a soft sleeve or a brace with a donut cut-out (for kneecap) if needed, and make sure it’s snug but not cutting off circulation. Use the brace during activities that would otherwise hurt, but try to wean off it as your knee gets stronger, so you don’t become dependent on it. Think of braces as temporary helpers, not permanent solutions.
No, bursitis and arthritis are different conditions, though they can cause similar knee pain and even occur together. Bursitis is inflammation of a bursa – a fluid-filled sac that cushions the outside of a joint. It’s typically a soft-tissue issue and usually localized (for example, the swelling just in front of the kneecap or at the inner knee). Arthritis, on the other hand, is a problem inside the joint – specifically, inflammation or degeneration of the joint itself (like the cartilage and bone). The most common arthritis in the knee is osteoarthritis, which involves wear-and-tear of cartilage. Arthritis pain tends to be deeper, can be more diffuse, and often comes with stiffness or grinding inside the joint. You usually won’t see a big, bulbous swelling with arthritis (though arthritis can cause joint effusion – fluid inside the knee – it’s not the same as a bursal swelling you can easily touch on the surface). Interestingly, knee arthritis can lead to bursitis as a side-effect: people with knee osteoarthritis often change how they walk, or have a slight bend in the knee, which can put extra stress on the pes anserine bursa – that’s why about 20% of folks with knee OA also have pes anserine bursitis. Rheumatoid arthritis (an autoimmune condition) can also inflame bursae as part of the overall joint inflammation. But fundamentally, if you have bursitis, it doesn’t automatically mean you have arthritis (and vice versa). They are diagnosed differently: arthritis is seen on X-rays or MRI as joint changes, while bursitis is often diagnosed by physical exam or ultrasound showing fluid in a bursal sac. The treatment overlaps somewhat (both involve reducing inflammation and pain), but for arthritis you’d focus more on joint cartilage protection, whereas for bursitis you target the specific bursa and mechanical causes of its irritation. If you’re unsure what’s causing your knee pain, a healthcare provider can do a thorough evaluation – sometimes knee pain initially thought to be “arthritis” is actually bursitis, or they coexist. We’ve seen patients who were told they had arthritis due to age, but it turned out a lot of their pain was from a treatable bursitis or tendon issue.
It’s a good idea to seek professional help for knee bursitis if:
Your pain and swelling came on after a significant injury (to rule out anything more serious like a fracture or tendon tear).
You notice signs of infection: fever, intense redness, the knee area is hot to touch, or you feel ill – these require prompt medical attention for possible antibiotics.
You’ve tried rest and basic self-care (ice, avoiding pressure, OTC meds) for about 2 weeks and see little improvement.
The bursitis keeps coming back repeatedly, or you have underlying issues like rheumatoid arthritis that could be contributing.
Pain is limiting your daily function significantly (trouble walking, can’t bend the knee, etc.).
A doctor can aspirate (drain) the bursa if it’s very swollen, which can relieve pressure. They can also administer a cortisone injection if appropriate, or prescribe anti-inflammatories. A physiotherapist or sports medicine practitioner will assess the mechanics of your knee and likely identify any muscle imbalances or biomechanical issues. In fact, seeing a physio early can be very beneficial – they can tape the knee or show you how to offload the bursa, and guide you on exercises to prevent a minor bursitis from becoming a chronic one. At Unpain Clinic, we often see patients who wish they’d come sooner – instead of “pushing through” pain for months. Early intervention can mean a quicker recovery. Also, if you’re not sure whether it’s bursitis or something else (meniscus tear, tendonitis, etc.), a professional evaluation can clarify that. In summary, if bursitis pain is more than a mild inconvenience, or isn’t improving with initial care, don’t hesitate to see a healthcare provider. They can give you options and peace of mind.
At Unpain Clinic, our approach to knee bursitis (and any musculoskeletal pain) is unique in that we take a holistic, root-cause-focused view. Rather than just addressing the inflamed bursa in isolation, we assess your whole body’s movement to find why that bursitis developed. For example, we’ll examine your gait, your hip and ankle mobility, muscle strengths and weaknesses, and even old injuries or scar patterns that might be affecting your knee. This is different from a standard quick exam that might just inject the bursa and send you off. We combine advanced therapies – like True Shockwave™ therapy, EMTT, neuromodulation – with traditional hands-on techniques and corrective exercise. Shockwave and EMTT are cutting-edge modalities that many clinics don’t offer; they help stimulate true healing in the tissues (as opposed to just temporary pain relief). Our clinicians are experts in these technologies (our founder, Uran Berisha, is a leading shockwave specialist) and know how to tailor them to conditions like bursitis. We also emphasize education and empowerment. During your session, we explain our findings in plain language so you understand what’s going on with your knee. Patients often say, “No one ever looked at my movement like that before,” and they appreciate finally knowing why they’re hurting and how we’re going to fix it. Another difference is our integrative sessions – we often deliver multiple therapies in one appointment (for instance, you might get shockwave, plus some manual release, plus an exercise review all together). This comprehensive care is why even chronic cases that failed standard treatments start improving with us. We don’t believe in just chasing symptoms; we aim to resolve the condition from all angles. Lastly, Unpain Clinic prides itself on a compassionate, personalized experience – we listen to our patients’ stories and goals. Our aim is not just to heal your knee bursitis, but to help you return to the activities you love stronger and wiser, with the knowledge to keep your pain away. (And as a bonus, we don’t upsell long treatment contracts or push unnecessary interventions – we genuinely focus on what will get you better).
Shockwave therapy for knee bursitis is generally very safe and well-tolerated. The treatment involves a probe that delivers percussive sound waves – it feels like rapid tapping on the skin. Most people find it mildly uncomfortable at worst, and many say it’s not painful, just a strange sensation. The therapist can adjust the intensity based on your feedback. When treating a tender bursitis, we might start at a lower intensity and increase as you get used to it. Any discomfort is usually brief during the actual pulses and stops immediately afterward. There is no need for anesthesia; you remain fully awake and can communicate during the treatment. After a shockwave session, it’s possible to have some soreness in the area for a day or two (similar to having exercised that spot), but this is part of the healing response and is usually minor. Using an ice pack after treatment can ease any post-session soreness, though many patients don’t even need it. Safety-wise, shockwave has an excellent profile: it does not involve any incisions, no injections, and no significant side effects for musculoskeletal uses. It’s non-ionizing (unlike X-rays) and doesn’t damage tissues when applied at therapeutic settings – in fact, it encourages repair. We avoid using shockwave over certain areas (like directly over growth plates in children, over tumors, or in pregnancy over the low back), but for knee bursitis in an adult, it’s considered very safe. Clinical studies on shockwave for various tendon and bursitis problems have reported no serious adverse events. Some patients actually find shockwave feels good in a “hurt-so-good” way, because it often relieves tight spots in muscles around the knee. And as mentioned, it doesn’t carry the tissue-weakening risk that repeated steroid injections might. To sum up: shockwave therapy might sting a bit on a very sore knee, but it’s brief and manageable – and many people are happy to trade a few minutes of mild discomfort for weeks or months of pain relief and healing gain. We will, of course, walk you through everything and stop if it’s too much. In our hands, shockwave is a trusted ally for bursitis treatment.
(Have more questions? Don’t hesitate to reach out – we’re here to help you understand and overcome your pain.)
Knee bursitis can be a real pain – literally and figuratively – but it doesn’t have to become a chronic hindrance in your life. We’ve covered a lot of ground in this guide: from understanding the bursae and why they get inflamed, to reviewing evidence-based treatments and practical self-care tips. The main takeaway is one of hope: with the right approach, knee bursitis is very treatable.
Remember that while quick fixes like injections can help in the short term, addressing the root cause leads to lasting relief.
Often, that means strengthening weak muscles, improving your joint mechanics, and using advanced therapies (like shockwave, EMTT, or neuromodulation) to accelerate healing. Science and our clinical experience both suggest a combination approach works best – calm the inflammation, stimulate healing, and correct the factors that led to bursitis in the first place. Whether you’re a gardener who’s spent a bit too much time on your knees, an athlete with an overuse injury, or someone with arthritis dealing with a side of bursitis, there are solutions available.
We empathize with how bursitis can frustrate your efforts to stay active. It might have limited your workouts, your work, or your daily chores. But by applying the knowledge you’ve gained here – and seeking out quality care when needed – you can break that cycle of “rest, flare-up, repeat.” Each patient’s journey is unique, but many before you have successfully healed their knee bursitis and gotten back to pain-free movement. With patience, consistent effort on your part, and guidance from therapies that have your back (or rather, your knee!), you can be next.
Your knees are meant to move freely and without pain. By taking a whole-body, well-rounded approach, you’re not just putting a band-aid on the problem – you’re fixing it for good. We hope this guide has given you clarity and confidence in managing your knee bursitis. If you’re looking for professional help and a team that truly looks at “why does it hurt?” instead of just “where,” we welcome you to reach out. Here’s to you finding relief and getting back to the activities you love, faster and stronger!
At Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
1. Berisha, U. (Host). (2025). Eliminate the cause of your knee pain with True Shockwave therapy (Unpain Clinic Podcast, Episode #5)unpainclinic.comunpainclinic.com. Unpain Clinic.
2. Unpain Clinic. (2025, November 24). Knee Pain Causes: How to Understand What Your Knee Is Telling Youunpainclinic.comunpainclinic.com. Unpain Clinic Blog.
3. Unpain Clinic. (2025). Patellofemoral Syndrome Relief: Best Braces & Rehab Toolsunpainclinic.comunpainclinic.comunpainclinic.com. Unpain Clinic Blog.
4. Gouda, W. et al. (2023). Comparing the Efficacy of Local Corticosteroid Injection, Platelet-Rich Plasma, and Extracorporeal Shockwave Therapy in the Treatment of Pes Anserine Bursitis: A Prospective, Randomized Study. Advances in Orthopedics, 2023, Article ID 5545520pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
5. Taha Khazraji, R. T., et al. (2022). Low-Energy Versus Middle-Energy Extracorporeal Shockwave Therapy for Treating Pes Anserine Bursitis. Journal of Modern Rehabilitation, 16(2), 93-100jmr.tums.ac.irjmr.tums.ac.ir.
6. Uysal, F., et al. (2015). Prevalence of pes anserine bursitis in symptomatic osteoarthritis patients: an ultrasonographic prospective study. Clinical Rheumatology, 34(3), 529-533pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov.
7. American Academy of Orthopaedic Surgeons (AAOS). (2003). Prepatellar (Kneecap) Bursitisorthoinfo.aaos.orgorthoinfo.aaos.org. OrthoInfo.
8.American Academy of Orthopaedic Surgeons (AAOS). (2003). Pes Anserine (Knee Tendon) Bursitisorthoinfo.aaos.orgorthoinfo.aaos.org. OrthoInfo.
