Bursitis of the Knee is a painful condition in which one or more of the 11 bursa sacs in the knee become irritated and inflamed, affecting the bursa and the soft tissue around it. A bursa is a sac of synovial fluid, rich in protein and collagen that acts as a cushion to protect soft tissue from rubbing - usually against bone. Bursae exist to protect soft tissue (such as tendons, ligaments and muscle) from friction and excess pressure; without bursae, inflammation and/or tearing of soft tissue is probable.
If you experience bursitis, then the bursa sac has become swollen with synovial fluid, blood and or pus. If the bursa fills with blood, it is usually due to trauma - a specific injury such as a fall or perhaps even a car accident. If the bursa sac contains pus, this means it is infected (also known as septic) and you are advised to seek medical attention immediately as this can quickly become life threatening. In any case, once the bursa has swollen then the bursa can no longer serve its purpose as a friction reducer; you will most likely find that the swollen bursa sac(s) can cause a lot of pain and interrupt your lifestyle quite significantly.
We have approximately 160 bursae in our bodies with most of them located in our joints - usually sandwiched between tendons and bone. Bursae in the knee include the suprapatellar bursa, prepatellar bursa, infrapatellar bursa (deep & subcutaneous), anserinus bursa, pretibial bursa, fibular bursa, fibulopopliteal bursa, subpopliteal bursa, gastrocnemius bursa (lateral & medial) and the bursa semimembranosa. The most commonly inflamed Bursae in the knee are the prepatellar bursa followed by the infrapatellar bursa, pes anserinus bursa and suprapatellar bursa.
There are 2 different kinds of bursitis - "septic" and "aseptic" bursitis. If your bursa becomes infected, it's known as "septic bursitis". Septic bursitis is not something to take lightly, as an infected bursa can spread infection throughout the body and become life-threatening. Consult your physician if you think you have septic bursitis as only they can confirm the condition and prescribe proper treatment options.
"Aseptic bursitis" will happen when your bursa isn't infected but your bursitis has been caused by inflammation from another soft tissue injury. For knee bursitis this might mean that you've hurt some of the soft tissue in the knee from a trauma (like a fall) or from repetitive damage over time as can be imagined from certain professions such as carpet installation or roofing.
Bursae in the knee are most often injured from overuse or as a result from excessive strain (even a traumatic accident or fall). Bursitis is most common in males (80%) between the age of 40 and 60; however bursitis that occurs due to trauma is most common before the age of 35. (reference: link)
Poor posture, knee joint degeneration (arthritis, osteoarthritis), auto-immune disorders (gout, psoriasis, thyroid disease), previous surgical intervention, bone spurs / calcium deposits, prolonged kneeling and leg-length discrepancy (one leg is shorter than the other) are all risk factors for knee bursitis (reference: 1). Basically, degenerative conditions affecting the knee or any type of injury or condition that alters the way you walk, stand or sit can lead to a change in the position of the bones and tissue in the knee joint - and these changes in positioning can result in knee bursitis. Degenerative conditions like osteoarthritis or arthritis, can also be hereditary; you may experience more problems in your knee and/or hip if you have older family members that have suffered from similar conditions in the past.
Everyone can be affected by degeneration of their knee joints over time. As we age, our tissue ages too. Any repetitive or frequent movement can place stress on the bursae in your knee over the years. This includes restricted movement due to sitting at a desk job for years, careers that require constant knee bending or resting on the knees, or even physical activities on the weekend. Be aware that knee bursitis can happen to anyone - especially if due to trauma - and it is not just something that happens to someone else.
In most cases, mild to moderate knee bursitis can be treated through conservative treatments outlined by a physician.
Recovery from knee bursitis can take a long time but proper healing is essential to regain strength and get you back to the activities you enjoy. Complete recovery can be easily delayed by re-injury to the tendons, ligaments or other soft tissue in your knee.
It's almost impossible to keep from re-injuring soft tissue in your knee - especially if you incur knee bursitis due to an overuse injury. If you don't take care to remove the underlying cause of your knee bursitis you will always be at risk of re-injury. Sometimes though, it's just not possible to stop everything and rest the injury properly; if your job is the reason you are suffering from knee bursitis, you need to seriously evaluate whether you should change professions - at least temporarily. What ends up happening is we continually re-injure tissue in the knee through our work and daily activities and suffer through on-going flare-ups of knee bursitis - continually setting back our recovery time.
Unless you seriously choose to rest your knee and let the injury heal, you will find that 100% recovery is nearly impossible without proper recovery protocol. Eventually, if left untreated, you might have chronic inflammation of your bursa and/or surrounding soft tissue; treatment becomes even more problematic at this point (you might need surgery to remove your bursa).
Prepatellar Bursitis is also known as "housemaid's knee"
The prepatellar bursa is located in front of the kneecap and takes the form of a flat, round structure. Its main function is to separate the kneecap from the patellar tendon and skin on the front of the knee. Prepatellar bursitis has historically been known as Housemaid's Knee as this condition is often associated with people whose work required kneeling for extended periods of time.
To learn more about prepatellar bursitis, click here.
Infrapatellar Bursitis is sometimes known as "clergyman's knee, plumber's knee, parson's knee, vicar's knee, hoe's knee"
There are 2 infrapatellar bursa and both are located below the kneecap. The deep infrapatellar bursa lies beneath the patella tendon - the tendon connecting the kneecap to the tibia bone (lower leg). The superficial infrapatellar bursa lies in front of (or above) the patellar tendon. Despite the fact that they lie on opposite sides of the patellar tendon, it can be difficult to determine whether one or the other (or both) are causing discomfort.
To learn more about infrapatellar bursitis, click here.
Pes Anserine Bursitis is also known as "goosefoot bursitis"
There is an area just below the knee joint on the inside (medial) part of the leg where the sartorius, gracilis and semitendinosus muscles (these are basically hamstring muscles) attach to the tibia (lower leg bone) just above the shin. These 3 muscles attach via tendons and these tendons effectively join together as they approach the bone. If you look at an image of the tendons, the form is similar to a goosefoot - ergo the term goosefoot tendon. There is a bursa between the goosefoot tendon and the tibia bone to prevent the tendon rubbing against bone, and this bursa is the pes anserine bursa, or more commonly termed the "goosefoot" bursa.
To learn more about pes anserine bursitis, click here.
Important: In some cases, an inflamed bursa may become infected with bacteria (referred to as septic bursitis) and this can quickly become life threatening! In all cases where you suspect you may have bursitis, see a physician for full diagnosis. If the bursa is septic (infected), getting to a doctor quickly may save your life.
There are two types of bursitis: chronic and acute. Chronic bursitis is caused by overuse or repetition of a certain area or joint. It will develop over time, and will likely get better and flare up over a long period of time. Acute bursitis is often the result of a trauma to the knee, such as a fall. It can also result from a simple movement such as lifting and twisting the wrong way or may come on quickly following irritation during knee surgery.
Some suffers cannot recall what triggered the knee pain, which is why some will not seek treatment, hoping it will resolve itself. However, it is always wise to address and deal with knee pain as soon as possible so that the problem does not worsen.
A healthy knee bursa is typically quite small, but it can swell very significantly when bursitis sets in. This is what creates the soft tissue damage in the area. Most symptoms of knee bursitis are specific to which type of knee bursitis you have, also common symptoms you may experience include:
Bursitis of the knee has been found to be statistically more prevalent in cases where the sufferer is involved in, or experiences one or more of the following factors:
The pain you'll feel for acute (short-term) vs. chronic (long-term) knee bursitis will be different. In the beginning you might feel a sharp, intense pain at your knee - however, the longer you have this injury the more this pain is likely to spread out into more of an achy feeling. One clear sign that you've re-injured your knee while recovering from knee bursitis is feeling that sharp, intense pain again if you've overworked it.
You may even notice an intense pain while getting up from a seated position - especially if you have a desk job, spend a lot of time seated on the couch or a kitchen chair during your "down time" or drive in your car for long distances.
Over time, if left untreated, you will start noticing more and more constant pain and have trouble sleeping at night. As I mentioned before, if this injury is left untreated you might need to get your bursa removed through surgery (a bursectomy). You might even suffer from "septic" bursitis - where your bursa gets infected by a bacteria. On-going pain, chronic swelling, or symptoms of an infection (fever or a general sick feeling) should be treated immediately by a doctor.
Time is unkind when it comes to an immobilized joint - you lose strength in your knee but worse than that, you lose the range of motion from atrophy (your flexible tendons, muscles and ligaments slowly shrink / waste away, decreasing joint elasticity). The more time that goes by with your knee immobilized, the more likely you'll wind up with a chronic problem (long term injury such as tendonitis or chronic inflammation / bursitis pain). Basically it means that your knee won't perform as well as it once did and it becomes more prone to injury again later on.
If you have an inflamed bursa in your knee, it's very important to heal it quickly and completely. Minimizing the healing time of your knee bursitis should be an obvious goal, as knee bursitis will limit your ability to go about your daily routine. As stated here (MedicineNet.com), if your long-term (chronic) knee bursitis is left untreated, calcium deposits can form within the bursae. These calcium deposits can lead to permanent stiffness in your injured knee.
Dealing with continuous re-injury, chronic inflammation / swelling and the possibility of getting calcium deposits means you'll have a greater chance of winding up with a chronic knee condition or a serious case that needs to be resolved with surgery.
You need to avoid chronic inflammation and the potential for developing calcium deposits. If you don't, your knee bursitis injury may plague you forever. This is why it's so important to continuously use conservative treatment tools to heal any recurring soft tissue damage and swelling from your bursa before it can build into something big. For any knee bursitis sufferer, having the right tools makes all the difference.
Relieving the symptoms of bursitis initially focuses on keeping the pressure off the bursa. Surgery may be required if your bursa irritation is a result of a bone formation problem, such as a bone spur. If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to treat the infection. For non-infectious bursitis, the preliminary treatment starts with non-operative options such as cold compression via use of a Cold Compress or Ice Pack.
The most important factor in healing bursitis is resting your knee. This can be difficult when you have to carry on with daily activities, but resting whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.
Treatments should involve decreasing swelling, relieving stress on the knee joint, correcting any bio-mechanical dysfunction (uneven leg length, bone spur, etc.), treating scar tissue, and then finally restoring strength and movement in your leg and knee. Circulatory Boost is recommended once inflammation has been calmed to heal the bursa and surrounding tissue faster and reduce the risk of bursitis returning.
To decrease inflammation and relieve the pain of trochanteric bursitis doctor's recommend the application of a cold pack. Applying cold to your inflamed bursa is the first step in treating bursitis - basically it gets the swelling down.
Once the inflammation of your bursitis has been reduced with cold it is time to take the next step in bursitis treatment. Use a Knee T•Shellz Wrap® to improve blood flow while simultaneously helping surrounding soft tissue to become elongated and more elastic. What this means is that not only is increased blood flow keeping the body's ability to heal running efficiently, tissues in the area are now longer and more elastic; this will alleviate pressure on the bursa from surrounding tissue.
We recommend the use of a T•Shellz Wrap®:
T•Shellz Wraps® contain a unique Carbon Fiber Energy Pad which is flexible and will shape to conform to your body. This Energy Pad emits a uniform wave of perfectly safe energy over its entire surface. This energy is absorbed by soft tissue in the treatment area, opening blood vessels, resulting in an increase in blood flow. Increased blood circulation is what your body needs to maximize its cabability of healing soft tissue and this is why we recommend the T•Shellz Wrap®.
The Knee T•Shellz Wrap® is an FDA Registered Medical Device and is suitable for use in therapeutic clinics and FROM HOME. It is completely safe for people and patients to use for themselves.
The technology found in a T•Shellz Wrap® has been used for decades in the worlds of professional and amateur sports - a contributing factor as to why athletes seem to recover from injuries so quickly.
Have you ever wondered by an athlete can return to activity after 4 or 5 weeks following a knee injury - while your average person takes much longer to return back to normal? The secret isn't really that much of a secret - it involves consistent treatments (meaning multiple times a day) using a treatment like the T•Shellz Wrap® to stimulate blood flow to the injured tissues. Most athletes have the luxury of using in-house facilities many times per day.
How many us can afford the time and money to visit a clinic multiple times a day? Very few indeed. This is how you can gain some of the advantages that athletes enjoy in their injury recovery - by using a device like the Knee T•Shellz Wrap® two or three times a day on a consistent basis.
We believe the T•Shellz Wrap® to be one of the most effective home treatments to increase localized blood flow in and around the treatment area.
We can promise that you will receive a product that is designed to be safe and does what it is supposed to do... reduce pain (as stated in "Therapeutic Heat and Cold", 4th edition. - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin) temporarily increase length & flexibility of soft tissue (as stated in "Therapeutic Heat and Cold", 4th edition. - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin) and aid your body in recovering from tendon, muscle and other soft tissue injuries via enhanced blood flow.
The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v.
The T•Shellz Wrap® has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long enough that you can sit or lie comfortably and watch TV, read or surf the net while you're using it.
We recommend 5 to 10 minute treatments to start; the safety shutoff controller is set to max 30 minutes in duration. The device can be worn over clothing and allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.
The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my T•Shellz Wraps® and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.
The T•Shellz Wrap® would then be used:
We are an FDA Registered Company, and our TShellz Wrap, also know as a Circulatory Boost Wrap, is an FDA Registered Medical Device suitable for use in hospitals and therapeutic clinics. Since it is deemed safe for patients to use themselves, the TShellz Wrap can be used for home treatment.
Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.
Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.
This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.
You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.
Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.
Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.
The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!
Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.
The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.
The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.
The notable ingredients in the Arnica Infusion formula include:
Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.
Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.
If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.
Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.
Follow up your T•Shellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the therapeutic benefits of the wraps to make your recovery go much more smoothly.
Do not apply Arnica Infusion within a 2 hour timespan before a T•Shellz Wrap® treatment.
Whether you decide to use the Arnica Infusion in conjunction with the T-Shell and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.
Keep using the T•Shellz Wrap® before activity and when you notice any stiffness in your knee to 'warm up' your muscles, tendons & ligaments.
NSAIDs, non-steroidal anti-inflammatory drugs, can be used if required to help manage your pain. However, these aren't recommended for long term use, as they can cause gastrointestinal difficulties and increase the risk of cardiovascular disease. The T•Shellz Wrap®, when used in conjunction with NSAIDs can greatly improve the effect of the medication; this can not only help you heal quickly but also reduce the amount of NSAIDs that you ultimately may require.
Your doctor may aspirate your inflamed bursa. This involves removing the extra fluid that has built up with a needle. Sometimes, the fluid will be tested at a laboratory to rule out infection.
If your bursitis does not get better with conservative treatments, the bursa may be surgically removed. Usually this is done by arthroscopy, which is a surgical procedure where tiny incisions are made and a pencil-sized camera is inserted into the area. A small shaver is inserted into another incision, and is used to remove the swollen bursa all together. The surgeon will then look for any damage to the knee and make repairs if necessary. This is also done to remove any bone spurs.
Recovery time for the surgery will depend on a number of different factors including your healing ability, diet, rest and how many procedures were done in your surgery.
Post-op recovery time can be reduced with the use of conservative treatments recommended by your physician. Cold compression is recommend by doctors following surgery to treat your pain in a natural, non-addictive way and to reduce swelling. Once the incision has healed, speak with your doctor about the use of a T•Shellz Wrap®.
Read more about Bursitis Surgery here.
Physio is a beneficial way to restore atrophied muscles and improve strength and mobility after treating bursitis. The type of PT and the duration will be dependent on the tissue damage and your symptoms. When you are treating or recovering from bursitis, it is important to ensure you do not perform any exercises that will further irritate the bursa.
Once your pain starts to diminish, a physiotherapist will set up an individualized strengthening and stretching exercise program for you to perform at home or in the gym. This will be based on your needs and abilities, and will help you return to performing your normal routines.
Individuals will often lift weights on their own, to try and build up their strength. However, in doing so, they can do more damage to their joint. It is extremely important to strengthen your muscles properly, as they may have weakened during the period of non-use. A trained therapist will help to ensure your rehabilitation process is appropriate and effective. For best, long term results use T•Shellz Wraps® at home, in conjunction with PT and an exercise program.
Shortened muscles and tendons due to lack of use is a real problem during recovery. When you start to feel better and use the joint, the shortened muscles and tendons get over-strained, introducing small microtears. These microtears start the formation of scar tissue, which unlike muscle or tendon, is completely inflexible. Once there is scar tissue in there, the tears will continue; eventually you've got a serious problem with a joint that does not flex as much as it did before and this becomes a chronic condition. You'll know you have scar tissue when you get shooting pain if you stretch your joint too far... it is something that physical therapist's often deal with (ie. shoulder manipulation).
To prevent this, use the TShellz Wrap before undertaking any significant activity, as this type of treatment is known to increase flexibility and length of tissues in the area of application. This is actually why we advise plantar fasciitis sufferers to treat themselves with a Plantar TShellz Wrap first thing in the morning before walking (walking stresses the plantar ligament on the bottom of the foot). After treatment, tissue in the bottom of the foot will be more flexible - this means it will be able to handle higher walking stresses before it starts to micro-tear. The ability for soft tissue to stretch further before micro-tearing will allow you to gently stretch your recovering joint without re-injuring it yet again. This is a huge boon for recovery. We also highly advise the TShellz Wrap it for post surgery recovery, as surgery will always introduce scar tissue and TShellz Wrap treatments in post-op recovery will reduce scar tissue growth, increase joint flexibility and get you back on your feet faster.
We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.
Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, does not equate to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.
This is why we recommend for people to continue with their doctor or PT recommended exercises and to continue with mild treatments of the T•Shellz Wrap® for a period of time - to better ensure complete recovery.
Ongoing treatments to enhance circulation are intended to soothe, relax and stimulate the body's ability to heal damaged tissue. T•Shellz treatments also result in the ability of soft tissue to extend further due to the effect of heat on soft tissue. As your muscles and tendons become longer, the pressure they exert on your bursa will decrease - thus reducing the aggravation and friction on your bursa. Further to this, longer and more flexible muscles are less likely to strain or sprain - further reducing your risk of new, secondary injury complications due to bursitis.
People tell us all the time, "I was told that if I stay off my feet for a few weeks, my pain will disappear for good."
The truth is, bursitis will often arise due to a culmination of numerous factors such as alignment issues, poor posture, acute injuries and overcompensation issues resulting from other muscle and soft tissue ailments.
It may take weeks or months for these pain triggers to surface. When they , however, merely resting will solve the underlying issues. You need to utilize actions and options that actually treat the source of the pain and help reverse the damage that has been done.
Resting has a role to play, but it is only one small factor in a recovery plan.
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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!
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