Infrapatellar Bursitis: Causes, Symptoms, and Effective Treatments

What is Infrapatellar Bursitis?

Infrapatellar bursitis is a painful knee condition involving swelling and inflammation of the bursa located beneath the kneecap (patella). The bursa is a fluid-filled sac that cushions the knee joint, reducing friction and allowing smooth movement. Infrapatellar bursitis, also known as “Clergyman’s knee,” can be caused by injury, infection, or overuse of the knee joint.¹

Infrapatellar Bursa Anatomy

The knee joint contains several bursae to minimize friction. The infrapatellar bursa is located beneath the patella and patellar tendon. It consists of two sacs:

• Superficial infrapatellar bursa: Lies just under the skin, in front of the patellar tendon.
• Deep infrapatellar bursa: Lies beneath the patellar tendon, close to the tibia.

Causes of Infrapatellar Bursitis

Infrapatellar bursitis can result from several factors:²

Acute/Chronic Trauma

Direct trauma to the knee (e.g., falls, sports injuries) can rupture blood vessels and cause bleeding into the bursa. Chronic microtrauma from repetitive kneeling or friction also increases risk, especially in athletes and those with bleeding disorders.

Overuse

Activities that require frequent knee bending—such as running, jumping, football, or stair climbing—can cause the bursa to swell due to overuse.

Underlying Knee Conditions

Conditions like patellar tendinopathy (jumper’s knee), osteoarthritis, or rheumatoid arthritis can lead to secondary infrapatellar bursitis if not managed properly.

Septic Infrapatellar Bursitis

Infection can enter the bursa through a skin wound or spread from deeper tissues, leading to septic bursitis. This is more common in people with weakened immune systems or those who perform repetitive knee motions. Early intervention is crucial to prevent complications. For those with metatarsal bursitis, early treatment is also key.

The most common knee bursitis is prepatellar bursitis. Fluid aspiration and analysis help identify the cause and guide antibiotic therapy.³

Symptoms of Infrapatellar Bursitis

Symptoms typically develop gradually and may include:

Swelling Around the Knee

Soft, tender swelling (cyst) just above or below the kneecap.

Knee Pain

Pain around and below the kneecap, worsening with bending, climbing stairs, or kneeling.

Redness and Warmth

Inflamed bursa causes the overlying skin to become red and warm, especially in septic cases.

Knee Joint Rigidity

Stiffness and difficulty bending the knee due to swelling and soft tissue damage.

Fever

Fever and elevated white blood cell count may occur in septic bursitis.^{3 4}

Diagnosis of Infrapatellar Bursitis

Diagnosis involves distinguishing infrapatellar bursitis from other knee conditions:

Radiographic Investigations

X-rays can detect fractures, deformities, or calcifications. If X-rays are inconclusive, Doppler ultrasound is used to assess the bursa and surrounding tissues.⁵

Blood Tests

Elevated white blood cell count suggests infection and may require further evaluation.

Bursal Aspiration

Fluid is aspirated from the bursa and analyzed for crystals or bacteria to distinguish between septic and aseptic bursitis.

Conditions Similar to Infrapatellar Bursitis

• Prepatellar bursitis (housemaid’s knee)
• Rheumatoid arthritis
• Patellar tendinitis
• Patellar bursitis
• Pes anserine bursitis
• Calcification of the knee joint

Treatment of Infrapatellar Bursitis

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat Infrapatellar Bursitis.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with Infrapatellar Bursitis.
As prolotherapy is helping to treat the root cause of Infrapatellar Bursitis, it is deemed to be a permanent fix, preventing the symptoms from returning.

Standard treatment includes NSAIDs for pain, corticosteroids for inflammation, and antibiotics for septic bursitis. Physical therapy helps restore knee mobility and strength.^{2 3 6}

Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.

Frequently Asked Questions

How do you treat Infrapatellar bursitis?

Reduce strain on the knee, use NSAIDs for pain, and consider physical therapy. Steroid injections may help with inflammation. Septic bursitis requires antibiotics.

How long does Infrapatellar bursitis last?

It can take weeks to months to resolve, but most cases improve within a month.

How painful is Infrapatellar bursitis?

Pain is severe during knee flexion, walking, or climbing stairs, but mild at rest.

How long does it take to recover from patellar bursitis?

Patellar bursitis is usually less severe and resolves in 2–3 weeks.

Is it OK to walk with knee bursitis?

Light walking is generally safe, but avoid strenuous activity until symptoms improve.

Is heat good for knee bursitis?

Warm baths or heat packs can help ease pain and stiffness.

Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call

Don’t let Infrapatellar Bursitis control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.

Get in Touch

• Phone: +44 1234 380345
• Email: info@prohealthclinic.co.uk

Our Clinic Locations

• London: 104 Harley Street, Marylebone, W1G 7JD
• Manchester: The Hadley Clinic, 64 Bridge Street, M3 3BN
• Bedford: The Village Medical Centre, Kingswood Way, MK40 4GH

All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.

Author Bio

Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating Infrapatellar Bursitis, with patients travelling to see him from across the UK, Europe, and the Middle East.

With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Infrapatellar Bursitis and providing effective treatment options to alleviate them.

He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.

Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.

Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
LinkedIn profile

References

1. Williams CH, Jamal Z, Sternard BT. Continuing Education Activity.
2. Khodaee M. Common superficial bursitis. American family physician. 2017 Feb 15;95(4):224-31. https://pubmed.ncbi.nlm.nih.gov/28290630/
3. Truong J, Mabrouk A, Ashurst JV. Septic Bursitis. InStatPearls [Internet] 2021 Sep 14. StatPearls Publishing.
4. Rishor-Olney CR, Pozun A. Prepatellar Bursitis. InStatPearls [Internet] 2021 Feb 22. StatPearls Publishing. https://neuro.unboundmedicine.com
5. Draghi F, Corti R, Urciuoli L, Alessandrino F, Rotondo A. Knee bursitis: a sonographic evaluation. Journal of ultrasound. 2015 Sep;18(3):251-7. https://link.springer.com/article/10.1007/s40477-015-0168-z
6. Sato M, Watari T. Housemaid’s Knee (Prepatellar Septic Bursitis). Cureus. 2020 Sep 11;12(9).

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.