Why Is There Pain and Swelling on the Front of My Knee?

Why Is There Pain and Swelling on the Front of My Knee?

Swelling over the kneecap, particularly after kneeling, is often Housemaid's Knee (prepatellar bursitis), where a small fluid-filled sac at the front of the knee becomes inflamed from repeated pressure. It's especially common in trades involving frequent kneeling, and importantly, it affects the tissue in front of the knee rather than the joint itself. Most cases respond well to rest, ice, and physiotherapy, though signs of infection, such as fever or spreading redness, need prompt medical attention rather than home management.

What Is Housemaid's Knee?

Housemaid's Knee is the inflammation of the prepatellar bursa, a small fluid-filled sac that sits just in front of your kneecap. Its job is simple: reduce friction between the skin and the bone. But when irritated, it can fill with fluid and become swollen and painful. One key thing to note: this condition affects the front of the knee, not the joint itself. The knee joint often remains structurally normal.

What Causes Housemaid's Knee?

This condition is usually linked to repeated pressure or irritation over time, such as:

• Frequent kneeling – common in trades like gardening, decorating, plumbing, or cleaning
• Direct impact – a fall or knock to the front of the knee
• Infection – bacteria entering through a cut or graze
• Underlying conditions – such as rheumatoid arthritis or gout

What Are the Signs and Symptoms?

Symptoms are usually quite visible and localised. You may notice:

• Swelling directly over the kneecap
• Tenderness when touching or kneeling
• Warmth or redness over the area
• Stiffness or discomfort when bending the knee

If infection is involved, additional symptoms can include fever, feeling unwell, or increased redness or heat. This requires prompt medical attention.

What Treatment Options Help?

Most cases respond well to conservative treatment, especially when addressed early.

Physiotherapy

Physiotherapy plays a key role in recovery and prevention. Treatment may include:

• Manual therapy to reduce stiffness and discomfort
• Targeted exercises to maintain knee strength and mobility
• Advice on modifying activities to avoid flare-ups

Settling Pain and Swelling

In the early stages, simple measures are very effective:

• Rest – avoid kneeling or pressure on the knee
• Ice therapy – 15–20 minutes, several times a day
• Compression – helps manage swelling
• Elevation – reduces fluid build-up

Medical Management (If Needed)

In more persistent or severe cases:

• Anti-inflammatory medication (e.g. ibuprofen) may help
• Antibiotics are required if infection is present
• Aspiration (draining fluid) may be considered
• Corticosteroid injections can reduce significant inflammation

How Can You Prevent Housemaid's Knee?

Prevention is especially important if your work or hobbies involve kneeling.

Practical Tips

• Use knee pads or cushioning when kneeling
• Modify tasks to reduce time spent on your knees
• Use tools that minimise bending or kneeling
• Maintain good posture during manual work

Keep Your Body Strong and Mobile

• Warm up before physical tasks
• Stretch regularly to maintain flexibility
• Strengthen your legs and core for better joint support

When Should You Get It Checked?

It's worth getting assessed if:

• Swelling doesn't improve
• Pain is affecting your daily activities
• You're unsure whether it's bursitis or another knee issue
• There are signs of infection

Getting Back to Pain-Free Kneeling

Housemaid's Knee can be uncomfortable, but it's usually very manageable with the right care. By reducing pressure on the knee, managing inflammation early, and building strength and resilience, you can get back to your normal activities without ongoing discomfort.

If knee pain is lingering or keeps coming back, getting a proper assessment and tailored plan can make all the difference in a quicker, smoother recovery.

Frequently Asked Questions

Does Housemaid's Knee affect the knee joint itself?

No. It affects the prepatellar bursa, a small fluid-filled sac in front of the kneecap, not the joint itself, which often remains structurally normal.

How do I know if my swollen knee is infected?

Signs of infection include fever, feeling unwell, and increased redness or warmth around the knee. This is different from typical bursitis and needs prompt medical attention rather than home management alone.

Can Housemaid's Knee be treated without seeing a doctor?

Many mild cases respond well to rest, ice, compression, and elevation, especially when addressed early. However, if symptoms persist, worsen, or show signs of infection, it's important to get it properly assessed.

Who is most likely to get Housemaid's Knee?

It's particularly common in people whose work or hobbies involve frequent kneeling, such as gardening, decorating, plumbing, or cleaning.

How can I prevent Housemaid's Knee if my job involves kneeling?

Using knee pads or cushioning, modifying tasks to reduce kneeling time, using tools that minimise bending, and maintaining good posture during manual work can all help reduce your risk.

About the Author:

Mohana Nedunchezian

Lead Physiotherapist, Independent Non-Medical Prescriber and Injection Therapist

Mohana Nedunchezian is a Specialist Physiotherapist at Relive Physiotherapy with over 15 years' experience in Musculoskeletal Medicine. She is a qualified Injection Therapist, an APPI-certified Pilates Physiotherapy Instructor, and trained in Kinesiology taping, Acupuncture, and Bobath techniques.

Mohana holds a Master's degree in Physiotherapy and spent over 10 years as a Specialist Physiotherapist in the NHS before joining Relive Physiotherapy. She has a particular interest in 1:1 Pilates and joint mobilisation techniques, and brings a warm, engaging approach to every session.

Mohana is a member of the Acupuncture Association of Chartered Physiotherapists (AACP) and the Association of Chartered Physiotherapists in Sports Medicine (ACPSEM).

Outside the clinic, Mohana is a full-time mother to two young children and enjoys music and cooking in her free time.