Knee Bursitis Symptoms Women Over 40 Should Watch For, Plus the Remedies That Truly Help
Discover why women may be more prone to this common condition
Finding it harder to do everyday activities like climb stairs or simply bend down to tie your shoes lately? If you have achy knees, it may be bursitis, a common inflammatory condition that causes pain and swelling. Keep reading for a top doctor’s insights into the surprising causes, sneaky risk factors and simple ways to both ease the pain and prevent flare ups.
What is knee bursitis?
“Knee bursitis is characterized by pain and swelling around the knee, not necessarily in the knee joint, but outside it,” reveals Laura Moore, MD, PhD, orthopedic surgeon at Hospital for Special Surgery (HSS) and an Assistant Professor in Orthopedic Surgery at Weill Cornell Medical College.
Bursitis occurs when the small fluid-filled sacs called bursae, which sit over the hamstring and knee tendons, become inflamed. “Normally, bursae are tiny and contain cells that secrete lubricating molecules, helping the tendons glide smoothly,” Dr. Moore explains. “But when the area experiences trauma, inflammation triggers these cells to go wild and overproduce fluid, leading to swelling, pain and irritation.”
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The two types of knee bursitis
“The first type, prepatellar bursitis, affects the front of the knee, usually around or just below the kneecap, and is more common in men,” Dr. Moore explains.
In fact, she estimates that the not-as-fair sex accounts for about 80 percent of prepatellar cases, largely due to trauma. “It’s typically caused by a direct injury to either the skin or the tissue in the front of the knee, particularly a chronic or repetitive injury in people who do a lot of kneeling, like workers whose jobs require it,” she adds.
The second type, called pes anserine bursitis, is much more common in women, accounting for about 75 percent of cases. “It tends to present with discomfort on the medial, or inside, part of the knee, usually at or just below the joint,” says Dr. Moore.
She adds that both types of knee bursitis—prepatellar and pes anserine—are more common between the ages of 40 and 60, when other contributing conditions like knee osteoarthritis tend to show up.
3 more risk factors for knee bursitis in women
It’s thought that women’s slightly more knock-kneed alignment, due to hip structure, may predispose us to pes anserine bursitis, according to Dr. Moore. In addition to knee osteoarthritis, she shares a few more common risk factors:
Diabetes
Diabetes, gout and autoimmune diseases are risk factors for both types of bursitis, says Dr. Moore. “We think that’s because these conditions predispose you to systemic inflammation, so that it doesn’t take as much to set off your inflammatory system, leading to knee bursitis.”
A change in gait
“In my clinical experience, I often see pes anserine bursitis develop after a minor knee injury or a small tweak causes someone to change their gait,” says Dr. Moore. “Instead of pushing off with the quadriceps as usual, they begin relying more on the hamstring, essentially ‘pulling’ through the stride.”
She explains that this overuse of the hamstring—especially when compounded by other knee issues like osteoarthritis, which is more common in women—can lead to tendonitis or bursitis where the hamstring tendons insert just below the knee. Physical therapy, she adds, can be very helpful for managing this type of injury.
Obesity
Simply put, extra pounds put pressure on the knees and may also contribute to pain and inflammation, potentially triggering knee bursitis.
3 knee bursitis treatment options
Because knee bursitis causes pain and swelling that can restrict your range of motion, the goal is to reduce or prevent inflammation “so that bursa cells can go back to doing what they’re supposed to do—act as thin cushions for the knee joint,” notes Dr. Moore. “In the vast majority of cases, knee bursitis can be managed conservatively.” Here, she shares a few strategies to discuss with your doctor:
Consider knee pads or compression sleeves
Whether you’re a gardener kneeling to tend the first buds of spring or crouching to clean tight spaces, it’s important to protect the affected area on the front of your knees. That’s why Dr. Moore recommends investing in knee pads to help prevent trauma.
Another option is a knee compression brace or sleeve, she adds. “Compression can be quite helpful in terms of convincing the [inflamed] bursa cells that they’ve already made enough fluid to lubricate the knee joint and can go back to normal.”
Reduce pain with the right meds
Aleve and ibuprofen are the most common over-the-counter oral anti-inflammatory medications, confirms Dr. Moore, who also recommends topical anti-inflammatories like Voltaren to relieve pain. And for extra relief, you can apply ice for about 15 minutes at a time.
Treat a limp ASAP
“If you have another type of knee injury that’s causing you to limp a lot, that’s probably a reason to talk to your medical professional, because long-term limping is not good for the rest of the knee,” notes Dr. Moore.
The bottom line on knee bursitis
In short, protecting your knees from trauma and maintaining a healthy lifestyle to reduce the risk of diabetes and obesity can help relieve or prevent knee bursitis symptoms.
Also of note: “There are some theories on the relationship between osteoarthritis and estrogen that researchers are still working to tease out,” notes Dr. Moore, who is quick to point out that no causal link has been established between declining estrogen levels and knee issues like bursitis.
That said, hormone replacement therapy (HRT) might be worth discussing with your doctor for the range of potential health benefits it may provide.
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