A bursa is a small fluid filled sac. There are lots of them in the body – often at joints, or where tendons slide over bony areas. Bursitis occurs when one or more of these sacs get inflamed. Elbows and knees are commonly affected, and bursitis around the knee in particular is a very common condition. It’s sometimes known as “housemaid’s knee” – although given its prevalence amongst combat sports athletes, “grappler’s knee” would perhaps be more appropriate. Typically, it’s extremely painful when any pressure is put on the affected bursa – sometimes described as being like “kneeling on a drawing pin”.
One of the most common causes of bursitis is impact, or frequent pressure – for example, coming down hard on your knee when shooting a takedown, spending a lot of time kneeling down, or resting your elbows on your desk at work. Repetitive movements may increase the risk, and it is certainly worth addressing muscle imbalances around the affected area. For example, bursitis at the elbow may accompany triceps muscle tightness.
The best way to prevent the problem from occurring is to avoid pressure on the area, and by wearing elbow or knee pads where appropriate. Muscle stretching or soft tissue treatment for repetitive strain conditions may also help in some cases.
Using R.I.C.E. early on can help, and removing the source of any repeated trauma or prolonged pressure is important. It is possible to use tape and padding to protect the affected area and remove pressure from the inflamed bursa during training. A video showing an example of this for bursitis of the knee is included in the Combat Sports Clinic iPhone app.
A course of anti-inflammatory tablets such as ibuprofen or diclofenac is often recommended to reduce the inflammation. Early treatment is important, to prevent chronic bursitis, scar tissue formation and infections.
For more severe or chronic cases, a doctor will sometimes recommend a cortisone injection or may drain the bursa. While these interventions can sometimes be very helpful, they need to be combined with rest and shouldn’t be seen as a “quick fix” solution to the problem. (See Kirsty Wilson’s article about cortisone injections here.) As a last resort, surgery may be needed to remove the bursa.