​ASKPHYSIO

The knee has 14 bursae. A bursa is a small sac that prevents friction from occurring between tendon, muscle, bone and skin. If the bursa becomes irritated it fills with fluid and becomes inflamed resulting in ‘bursitis’. The pre-patellar bursa is the most commonly affected bursa of the knee. This is referred to as ‘housemaid’s knee’.

• Pain (overhead activities – throwing, swimming, weights)

• Catching feeling

• Impingement with combined abduction and internal rotation

• Swelling

• Weakness

• Tenderness on palpation of the rotator cuff tendon

• Painful arc on movement (between 70 and 120 degrees of abduction)

• Poor control of shoulder and scapula

• Repetitive overhead activities

• Overuse (increased volume of training)

• Shoulder instability

• Trigger points and tightness within rotator cuff muscles

• Training technical faults

• R.I.C.E. protocol

• Avoid  aggravating activities such as those listed above

• Assessment of the shoulder complex

• Review and modification of sporting or work activities aggravating shoulder

• Assess rotator cuff and other stabilising muscles for weakness and/or imbalance

• Biomechanical review of shoulder and scapular function and stability

• Prescribe an individualised program to improve stability and strength

• Soft tissue massage and trigger point release

• Acupuncture and dry needling

• Liaising with coach RE sporting technique if required

• Assess the patellar tendon to determine if it is the source of pain

• Biomechanical review

• Muscle imbalance correction

• Eccentric loading program for the patellar tendon

• Prescription of a brace to offload the patellar tendon

• Deep transverse frictions

• Stretching of hamstrings, calves, ITB, and calf muscles

• Strengthening of quadriceps, glutes and gastrocs.

• Neural mobilisation