I kneel all day at work and now my kneecap is swollen. What should I do?

Why kneeling jobs cause it

Between the skin and the kneecap is a thin sac called the prepatellar bursa. Repeated pressure and friction, from tiling, plumbing, electrical work, flooring, cleaning or car repair, irritate it until it fills with fluid. The swelling sits right on top of the kneecap, may be the size of an egg, and the knee usually still bends and straightens well.

Small cuts and grazes from rough floors, sand or concrete can let bacteria into the bursa, which is why infection is more common in manual workers than in people who kneel on clean surfaces.

Protecting your knee at work

• Wear good-quality knee pads with thick, soft cushioning, and replace them when they flatten
• Use a kneeling mat or foam board on hard or hot surfaces
• Alternate between kneeling, squatting, sitting on a low stool and standing where the task allows
• Take short breaks to straighten the legs
• Clean and cover any graze on the knee promptly
• Ask your supervisor about rotating tasks while the swelling settles

What to do now

Stop kneeling on the affected knee as much as your job allows. Ice for 15 to 20 minutes a few times a day and use a light compression bandage. Simple pain relief or a short course of anti-inflammatory medicine can help if suitable for you. Most non-infected bursitis improves over a few weeks once the pressure stops, although a thickened bursa can take longer.

If you need a short period of modified duties, a medical report from your doctor can help explain this to your employer.

Warning signs and when to see a doctor

Seek same-day care if the swelling becomes hot, red and increasingly painful, if redness spreads up the thigh or down the leg, or if you develop fever or feel unwell. These suggest an infected bursa, which needs antibiotics and sometimes drainage.

Book an assessment if the swelling has not improved after two to three weeks, keeps returning, or stops you working. At Aman Hospital in Doha, Dr. Gelber examines the bursa and the knee joint, and an ultrasound can confirm fluid and guide drainage if needed.