Prepatellar bursitis

What it is

Inflammation of the bursa, a small fluid-filled cushion that sits between the kneecap and the skin to let them slide over each other. Repeated impact or pressure makes it fill with fluid, producing a swelling you can see and move that sits on top of the kneecap rather than inside the joint. That distinction matters: the knee joint itself is usually fine.

How volleyball causes it

Diving and sliding onto the knees does it, which in volleyball means defence, pancakes and any dig that ends on the floor. It builds up over a run of heavy defensive sessions, or arrives after one hard landing on a knee. Grass and sand are kinder here than a gym floor, but an abrasion on any surface can let bacteria in, which turns a mechanical problem into an infected one.

DefensePassing

What it feels like

• A soft, squashy swelling directly over the kneecap that moves under the skin.
• Sore to kneel on, often more uncomfortable than genuinely painful.
• The knee bends and straightens normally and feels stable.
• No swelling inside the joint itself.
• Often follows a run of diving-heavy sessions or one hard landing.

Stop and get it seen if

• Redness, heat, or skin that looks angry over the swelling.
• Fever, feeling unwell, or spreading redness up or down the leg, which suggests infection and needs same-day care.
• A break in the skin, graze or cut over the swelling.
• Rapidly increasing pain or swelling.
• Inability to bend the knee, or swelling inside the joint rather than on top of it.

What recovery usually looks like

Stages, not a schedule. Everyone moves through these at their own pace, and the ranges are wide because real recoveries are.

1. 1. Rule out infection and settle it

   1 to 2 weeks

   Confirm it is not infected, then take the pressure off.

   • No redness, heat or fever, or infection has been treated.
   • Kneeling avoided, and diving onto the knee stopped for now.
   • Swelling reducing rather than growing.
   • Full knee range and normal walking.

2. 2. Protect and rebuild

   2 to 4 weeks

   Get back to defensive work without reloading the bursa immediately.

   • Swelling largely resolved.
   • Kneepads in use, and the landing technique looked at rather than assumed.
   • Lower-limb strength work continuing throughout.
   • Controlled dives onto a mat tolerated.

3. 3. Back to defence

   1 to 3 weeks

   Full defensive volume without the swelling returning.

Ready to play again when

• Swelling resolved and the kneecap looks like the other one.
• Kneeling comfortable.
• Full defensive session including dives without recurrence.
• No redness, heat or signs of infection.
• Kneepads and landing technique addressed rather than ignored.

Keeping it from coming back

This is ordinary training, so unlike the rest of this page it does tell you what to do.

• Wear kneepads that still have padding in them, and position them over the kneecap rather than pushed down the shin. Most volleyball kneepads are worn until they are decorative.
• Learn to slide and roll rather than land square on the kneecap. A dig that finishes along the thigh and hip spreads the impact; one that finishes on the point of the knee concentrates it.
• Build quad and hip strength so you can get low and stay low, which means reaching more balls without dropping onto the knee at all.
• Clean and cover any graze over the kneecap properly. An infected bursa is a different and more serious problem, and it starts with broken skin.
• On grass and sand, check the court for stones, shells and glass before a defensive session, because the surface hides them and a knee finds them.
• Cut diving volume during a heavy tournament block rather than adding to it, and let the bursa recover between competition weekends.