It does indeed sound like you have bursitis of one of the large bursas in the body - the prepatellar bursa. The bursa in your case is over your kneecap (the patella) and it normally allows the skin over the front part of your knee to glide over your kneecap with a minimal amount of friction. In this case, it sounds like it has been contused, or banged up, on several occasions and is now inflamed and is producing a larger amount of fluid than it normally would because of inflammation.

Prepatellar bursitis is fairly common in ice hockey players. It is usually caused by taking a slapshot to a relatively unprotected knee or falling on the front part of a bent (flexed) knee. The swelling around the knee in this case is not actually inside the knee and does not restrict motion of the knee joint.

The main treatment for a prepatellar bursitis is a well fitted compression bandage which should be applied over the kneecap to place constant pressure over the bursa. I have commonly supplemented this wrap with a piece of foam to further apply pressure over the bursa. The main goal of this wrap is to decrease the size of the bursal sac and prevent reaccumulation of fluid. Other concurrent treatments for prepatella bursitis include ice and over the counter anti-inflammatory medications. In rare occasions, a knee immobilizer may be used for a limited time to prevent further swelling of the bursa.

Once an athlete has normal strength and range of motion of the knee, return to play is allowed. The athlete should keep a protective pad and compression bandage over the knee to prevent further blows and repeated swelling.

If there are any small lacerations or abrasions around the bursa or any redness of the skin or increased warmth of the bursa, it should be evaluated by a physician to make sure there is not an infection present. In general, we do not tend to drain a prepatellar bursa that is swollen as they commonly continue to drain out the needle site of the aspiration and can become secondarily infected.

To summarize, the usual effective treatment for prepatellar bursitis is a well fitted compression wrap, ice, and anti-inflammatory medications if needed. Once an athlete has full motion and strength of their knee, return to play is allowed with a compression wrap and protective pad over the knee. If this treatment does not prove effective, further medical evaluation should be sought.