Pes Anserine Bursitis: Relief for Inner Knee Pain

What is Pes Anserine Bursitis?

**Pes Anserine Bursitis** is an inflammatory condition affecting the bursa located on the inner side of your knee, approximately 2-3 inches below the joint line. A bursa is a small, fluid-filled sac that acts as a cushion between bones, tendons, and muscles, reducing friction during movement.

The "pes anserine" (Latin for "goose's foot") refers to the collective insertion of three hamstring tendons (sartorius, gracilis, and semitendinosus) onto the tibia (shin bone) in this area. When the bursa becomes inflamed, it leads to pain, tenderness, and swelling, making daily activities difficult.

Common Symptoms

The primary symptom of Pes Anserine Bursitis is pain and tenderness on the inner side of the knee. Other common symptoms include:

• Localized Pain: A sharp or aching pain on the inside of the knee, usually a few inches below the joint.
• Tenderness to Touch: The affected area is often very tender when pressed.
• Pain with Activity: Worsens with activities like climbing stairs, walking, running, or getting up from a chair.
• Night Pain: Pain may increase at night, especially when sleeping on your side with knees touching.
• Stiffness: A feeling of stiffness or reduced flexibility in the knee.
• Swelling: Visible swelling or warmth in the affected area, though not always present.

Causes & Risk Factors

Pes Anserine Bursitis is typically caused by overuse or repetitive friction and pressure on the bursa. Common risk factors include:

• Overuse in Athletes: Common in runners, cyclists, and athletes involved in sports requiring repetitive knee flexion and extension (e.g., basketball, soccer).
• Tight Hamstrings or Quadriceps: Muscle tightness can increase friction on the bursa.
• Obesity: Excess weight puts greater stress on the knee joint and surrounding structures.
• Knee Osteoarthritis: Degenerative changes in the knee joint can alter mechanics and increase friction.
• Flat Feet or Overpronation: Biomechanical issues in the feet can affect knee alignment.
• Incorrect Training Techniques: Improper form during exercise or sports.
• Direct Trauma: A direct blow or fall onto the inner side of the knee.
• Bone Spurs: Bony growths near the bursa can irritate it.

Diagnosing Pes Anserine Bursitis

Our physiotherapists will conduct a thorough examination to accurately diagnose Pes Anserine Bursitis:

• Detailed Medical History: Discussing your symptoms, their onset, activities that aggravate the pain, and your medical background.
• Physical Examination: Palpating the inner knee to pinpoint tenderness over the bursa, assessing knee range of motion, muscle strength, and flexibility of hamstrings and quadriceps.
• Gait Analysis: Observing your walking pattern to identify any biomechanical factors contributing to the condition.
• Rule Out Other Conditions: Performing tests to differentiate Pes Anserine Bursitis from other knee issues like meniscal tears, ligament injuries, or osteoarthritis.
• Imaging (if needed): While often diagnosed clinically, X-rays might be used to rule out bone issues, and MRI is rarely necessary but can confirm inflammation.

Physiotherapy for Pes Anserine Bursitis: Our Approach

Physiotherapy is highly effective in treating Pes Anserine Bursitis by reducing inflammation, restoring function, and addressing underlying causes. Our tailored programs include:

• Pain and Inflammation Management:
  • **Rest and Activity Modification:** Guidance on reducing aggravating activities to allow the bursa to heal.
  • **Ice Therapy:** Applying ice to reduce swelling and pain.
  • **Modalities:** Use of therapeutic ultrasound or electrical stimulation (TENS) to decrease pain and inflammation.
• Manual Therapy: Gentle techniques to improve joint mobility, reduce muscle tension, and address soft tissue restrictions around the knee.
• Stretching Exercises: Specific stretches for tight muscles, especially the hamstrings, quadriceps, and hip adductors, to reduce tension on the bursa.
• Strengthening Exercises: Targeted exercises to strengthen muscles around the knee and hip, including quadriceps, hamstrings, glutes, and core, to improve stability and support.
• Gait and Biomechanical Correction: Analysis of walking and running patterns, and prescription of exercises or footwear advice to correct any imbalances.
• Patient Education: Guidance on proper body mechanics, activity modification, self-management strategies, and prevention of recurrence.