Pes Anserine Bursitis — Causes and Treatment

Pes anserine bursitis occurs when there is inflammation of this bursa. A bursa is a fluid-filled sac that are located throughout the body where tendons must slide and glide over one another. They function to reduce friction as the tendons move over top one another. The most common areas where bursae can be found are the shoulder, hip, and knee.

The pes anserine is a bony landmark located on the tibia (shin bone) where 3 muscles attach. These are the gracilis, sartorius, and semitendinosus. All three muscles assist with knee movement.

Symptoms of Pes Anserine Bursitis

Pes anserine bursitis causes pain on the inside of the knee. The pes anserine bursa is located roughly 2-3 inches below the knee cap on the inside of the knee. This condition typically causes knee pain that is felt with: 

  • Kneeling on the knee
  • Bending activities such as squatting
  • Lunging
  • Going up or down stairs
  • Walking long distances

The bursa will also be tender to the touch. There can also be visual swelling and possibly redness around the inside of the knee.

Causes of Pes Anserine Bursitis

If this problem is occurring in a younger individual it’s likely due to overuse. For example, lots of running or activities that require bending the knee. 

For the general population it’s typically caused by one or more:

  • Knee weakness
  • Hip weakness
  • Core weakness
  • Obesity
  • Overuse injury

When we see this problem for physical therapy in Durham, NC, it’s typically associated with hip and core weakness. All three of the muscles that attach to the pes anserine also attach in the hip. Therefore, if there is hip weakness they must compensate which can lead to knee pain. 

This problem may also be associated with someone who has recently increased their activity level — thus an overuse injury. 

Pes Anserine Bursitis Treatment

Treatment will depend on the root cause of these symptoms. However, there are a few commonalities for all pes anserine bursitis pain:

  • Screen the knee
  • Screen the hip
  • Screen the ankle
  • Screen the spine

Every step you take throughout the day requires the ankle, knee, hip, and spine to work as a unit. Many times when any of these areas begin to hurt it’s a result of dysfunction at a different joint. 

The knee joint really only performs 2 movements:

Knee flexion (bending)

Knee extension (straightening)

The ankle, hip, and spine all perform 6 movements. Therefore, it is likely the knee joint is compensating for dysfunction occurring at one (or more) of these joints. 

Treatment should consist of treating the symptoms with a combination of rest and hands on therapy initially. Then, screening the spine, hip, knee, and ankle for any movement dysfunctions is necessary. 

There is likely to be a combination of joint stiffness, weakness, and/or balance deficiencies that need to be addressed to fix the underlying problem.

Pes anserine is one of the easier problems to treat and should never require surgery. Many people will be offered steroid injections and pain meds which both have long-term negative side effects. 

Steroid injections have been shown to decrease muscle mass and bone density. Therefore, injections should be avoided for the majority of people.

If you live near Durham, NC and are looking for a pain solution that avoids surgery, pain meds, and steroid injections then we invite you to schedule a phone consultation with our physical therapy clinic. We want to ask you more questions about your problem so we can find out if our therapy is the best fit for your pain.

Medical Disclaimer:

All information on this website is intended for instruction and informational purposes only. The authors are not responsible for any harm or injury that may result. Significant injury risk is possible if you do not follow due diligence and seek suitable professional advice about your injury. No guarantees of specific results are expressly made or implied on this website.