During activities such as walking, running and jumping, poor lower limb strength and control can lead to repetitive irritation to the Pes Anserine bursa.įigure 2. Poor hip, knee or ankle stability during repetitive dynamic activities can result in an extensive amount of force going through the medial knee (Figure 2). Repetitive activity with poor biomechanics An increase in knee valgus stress can be caused by 3 key predisposing factors ġ. Pes Anserine bursitis occurs in response to excessive valgus strain to the medial knee structures and is thus more common in cyclists, breaststroke swimmers, runners and overweight populations (Brukner & Khan, 2012). Pes Anserine bursitis often has a slow onset and is more commonly associated with an overuse injury, rather than the result of an acute injury. Differential diagnoses include MCL sprain, medial meniscus injury, medial plica irritation and knee OA (Calmbach & Hutchens, 2003). Key symptoms include localised tenderness and swelling directly over the anteromedial knee, pain with resisted knee flexion and internal rotation, pain with passive hamstrings stretch and pain ascending and/or descending stairs (Rennie & Saifuddin, 2005).ĭifferential diagnoses of Pes Anserine bursitisīecause the Pes Anserinus is located on the medial knee, it can often be misdiagnosed due to false positive tests. There are several distinct diagnostic features for Pes Anserine bursitis that your physiotherapist will confirm on examination. Pes Anserine muscle attachment and bursa location Further pain can be attributed to the separate nerve supply for each individual muscle of the Pes Anserinus (Brukner & Khan, 2012).įigure 1. In some circumstances, overloading one or more of the three muscles in the Pes Anserinus can result in inflammation of the bursa and a significant degree of pain. The Pes Anserine bursa assists muscle tendon gliding by reducing friction during knee movements (Figure 1). The muscles of the Pes Anserinus primarily flex the knee but also play a stabilisation role by resisting forces applied to the outside of the knee (Lee at el., 2014). This common insertion point mimics the shape of a ‘goose’s foot’, thus the translation of the name.
The Pes Anserinus is the common insertion point for three key muscles of the lower limb Sartorius, Gracilis and Semitendinosus. Lifestyle modification: Athletes may be suggested to reduce or alter their exercise programs to prevent the condition from recurring.Pes Anserine bursitis is an inflammation of the bursa located on the inside of the knee, just below the joint line. Surgery: In case the symptoms do not subside, the doctor may recommend surgical removal of the bursa. Physical therapy: Performing light stretching exercises may help to release stiffness and strengthen the hamstring muscles. Injections: Injecting steroid mediations directly into the joint may be suggested in case of severe pain and swelling. Antibiotics may be prescribed in case of infection of septic bursitis. Medications: The orthopedic doctor may prescribe anti-inflammatory medications to provide relief from pain. Ice pack: Application of ice packs at frequent intervals may reduce swelling and stiffness. Rest: The patient may be advised to take rest for a few days and avoid any activities that may aggravate the pain. The doctor may take a sample of bursa fluid to be tested in case infection is suspected.CT scan or MRI may be required to assess damage to the medial compartment of the knee.An X-ray may be conducted to rule out a stress fracture.He may inquire about the patient’s medical history and nature of activities performed on a daily basis.The orthopedic doctor may physically examine the knee and check for tightness in hamstring muscles.Pain may increase while exercising, climbing stairs or any other stressful activity.
Difficulty bending or straightening the knee.Pain at the inner part of the knee Tenderness to touch.Forceful twisting with the foot planted on the ground.Outward turning of the lower leg due to.Trauma or contusion to the inner part of the knee.Medical conditions such as Knee Osteoarthritis or Medial Meniscus Tear.Sports activities like running and swimming.Certain factors may increase a person’s susceptibility to developing Pes Anserine Bursitis. The condition occurs when the bursa produces excess fluid and becomes inflamed, thereby placing pressure on the adjacent parts of the joint. The bursa is a lubricating sac located between the shinbone and hamstring tendons that prevents the two structures from rubbing against each other.
Pes Anserine Bursitis, or Knee Tendon Bursitis, refers to an inflammation of the bursa on the inner side of the knee.