Pes anserine bursitis physiotherapy may help settle inner knee pain, improve control, and rebuild your capacity for stairs, hills, walking, and running. Pain often sits a few centimetres below the inner knee joint line, where a small bursa and three tendons meet the shin bone.

In day-to-day practice, bursitis and tendon overload often occur together. That is why you will see the term pes anserine tendinopathy used alongside bursitis, and sometimes “pes anserine syndrome”.

If you have related knee symptoms, these pages may help you compare common causes: knee pain, knee osteoarthritis, knee bursitis, and patellofemoral pain. Movement factors also matter, so see biomechanical assessment for walking and running guidance.

Inner knee pain and pes anserine bursitis

Pes anserine bursitis is a common cause of inner knee pain. It affects a small fluid-filled sac (bursa) on the inside of the knee where three tendons meet the shin bone. Symptoms often flare with stairs, hills, running, or getting up from a chair.

What is the pes anserinus?

The term “pes anserinus” means “goose foot”. It describes the fan-shaped insertion of three muscles onto the upper inner shin bone (tibia):

• Sartorius
• Gracilis
• Semitendinosus (one of the hamstring muscles)

These muscles help bend the knee, rotate it slightly inwards, and support the leg during walking, running, and changes of direction. Between their tendons and the bone sits the pes anserine bursa, which helps the tendons glide smoothly.

What is pes anserine bursitis and tendinopathy?

Pes anserine bursitis occurs when the bursa on the inner knee becomes irritated. It may cause localised pain, warmth, and tenderness.

Pes anserine tendinopathy involves overload or irritation of the three tendons that insert into the pes anserinus. Because the tendons and bursa sit close together, symptoms often overlap.

Common symptoms

• Inner knee pain a few centimetres below the joint line
• Pain walking up or down stairs or hills
• Pain when rising from a chair, squatting, or kneeling
• Localised tenderness to touch on the inner knee
• Mild swelling or a feeling of fullness at the inside of the knee
• Stiffness after rest or first thing in the morning
• Discomfort when lying on the affected side with the knees together

Causes and risk factors

Pes anserine bursitis and tendinopathy often develop due to a mix of load, biomechanics, and individual factors. Common contributors include:

• Repetitive activities such as running, brisk walking, or frequent stairs
• Rapid increases in training volume or intensity
• Knee position or movement control issues (for example, a knee that collapses inward when you step or squat)
• Hip and knee strength deficits, especially around the glutes and hamstrings
• Knee osteoarthritis and other degenerative joint changes
• Higher body weight, which increases load on the inner knee
• Unsuitable or worn footwear, especially for runners
• Work or sport that includes frequent kneeling

How pes anserine bursitis is diagnosed

In most cases, a physiotherapist can diagnose pes anserine bursitis through a detailed history and examination. They may:

• Ask about your pain pattern and aggravating activities
• Check local tenderness and swelling
• Assess hip, knee, and ankle strength, flexibility, and control
• Review your walking or running pattern when relevant

Sometimes, your clinician may suggest imaging (such as ultrasound or MRI) to rule out other causes of inner knee pain. Many people do not need scans because the diagnosis is mainly clinical.

Physiotherapy treatment for pes anserine bursitis

Most people improve with non-surgical care. Physiotherapy aims to settle symptoms, address contributing factors, and guide a safe return to activity.

Settle pain and irritation

• Load modification to reduce stress on the inner knee while symptoms are high
• Ice or heat, depending on what suits your symptoms
• Short-term changes for stairs, hills, and squatting
• Taping, hands-on treatment, and movement retraining when appropriate
• Discussion with your GP about medication options if required

Restore strength, control, and flexibility

Your program should match your goals, irritability, and current fitness. It often includes:

• Progressive strengthening for quadriceps, hamstrings, and hip muscles
• Technique and control work for squats, stairs, and step tasks
• Mobility work if stiffness contributes to overload
• Balance and proprioception training to support knee stability

Some people also benefit from exercise physiology to support longer-term conditioning and general health goals.

Activity, sport, and workplace changes

• Adjusting walking and running distance, surfaces, and hills
• Planning a gradual return to speed, distance, and sport
• Footwear review and, when suitable, short-term support options
• Modifying kneeling or squatting tasks at work and home

Home management tips

• Use an ice pack after activity if the area feels hot or reactive
• Avoid deep squats or long kneeling during a flare
• Break long walks with short rests on flat ground
• Keep exercises consistent, then progress gradually

Returning to walking, running, and sport

A steady progression works best. Many people start with flat walking, then add gentle inclines, then short jog intervals, before building distance, speed, and sport-specific drills.

If you keep flaring as you build load, a review can help. Often, the fix is better pacing, stronger hips and hamstrings, or improved movement control under fatigue.

People also ask: pes anserine bursitis

Is pes anserine bursitis serious? It is usually not dangerous, yet it can be stubborn. A clear plan often settles it faster and reduces flare-ups.

Can pes anserine bursitis go away on its own? Mild cases may settle with short-term load reduction. However, pain often returns if strength and control do not improve.

Do I need surgery for pes anserine bursitis? Surgery is rarely needed. Most people improve with guided rehabilitation and sensible load changes.

When should you see a physiotherapist?

Book an assessment if your inner knee pain lasts more than one to two weeks, limits stairs or walking, keeps returning, or occurs alongside knee osteoarthritis. If your pain followed a twist, fall, or sudden swelling, also consider an early review.

What to do next

Start by reducing the one or two activities that spike your pain (often stairs, hills, or deep squats). Then build back up with a graded strengthening plan that targets hip control and inner-knee load tolerance. If symptoms persist, an assessment can confirm the diagnosis and tailor your next steps.

Social media

For more tips on knee tendon and muscle health, follow PhysioWorks on social media. You will find practical guidance to help you stay active.

Related knee conditions and resources

• Knee bursitis
• Patellofemoral pain
• Knee osteoarthritis
• Sports injury physiotherapy
• Biomechanical assessment

For a plain-language overview of pes anserine bursitis, see the NCBI Bookshelf page: Pes Anserine Bursitis (StatPearls).

References

1. Mohseni M, et al. Pes Anserine Bursitis. StatPearls. Updated 2024. https://www.ncbi.nlm.nih.gov/books/NBK532941/
2. Majidi L, et al. Local corticosteroid injection vs extracorporeal shockwave therapy for pes anserine bursitis: randomised clinical trial. 2023. https://pubmed.ncbi.nlm.nih.gov/37123337/
3. Gouda WA, et al. Comparing local corticosteroid injection, platelet-rich plasma, and shockwave therapy in pes anserine bursitis. 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10560108/
4. Hasan M. Knee bursae: clinical evaluation and management review. 2025. https://pmc.ncbi.nlm.nih.gov/articles/PMC12619696/
5. Mohammadi-Kebar Y, et al. Frequency of pes anserine bursitis in patients with knee osteoarthritis. Int J Res Med Sci. 2023. https://www.msjonline.org/index.php/ijrms/article/view/12622