What is Pes Anserine Bursitis?
Pes anserinus is the area on the inside of the knee where the tendons for the gracilis, sartorius and semitendinosus muscles attach. Under these tendons is a bursa (fluid-filled sac) which is essential in reducing friction between the tendons and the bone.
What is Pes Anserine Tendinopathy?
Pes anserinus tendinopathy refers to inflammation of the gracilis, sartorius and semitendinosus tendons. Pes anserinus bursitis is the name given to inflammation of the underlying bursa. Due to their close anatomical relationship, these conditions often co-occur.
What Causes Pes Anserine Bursitis/Tendinopathy?
There are a variety of factors which can cause (or place you at a higher risk of developing) pes anserinus bursitis/tendonitis, including:
- Activities/sports which involve repetitive use of the sartorius, semitendinosus and gracilis tendons such as running, dancing and games which require a lot of direction changes (e.g. soccer, basketball)
- Abnormal hip, knee or ankle biomechanics
- Underlying knee pathology (e.g. OA)
- Inadequate warm-up and stretching before and following exercise
- Muscle imbalances
- Inappropriate footwear
- A sudden increase in activity level/sports training
What are the Symptoms of Pes Anserine Bursitis/Tendinopathy?
You may experience one or more of the following:
- Pain in the inner knee with knee bending or straightening
- Inner knee pain when going up or downstairs.
- Weakness or feeling of giving way around the knee
- Swelling over the inside aspect of the knee
- A decrease in knee range of motion due to pain
How is Pes Anserine Bursitis/Tendinopathy Diagnosed?
An MRI or diagnostic ultrasound may confirm the diagnosis. On examination, your physiotherapist or sports doctor will look for signs of pes anserinus bursitis and tendinitis. In most cases, a thorough clinical examination is all you will need.
Pes Anserine Bursitis/Tendinopathy Treatment
Many patients with pes anserinus bursitis and tendonitis start to feel better within a few weeks of the injury. Your physiotherapy treatment will aim to:
- Reduce pain and inflammation.
- Normalise joint range of motion.
- Stretch tight muscles around the knee
- Strengthen your knee: especially quadriceps (esp VMO) and hamstrings.
- Strengthen your lower limb: calves, hip and pelvis muscles.
- Improve patellofemoral (kneecap) alignment
- Normalise your muscle lengths
- Improve your proprioception, agility and balance
- Improve your technique and function, e.g. walking, running, squatting, hopping and landing.
- Minimise your chance of re-injury.
However, we strongly suggest that you discuss your knee injury after a thorough examination from a knee injury clinician such as a sports physiotherapist, sports physician or knee surgeon.
The majority of people with pes anserinus bursitis and tendonitis will make a full recovery with conservative physiotherapy treatment. An injection into the site of inflammation is sometimes also required to decrease pain and inflammation.
How to Prevent Pes Anserine Bursitis/Tendinopathy?
There are a variety of ways to reduce your risk of developing pes anserinus bursitis/tendonitis. These include:
- Correction of exercise technique
- Adequate warm-up and cool down before and after exercise
- Correction of muscle imbalances
- Appropriate footwear during exercise
- A gradual increase in training intensity/quantity
Return to Sports with Pes Anserine Bursitis/Tendinopathy?
It is crucial athletes who have experienced pes anserinus bursitis/tendinopathy complete a full rehabilitation program to prevent recurrence or ongoing issues. This preparation will include a graduated return to your sports program.
Excellent for stretching your tight thigh structures: ITB, quadriceps and hamstrings.
Common Causes - Knee Pain
Knee pain can have many origins from local injury, referred pain, biomechanical issues and systemic issues. While knee pain can appear simple to the untrained eye, a thorough assessment is often required to ascertain the origin of your symptoms. The good news is that once a definitive diagnosis is determined, most knee pain quickly resolves with the correct treatment and rehabilitation.
Knee Ligament Injuries
- Knee Ligament Injuries
- ACL Injury
- PCL Injury
- MCL Sprain
- LCL Sprain
- Posterolateral Corner Injury
- Superior Tibiofibular Joint Sprain
Knee Meniscus Injuries
- Chondromalacia Patella
- Fat Pad Syndrome
- Patella Dislocation
- Patellofemoral Pain Syndrome
- Osgood Schlatter’s Disease
- Sinding Larsen Johansson Syndrome
Knee Tendon Injuries
- Corked Thigh
- Thigh Muscle Strain
- Hamstring Strain
- ITB Syndrome
- Popliteus Syndrome
- Muscle Strain (Muscle Pain)
- DOMS – Delayed Onset Muscle Soreness
Children’s Knee Conditions
Other Knee-Related Conditions
- Runner’s Knee
- Plica Syndrome
- Stress Fracture
- Overuse Injuries
- Restless Legs Syndrome
For specific information regarding your knee pain, please seek the assistance of a healthcare professional with a particular interest in knee condition, such as your physiotherapist.
What is Physiotherapy Treatment?
Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice. Physiotherapists maintain physical health, help patients to manage pain and prevent disease for people of all ages. Physiotherapists help to encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing activities of daily living while assisting them to remain functionally independent.
There is a multitude of different physiotherapy treatment approaches.
Acute & Sub-Acute Injury Management
Hands-On Physiotherapy Techniques
Your physiotherapist's training includes hands-on physiotherapy techniques such as:
- Joint Mobilisation (gentle joint gliding techniques)
- Joint Manipulation
- Physiotherapy Instrument Mobilisation (PIM)
- Minimal Energy Techniques (METs)
- Soft Tissue Techniques
Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, just to name a few.
Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.
Alternatively, your physiotherapist may recommend a supportive brace.
Acupuncture and Dry Needling
Many physiotherapists have acquired additional training in the field of acupuncture and dry needling to assist pain relief and muscle function.
Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.
- Muscle Stretching
- Core Exercises
- Strengthening Exercises
- Balance Exercises
- Proprioception Exercises
- Real-Time Ultrasound Physiotherapy
- Swiss Ball Exercises
Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.
Aquatic water exercises are an effective method to provide low bodyweight exercises.
Sports physio requires an extra level of knowledge and physiotherapy skill to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.
Women's Health Physiotherapy is a particular interest group of therapies.
Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.
Plus Much More
Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your individual problem, please contact your PhysioWorks team.
ACL TearAn ACL (Anterior Cruciate Ligament) tear most often occurs during sporting activities when an athlete suddenly pivots, causing excessive rotational forces on the ligament. Individuals who experience ACL tears describe a feeling of the joint giving out, or buckling. You'll commonly hear a "pop."
Signs You May Have Sustained an ACL Tear:
- Sudden giving way of the knee
- Hearing a 'pop' at the time of injury
- Sudden swelling of the knee joint
- Pain in the knee when walking
How is an ACL Tear Diagnosed?A well trained Sports Physiotherapist, Sports Physician or Orthopaedic Surgeon will generally be able to confirm the diagnosis of an ACL tear within the clinic and from your injury history. An MRI scan can confirm your ACL tear and identify other knee injuries that may have occurred when your ACL was ruptured. These accessory injuries commonly include meniscal tears, bone bruising and collateral ligament injuries. Confirmation of an ACL tear is essential since the treatment differs from a common knee ligament strain or a meniscus tear.
What to do if have a Ruptured ACL?Please be guided by your trusted healthcare practitioner for an ACL tear. Successful rehabilitation options vary depending on your age, activity level and extent of the injury. For specific advice, please consult your physiotherapist, knee surgeon or doctor.
Why are ACL Tears Such a Big Problem?When an ACL injury occurs, the knee becomes less stable. The ACL injury is a problem because this instability can make sudden, pivoting movements difficult, and it may make the knee more prone to developing arthritis and cartilage tears. If your knee is unstable, a common complaint of a sensation that the knee will 'give out' from under them. When this giving way sensation is because of an ACL injury, the knee joint is sliding too much. Joint sliding can be a problem because each episode of instability (the 'giving way' sensation) can cause damage to the knee cartilage. Therefore an ACL injury makes patients more prone to developing arthritis and meniscus tears. Athletes often have particular difficulty once they have sustained an ACL injury. Many sports require a functioning ACL to perform common manoeuvres such as cutting, pivoting, and sudden turns. These high demand sports include, but are not limited to:
- Hockey (Ice and Field)