Pes Anserine

Pes Anserine Bursitis

Article by John Miller

Pes Anserinus

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?

pes anserine

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:

  1. Reduce pain and inflammation.
  2. Normalise joint range of motion.
  3. Stretch tight muscles around the knee
  4. Strengthen your knee: especially quadriceps (esp VMO) and hamstrings.
  5. Strengthen your lower limb: calves, hip and pelvis muscles.
  6. Improve patellofemoral (kneecap) alignment
  7. Normalise your muscle lengths
  8. Improve your proprioception, agility and balance
  9. Improve your technique and function, e.g. walking, running, squatting, hopping and landing.
  10. 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.

ITB Roller

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 Meniscus Injuries

Kneecap Pain

Knee Arthritis

Knee Tendon Injuries

Muscle Injuries

Knee Bursitis

Children’s Knee Conditions

Other Knee-Related Conditions

Knee Surgery

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.