Pes Anserine … What?

Pes Anserine Bursitis/Tendonitis, that’s what.

1. What is it?

This injury occurs where three muscles come together and attach to the tibia bone on the medial side of the knee, just below the knee joint. The three muscles are the gracilis, sartorius and semitendinosis.

These muscles and the bursa associated with them can be subjected to overuse, micro trauma or soft tissue contractures leading to injury.

2. What are the causes/predisposing factors of injury?

There are numerous causes such as overtraining, too much hill or speedwork, flexibility issues and biomechanical faults in the lower extremity.

3. What are the symptoms?

Usually there is a sharp point tenderness that is felt about 4cm below the medial side of the knee joint. There may also be associated redness or swelling in the area. Pain may also sometimes radiate to the back of the thigh. Walking up stairs may further aggravate this condition.

4. What can be done to prevent or treat this condition?

Prevention is focused on increasing the strength and flexibility of the muscles surrounding the knee joint (quadriceps, hamstrings, iliotibial band, adductors). Biomechanical faults of the lower extremity such as overpronation or pelvic rotation should be corrected as needed to reduce the likelihood of injury.

Treatment is first directed at reducing inflammation. Modalities such as ice, ultrasound, laser and NSAIDS can be used. Soft tissue therapy is also recommended to promote proper healing and to deal with any adhesions or scarring that may result. Rehabilitation exercises and stretching are also utilized. Orthotics may also be useful if faulty foot biomechanics are contributing to the problem.