Oh My Knee!

April 20, 2018 | By | Reply

If you are suffering from pain on the inner aspect of the knee you might be suffering from pes anserinus bursitis

What is pes anserinus?
It is a a name given to three tendons that insert into the inner side of the knee in the front. Its name comes from the webbed foot appearance of its insertion onto to the tibia(shin bone)

The three muscles that form the pes anserinus are:

  • Sartorius
  • Gracilis
  • Semitendinosus

Knee anatomical diagram and model

What is pes anserine bursitis?

It is a common knee condition that affects a large population of people involved in sports activities, middle aged women, obese people and those with an underlying osteoarthritis.

Knee anatomical diagram

The pes anserine bursa is a small sac filled with fluid located 2-3 inches below the inner part of the knee joint.
It is under the tendons of the three hamstring muscles to avoid friction between the tendon and the bones of the lower leg.
Due to continuous stresses on the bursa due to sudden change in directions,certain activities or underlying pathologies of the knee joint can cause irritation and of the bursa causing it to inflame.

The reasons which can cause bursitis include:

  • Sudden change in direction without movement of the foot
  • Obesity
  • Underlying osteoarthritis
  • Direct injury to that area
  • Flat feet
  • Tight hamstring muscle

Symptoms of pes anserine bursitis:

  • Pain and tenderness in the area of the bursa
  • Pain while doing daily activities while walking, climbing stairs, running, getting up from the chair
  • Pain while straightening the knee
  • To diagnose bursitis a detailed evaluation can be carried out by the physiotherapist by using various special tests and palpating around the anatomical landmarks. An orthopaedic’s advice and certain investigations might also be recommended to rule out any red flags.

How can a physiotherapist help?

After carrying out a detailed evaluation and confirming the diagnosis the physiotherapist would first aim at :

  • Reducing the pain and swelling around that area by using various pain relief modalities
  • The therapist will help you with active assisted and then eventually active exercises.
  • Improving balance and proprioception of the joint which would be reduced after the injury
  • Stretching the tight muscles like the hamstrings
  • Strengthening the knee muscles so that getting back to daily activities and sports is more pain free
  • Avoiding re-occurrence by explaining the correct form of exercises, an appropriate warm up before sports and agility training.

Knee exercises
Knee exercises

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