Pes Anserinus is the area on the inside of, and just below the knee, where the tendons of three different muscles, the gracilis, sartorius and semitendinosus, attach. As this area is structurally vulnerable to friction and resultant tendon damage, there is a bursa (fluid filled sac) underneath the tendons which assists in reducing friction between the tendons and the bone.
Pes Anserinus Bursitis indicates that the bursa has been irritated and became inflamed. Pes Anserinus Tendinopathy, on the other hand, refers to the tendons themselves having taken strain. The close anatomical relationship of these structures and their related mechanisms of injury, or irritation, very often have the two conditions occurring simultaneously.
What are the Symptoms of Pes Anserinus Bursitis/Tendinopathy?
You may experience pain in the inner knee below the knee cap with bending and/or straightening the knee, as well as inner knee pain when going up or down stairs.
Weakness or a feeling of giving way around the inner knee or swelling over this aspect, as well as a decrease in knee range of motion due to pain.
What Causes Pes Anserinus Bursitis/Tendinopathy?
There are a variety of factors which can cause or place you at a higher risk of developing Pes Anserinus Bursitis/Tendinopathy, including:
- Activities/sports which require a lot of direction changes like running, dancing and soccer as these movements involve repetitive use of the sartorius, semitendinosus and gracilis tendons
- Abnormal hip, knee or ankle biomechanics, or muscle imbalances
- Inadequate warm-up and stretching prior to and following exercise
- Inappropriate footwear
- Underlying knee pathology (e.g. OA)
- Sudden increase in activity level/sports training
What is my best course of action?
On examination, your Physiotherapist will look for signs of Pes Anserinus Bursitis and Tendinopathy. While the condition is generally straightforward to diagnose, it is also important to ensure that any similarly-presenting conditions are ruled out through a series of simple, clinical tests.
Once correctly diagnosed, it responds very well to conservative management. The condition is one which develops in the presence of excessive pressure and we need to teach your body to move more effectively so that the excessive recruitment of these muscles is no longer needed. Many patients with Pes Anserinus Bursitis and Tendinopathy start to feel better within days, if not hours. Your physiotherapy treatment will aim to:
- Address the biomechanical factors from day one
- Reduce pain and inflammation
- Normalise joint range of motion
- Stretch tight muscles around the knee
- Strengthen your supportive muscles around the knee
- Strengthen your lower limb: calves, hip and pelvic muscles.
- Improve kneecap control
- Normalise your muscle lengths
- Improve your proprioception, agility and balance
- Improve your technique and function during daily and sports activities
- Minimise your chance of re-injury
Contact us directly to have you back to a pain free, active lifestyle as soon as possible.