Pes Anserine Bursitis

Pes anserine bursitis is a condition characterized by inflammation of the bursa, a fluid-filled sac found on the inner upper shin side, just beneath the knee joint. This bursa serves as a cushion for the tendons of the sartorius, gracilis and semitendinosus muscles as they pass over the tibia (shinbone). An irritation or inflammation of the bursa, or surrounding tendons can lead to swelling, pain, and localized tenderness in the affected area.

Symptoms

The main symptom associated with pes anserine bursitis is pain on the inner side of the upper shinbone below the knee. This discomfort often worsens with activities that require knee bending or flexion, including climbing stairs, squatting, or prolonged sitting. Additional symptoms of pes anserine bursitis may include:

• Swelling and tenderness near the inner knee
• A sensation of burning or aching in the affected area
• Difficulty straightening or bending the knee fully
• A popping or snapping sound during knee movement

Causes

Frequent movements that involve the gracilis, sartorius, and semitendinosus tendons can place excessive strain on the pes anserine bursa, leading to irritation and inflammation. Activities such as golf, running or basketball may contribute to this condition over time. Additional factors likely to increase the risk of pes anserine bursitis are:

• Injury to the medial collateral ligament (inner knee ligament)
• Knee osteoarthritis
• Flat feet, which cause biomechanics problems
• Excess body weight
• Diabetes

Diagnosis

To diagnose pes anserine bursitis, the doctor will perform a detailed assessment of your knee as well as review your symptoms and medical history. Because pes anserine bursitis can mimic the symptoms of a strain fracture, an X-ray may be recommended to exclude any bone injuries. In some cases, ultrasound or MRI scans might be used to evaluate the severity of the inflammation and ensure an accurate diagnosis.

Treatment

At The Joint Pain Clinic, we often treat pes anserine bursitis with non-surgical methods focusing on reducing inflammation and preventing recurrence. Athletes experiencing this condition should modify their training to avoid aggravating the bursa.

Our common treatment options consist of:

• Rest: Limiting, or adjusting activities to allow the inflammation to subside.
• Ice therapy: Applying ice packs to the affected area 3 to 4 times a day for 20-minute sessions.
• Anti-inflammatory drug: Non-steroidal anti-inflammatory drugs (NSAIDs), including topical options, can help relieve pain and inflammation.
• Corticosteroid injection: A targeted injection into the bursa may provide rapid relief from pain.
• Physical therapy: A structured rehabilitation program, including specific stretching exercises, ice applications and ultrasound therapy, can improve flexibility and restore knee function.

Surgery is hardly necessary for pes anserine bursitis and is only considered in cases where conservative treatments have been ineffective in providing long-term relief.