This occurs when other structures are also damaged such as the meniscus (cartilage).
Some patients also have pain in the center of the tibia. This term refers to the front inside edge of the tibia. Proximedia is short for proximal and medial. This is referred to as the anterior knee or proximedia tibia. The pes anserine is located about two to three inches below the joint on the inside of the knee. The patient often points to the pes anserine as the area of pain or tenderness. A turned out position of the knee or tibia, genu valgum (knock knees), or a flatfoot position can lead to pes anserine bursitis. And alignment of the lower extremity can be a risk factor for some individuals. The bursa then becomes inflamed and tender or painful.Īnyone with osteoarthritis of the knee is also at increased risk for this condition. A contusion to this area results in an increased release of synovial fluid in the lining of the bursa. It can also be caused by trauma such as a direct blow to this part of the knee. Improper training, sudden increases in distance run, and running up hills can contribute to this condition. Overuse of the hamstrings, especially in athletes with tight hamstrings is a common cause of goosefoot. Related Document: A Patient’s Guide to Knee Anatomy Causes The MCL is underneath the semitendinosus tendon. The pes anserine bursa provides a buffer or lubricant for motion that occurs between these three tendons and the medial collateral ligament (MCL). This area is called the pes anserine or pes anserinus. Together, these three tendons splay out on the tibia and look like a goosefoot. The sartorius muscle bends and externally rotates the hip. The semitendinosus tendon is also just behind the attachment of the sartorius muscle. The gracilis muscle adducts or moves the leg toward the body. Just above the insertion of the semitendinosus tendon is the gracilis tendon. Medial refers to the inside of the knee or the side closest to the other knee. It inserts into the medial surface of the tibia and deep connective tissue of the lower leg. The semitendinosus wraps around from the back of the leg to the front. There are three tendons of the hamstring: the semitendinosus, semimembranosus, and the biceps femoris. The hamstring muscle is located along the back of the thigh.
The pes anserine bursa is a small lubricating sac between the tibia (shinbone) and the hamstring muscle. The pes anserine bursa is the main area affected by this condition. Bursae can become inflamed and irritated causing pain and tenderness. Bursae can also protect other tendons as tissues glide over one another. The bursa is a small sac that cushions the bone from tendons that rub over the bone. If it hurts, back off!Ĭheck back in and I'll connect you with a licensed physical therapist in your area.Bursitis of the knee occurs when constant friction on the bursa causes inflammation. Once the pain eases, slowly return to your normal activities. These strategies should lead to noticeable improvement within a week. You can slowly cycle down as the pain diminishes. Try to do your exercises a few times a day. Luckily you don't have to figure out which exercises to perform, our PT's have done it for you! Just select the exercise option below. For best results, make sure you address both strength and flexibility. If you notice swelling, go with ice instead of hot packs (instructions on exercise link below.)Īlso begin a targeted pes anserine bursitis exercise program. Even just a few days can go a long way to promote recovery. With that in mind, minimize activities that exacerbate your pain (running, squats etc.) Don't worry, this isn't forever, just long enough to give the joint a rest. This will allow inflammation to settle down and healing to begin. First you need to understand our main objective: Reducing strain on the bursa.
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