Medial knee pain (pain on the inside of the knee) can come from a number of causes including ligament sprain, cartilage injury and osteoarthritis. However a frequently underdiagnosed cause of medial knee pain is pes anserine bursitis.
Knee Pain Info: What is the Pes Anserine Bursa?
A bursa is a fluid filled sac whose purpose is to reduce friction between two adjoining structures. The pes anserine bursa sits inbetween the tendons of three muscles (sartorius, gracilis and semi tendinosis) and the broad ligament that runs across the inside of the knee joint (the medial collateral ligament) The pes anserine bursa is at the top of the shin bone, just below the knee joint on the inside of the shin.
Bursitis simply means inflammation of the bursa hence pes anserine bursitis means that the pes anserine bursa is inflamed.
Knee Pain Info: What are the Symptoms of Pes Anserine Bursitis?
- Medial knee pain; pain on the inside of the knee/ upper shin just below the knee joint
- No one causative factor. Pes anserine bursitis is not caused by an injury or incident, the pain does not come on suddenly, but builds up over time
- The area over the lower, inside part of the knee may be tender to touch.
- The area over the lower inside area of the knee may appear swollen.
- The pes anserine bursa is not inside the knee joint so pes anserine bursitis does not cause the knee to lock, or to give way.
Knee Pain Info: What Causes Pes Anserine Bursitis?
The bursa lies under three tendons: gracilis and sartorius pull the leg across towards the other leg. Semi tendinosis is one of the hamstrings so is responsible for bending the knee. Any movement that repeatedly uses these three tendons can cause bursitis by increasing the pressure on the bursa. Sports that use these movements frequently, and therefore are most likely to irritate the bursa, include golf, running, dancing and basketball.
There are several factors that make it more likely that an individual will get pes anserine bursitis:
- Underlying osteo arthritis of the knee
- Injury to the large ligament on the inside of the knee, (the medial collateral ligament).
- Flat feet
Knee Pain Info: What is the Treatment for Pes Anserine Bursitis Causing Medial Knee Pain?
- RICE: Rest, Ice, Compression and Elevation, to reduce the pain and swelling.
- Anti Inflammatory medication may be prescribed.
- Selctive stretching and strengthening exercises
- Correction of lower limb biomechanics. Altered foot position may be an underlying cause of pes anserine bursitis. Core stability exercises can also be useful.
Disclaimer: The information on this page is written by a Chartered Physiotherapist to help you understand your injury. There are many possible causes for pain around the knee and should you have any concerns you should always seek advice from a qualified health professional such as a Chartered Physiotherapist or your GP.