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Pes Anserine Tendinopathy - Bursitis

Pes Anserine TendinopathyPes anserine tendonitis is inflammation of a tendon on the inside of the knee. A bursa or small fluid sac can also become inflamed causing pain.

Symptoms of pes anserine tendinopathy  

Pes Anserine Tendonitis is often difficult to distinguish from a medial ligament injury because the symptoms are similar and both are likely to be painful when stressing the inside of the knee joint. Symptoms include pain over the inside of the knee, particularly the lower part. Pain may be felt when climbing stairs or when contracting the hamstring muscles against resistance. Stretching the hamstring muscles may also cause pain.

Pes anserine explained

GracilisThe Pes Anserine, also known as pes anserinus or the goose's foot is the combined tendon of the semitendinosus muscle (one of the hamstrings), sartorius (the strap like muscle which crosses the front of the thigh) and gracilis muscle which is one of the long adductor muscles. They all attach together to the tibia or shin bone on the inner part of the lower knee.

Sartorius muscleIn this area there is also a bursa, called the anserine bursa which lies between this combined tendon and the Tibia bone underneath. This bursa may become inflamed due to repetitive friction in sports such as cycling, running and swimming, especially breaststroke. This results in bursitis and / or tendinopathy (sometimes called tendonitis),

Treatment of pes anserine tendinopathy  

SemitendinosusTreatment approach should be to treat the symptoms as well as the cause of the tendon or bursa inflammation. Treatment of symptoms includes resting from any aggravating activities and applying ice or cold therapy to reduce pain and inflammation.

Ice can be applied for 10 minutes every hour initially for the first 24 to 48 hours reducing to 3 or 4 times a day as required. A doctor may prescribe anti inflammatory medication such as ibuprofen which may help reduce pain and inflammation. Stretching the surrounding muscles such as the quadriceps, hamstrings and adductor muscles may help.

A therapist may apply electrotherapy such as ultrasound and if treatment is not successful then corticosteroid injections have been shown to be effective.

The second phase of treatment should be to consider what may have caused the injury and to correct the problem. It may be something as simple as having tight hamstring muscles and in which case these should be stretched regularly and sports massage applied to improve elasticity.

Other common causes include obesity, overpronation of the foot where the foot flattens or rolls in too much when running as well as a valgus knee deformity where the knee falls or bows inwards. A knee support or brace may help.

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