Pes Anserine Bursitis

Pes anserine bursitis is inflammation of the bursa between your lower leg shinbone and the hamstring tendons on the inside part of the knee. It happens when the pes anserine bursa gets irritated and swollen.  This puts pressure on adjacent parts of the knee.

WHAT ARE THE SYMPTOMS?

Common symptoms of Pes Anserine bursitis include pain, tenderness, and swelling on the inside of the knee about 2-3 inches below the joint. It’s common to have pain with bending or straightening out of the knee.  Many times people will have pain that increases with exercise or with climbing stairs. Pes Anserine Bursitis is common in swimmers who perform the breaststroke and is sometimes referred to as breaststroker's knee.  If you have these types of symptoms then it is recommended to see a doctor for an examination and an xray to help confirm a diagnosis. The doctor will compare the condition of both knees, determine the range of motion in the affected knee, and evaluate if it hurts when you bend or flex the knee.

How Does It Occur? 

Pes anserine bursitis is caused by a number of factors:

• 1. Overuse, as in breaststroke kicking or kicking a ball repeatedly.
• 2. Repeated pivoting from a deep knee bend.
• 3. A direct blow to the area.

WHAT IS THE TREATMENT? 

Pes Anserine Bursitis treatment consists of R.I.C.E (rest, ice, compression, elevation), and anti-inflammatories to help reduce inflammation.

If the inflammation is caused by an infection then the doctor may try prescribing a course of antibiotic treatment to help get rid of any infection. Treatments for more severe cases of bursitis can involve a cortisone injection into the bursa to help reduce inflammation.  Other treatments include aspiration of the bursa to remove excess fluid and treat the bursitis. Sometimes with severe, chronic bursitis, surgery to remove the bursa can help.

Physical therapy can also help pes anserine bursitis.  A physical therapist will often focus the treatment on improving the strength of the quadriceps muscles surround the knee.  This can help relieve strain and pressure on the bursa, and help the person regain full range of motion of the knee.

A pes anserine bursitis knee brace from our selection can help relieve pain and stress/pressure on the bursa.  These braces can provide more stability for the knee and reduce pain with activity.

PES ANSERINE BURSITIS EXERCISES

These pes Anserine Bursitis exercises are designed to help you regain pain-free range of motion in the knee and improve the strength of the quadriceps and hamstring muscles that surround the knee.  You can stretch your leg right away by doing exercises 1 through 3. Start strengthening your leg by doing exercises 4 through 6.

1. Hamstring stretch: Lie on your back with your buttocks close to a doorway and extend your legs on the floor straight out in front of you through the doorway. Raise your injured leg and rest it against the wall next to the door frame. Hold this position for 30 to 60 seconds, feeling a stretch in the back of your thigh. Repeat 3 times.
2. Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg on the floor. Turn your foot on your injured leg slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 30 seconds. Do this several times a day.
3. Quadriceps stretch: Stand an arm's length away from a wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel up toward your buttocks. Don't arch or twist your back. Hold this position for 30 seconds. Repeat 3 times.
4. Hip adductor stretch: Lie on your back, bend your knees, and put your feet flat on the floor. Gently spread your knees apart, stretching the muscles on the inside of your thigh. Hold this for 20 seconds. Repeat 3 times.
5. Isometrics:

A. Quadriceps Isometrics: Sitting on the floor with your injured leg straight and the other leg bent, press the back of your knee down into the floor while tightening the muscles on the top of your thigh. Hold this position for 5 seconds. Repeat 20 times.

B. Hamstring Isometrics: Sitting on the floor with the injured leg slightly bent, dig the heel of your injured leg into the floor and tighten up the back of your thigh muscles. Hold this position for 5 seconds. Repeat 20 times.

6. Heel slide: Sitting on a firm surface with your legs straight in front of you, slowly slide the heel of your injured leg toward your buttocks by pulling your knee to your chest as you slide. Return to the starting position. Repeat 20 times.

When Can You Return To Sports Or Activity? The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to prolonged symptoms. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

• 1. Your injured knee can be fully straightened and bent without pain.
• 2. Your knee and leg have regained normal strength compared to the uninjured knee and leg.
• 3. Your knee bursa is not swollen or tender to touch.
• 4. You are able to jog straight ahead without limping.
• 5. You are able to sprint straight ahead without limping.
• 6. You are able to to do 45-degree cuts.
• 7. You are able to do 90-degree cuts.
• 8. You are able to do 20-yard figure-of-eight runs.
• 9. You are able to do 10-yard figure-of-eight runs.
• 10. You are able to jump on both legs without pain and jump on the injured leg without pain.
• 11. If you are a swimmer, you need to be able to do the breaststroke kick without pain.