Pes Anserine Bursitis


Pes Anserine Bursitis

Description, Causes and Risk Factors:

Alternative Name: Pes Anserine (Goosefoot) bursitis.

Pes anserine bursitis is an irritation or inflammation of a bursa in your knee.

The pes anserine bursa is a small lubricating sac between the tibia (shinbone) and the hamstring muscle. The hamstring muscle is located along the back of the thigh. There are three tendons of the hamstring: the semitendinosus, semimembranosus, and the biceps femoris. Pes anserine bursa acts as a cushion for the tendons of the sartorius, gracilis, and semitendinosus muscles at the distal point of insertion on the shinbone (tibia). The main function of these muscles are to help bend the knee, cross the leg, turn the lower leg in, and give additional support to the knee.

    Overuse of the hamstrings, especially in athletes (especially involved in running, bicycling, and swimming) with tight hamstrings is a common cause of goosefoot. Runners are affected most often. Improper training, sudden increases in distance run, and running up hills can contribute to this condition.

  • It can also be caused by trauma such as a direct blow to this part of the knee. A contusion to this area results in an increased release of synovial fluid in the lining of the bursa. The bursa then becomes inflamed and tender or painful.

  • It can also be caused by poor flexibility, improper or worn out shoes, muscle weakness or imbalance, or overtraining.

Symptoms:

Symptoms may include pain, tenderness, and swelling. You may have pain when you bend or straighten your leg.

Diagnosis:

A history and clinical exam will help thephysician differentiate pes anserine bursitisfrom other causes of anterior knee pain, suchas patellofemoral syndrome or arthritis. AnX-ray is needed to rule out a stress fracture orarthritis. An MRI may be needed to look fordamage to other areas of the medial compartment of the knee. Fluid from the bursa may beremoved and tested if infection is suspected.

Treatment:

    Stopping the activity that brings on or aggravates the symptoms is the first step toward pain reduction.

  • Ice, rest and non-steroidal anti-inflammatory drugs (NSAIDs) may be useful.

  • Injection with anesthetic with or without corticosteroid may be helpful.

  • Aspiration of the bursa usually is not required.

  • Surgical intervention is required only rarely.

Physical therapy: Physical therapy is beneficial and often is indicated for patients with pes anserine bursitis. Tight hamstrings and hip adductors seem to be the biggest problems and effective stretching will often lead to resolution of the knee pain. Foot orthotics in the shoes may help to improve varus and valgus alignment at the knee. If there is varus alignment or bowing at the knee, an orthotic with a lateral buildup may help to reduce stresses on the medial knee ligaments. If there is valgus alignment or knock-knees, an orthotic with arch support and medial buildup at the heel may help to reduce the demands on the muscles of the pes anserinus.

Preventive Measures: Pes anserine bursitis is best prevented by a proper warm-up that includes stretching of the hamstring muscles, the inner thigh muscles, and the top thigh muscles. Gradually increasing your activity level, rather than doing everything at once, will also help prevent its development.

Rehabilitation exercises may include:

    Hamstring stretch.

  • Standing calf stretch.

  • Quadriceps stretch.

  • Hip adductor stretch.

  • Quadriceps isometrics.

  • Hamstring isometric.

Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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