Pes Anserine (Knee) Bursitis

What is pes anserine bursitis?

Pes anserine bursitis is an irritation or inflammation of a bursa in your knee. A bursa is a fluid-filled sac that acts as a cushion between tendons, bones, and skin.

The pes anserine bursa is located on the inner side of the knee just below the knee joint. Tendons of three muscles attach to the shin bone (tibia) over this bursa. These muscles act to bend the knee, bring the knees together, and cross the legs.

Pes anserine bursitis is common in swimmers who do the breaststroke and is sometimes called breaststroker's knee.

How does it occur?

Pes anserine bursitis can result from:

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

What are the symptoms?

Pes anserine bursitis causes pain on the inner side of the knee, just below the joint. You may have pain when you bend or straighten your leg.

How is it diagnosed?

Your healthcare provider examines your knee for tenderness over the pes anserine bursa.

How is it treated?

Treatment may include:

• Using ice packs on your knee for 20 to 30 minutes every 3 to 4 hours for 2 or 3 days or until the pain goes away.
• Wrapping an elastic bandage around your knee to reduce any swelling or to prevent swelling from occurring.
• Taking anti-inflammatory medicine. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval.
• Shot of a medicine like cortisone into the swollen bursa.
• Leg stretching and strengthening exercises.

How long will the effects last?

Pain from pes anserine bursitis usually goes away within a few weeks. You need to stop doing the activities that cause pain until your knee has healed. If you continue doing activities that cause pain, your symptoms will return and it will take longer to recover.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

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

• Your injured knee can be fully straightened and bent without pain.
• Your knee and leg have regained normal strength compared to the uninjured knee and leg.
• Your knee bursa is not swollen or tender to touch.
• You are able to bend, squat and walk without pain.

How can I prevent pes anserine bursitis?

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.