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 knees.
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
- repeatedly 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 doctor examines your knee for tenderness over the pes anserine bursa.
HOW IS IT TREATED?
Treatment may include:
- using ice packs on your knee for 20-30 minutes every 3-4 hours for 2-3 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 medication
- removal of fluid within the bursa if it is swollen
- injection of a medication (like cortisone) into the swollen bursa
- leg stretching exercises
WHEN CAN I RETURN TO MY SPORT 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 permanent damage. Everyone recovers from injury at a different rate. Return to your 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 that you have symptoms before you start treatment, the longer it will take you 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:
- 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
- You are able to jog straight ahead without limping
- You are able to sprint straight ahead without limping
- You are able to do 45 degree cuts
- You are able to do 90 degree cuts
- You are able to do 20 yard figure-eight runs
- You are able to do 10 yard figure-eight runs
- You are able to jump on both legs without pain, and jump on the injured leg without pain
- If you are a swimmer, you can do the breaststroke kick without pain
HOW CAN I PREVENT PES ANSERINE BURSITIS?
Pes anserine bursitis is best prevented by a proper warmup 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 the development of pes anserine bursitis.
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