Overview

Pes anserine bursitis is an inflammation of the pes anserine bursa, a small fluid-filled sac located on the inner side of the knee, just below the joint line. The term “pes anserine” translates to “goose’s foot,” referring to the conjoined tendons of three muscles, sartorius, gracilis, and semitendinosus, which together form a structure resembling a goose’s foot. The bursa beneath these tendons reduces friction between them and the underlying bone (the medial tibia).

When this bursa becomes inflamed due to repetitive stress, friction, trauma, or biomechanical imbalances, it results in pes anserine bursitis. This condition commonly affects athletes, particularly runners, and individuals with osteoarthritis, obesity, or tight hamstrings. The pain is typically localized at the inner knee, often aggravated by climbing stairs, squatting, or getting up from a seated position.

At DMPhysios, a leading physiotherapy clinic in Noida specializing in spine and sports rehabilitation, the approach to pes anserine bursitis focuses on identifying the root cause, reducing inflammation, restoring muscle balance, and preventing recurrence through patient-centered rehabilitation.

Symptoms

The symptoms of pes anserine bursitis often mimic those of other knee conditions, which is why accurate diagnosis by an experienced physiotherapist is essential. Common symptoms include:

1. Pain on the inner side of the knee, about 2–3 inches below the joint line.
2. Tenderness and swelling at the medial aspect of the knee.
3. Pain aggravated by climbing stairs, running, or getting out of a chair.
4. Morning stiffness or discomfort after prolonged sitting.
5. Weakness or instability in the knee due to pain inhibition.
6. Localized warmth or redness if inflammation is significant.

In chronic cases, the pain may radiate slightly down the leg or worsen during activities involving repetitive knee flexion and extension.

Types of Pes Anserine Bursitis

While not commonly classified into formal subtypes, pes anserine bursitis can be described based on the nature and duration of the condition:

1. Acute Pes Anserine Bursitis – Sudden onset due to direct trauma or a single episode of overuse.
2. Chronic Pes Anserine Bursitis – Gradual development from repetitive stress or improper biomechanics.
3. Septic Pes Anserine Bursitis – Rare; occurs when infection reaches the bursa, requiring medical intervention.

At DMPhysios, clinicians identify the type and severity of pes anserine bursitis through detailed clinical assessment, palpation, and movement analysis, ensuring the treatment approach is customized for each patient.

Causes

Several factors can contribute to the development of pes anserine bursitis, including biomechanical, muscular, and environmental factors. Common causes include:

1. Overuse or repetitive stress – Common in athletes such as runners or cyclists.
2. Tight hamstrings or adductors – Increased tension pulls on the tendons, irritating the bursa.
3. Improper training techniques – Poor running form, sudden increase in intensity, or lack of warm-up.
4. Obesity – Excess weight increases stress on the medial knee structures.
5. Osteoarthritis of the knee – Alters joint mechanics, placing strain on the pes anserine region.
6. Knee malalignment – Conditions like genu valgum (knock knees) or flat feet can alter load distribution.
7. Previous knee injuries – Trauma or surgery can predispose the bursa to irritation.

Risk Factors

Individuals more susceptible to pes anserine bursitis include:

• Athletes, particularly long-distance runners, basketball players, and footballers.
• Middle-aged or older adults with osteoarthritis.
• Women, due to wider pelvis and altered knee alignment.
• People with diabetes, as metabolic factors may contribute to tissue inflammation.
• Individuals with tight hamstrings or weak quadriceps.
• Obese individuals, where excess body weight stresses the inner knee.

Understanding these risk factors helps physiotherapists at DMPhysios Noida create preventive and corrective rehabilitation programs tailored to the patient’s needs.

Diagnosis

A thorough clinical assessment is key to diagnosing pes anserine bursitis. At DMPhysios, physiotherapists conduct a detailed evaluation involving:

1. Patient history – Understanding activity level, onset of pain, and aggravating factors.
2. Palpation – Tenderness localized over the medial tibia, about 5 cm below the knee joint line.
3. Functional tests – Pain elicited with resisted knee flexion or during stair climbing.
4. Differential diagnosis – To rule out medial meniscus injury, MCL strain, or osteoarthritis flare-up.
5. Imaging (if needed) – Ultrasound or MRI can confirm bursal inflammation and rule out other conditions.

Treatment

The treatment approach to pes anserine bursitis aims to reduce inflammation, relieve pain, and address the underlying cause of irritation. The primary stages of management include:

1. Rest and Activity Modification

• Avoid aggravating activities like squatting, running on uneven surfaces, or climbing stairs.
• Use supportive footwear to reduce impact and improve knee alignment.

2. Cold Therapy

• Ice application for 15–20 minutes, 2–3 times daily, helps reduce inflammation in acute cases.

3. Medication

• Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed by a doctor for pain control.
• Corticosteroid injections may be used in persistent or chronic cases, though sparingly.

4. Supportive Bracing

• Knee braces or taping may help offload pressure from the medial side and provide temporary relief.

However, for long-term recovery, physiotherapy plays the most vital role — and this is where DMPhysios in Noida stands out with its evidence-based, patient-centered rehabilitation programs.

Physiotherapy Treatment

At DMPhysios, physiotherapy management for pes anserine bursitis is personalized based on pain level, underlying cause, and biomechanical findings. The treatment is divided into several phases:

Phase 1: Pain Relief and Inflammation Control

• Cryotherapy: Application of ice packs or cold compression devices to reduce swelling.
• Ultrasound Therapy: Promotes tissue healing and reduces inflammation.
• TENS (Transcutaneous Electrical Nerve Stimulation): For pain modulation and muscle relaxation.
• Accelerated Healing Therapy: Used at DMPhysios to accelerate tissue recovery in chronic cases.

Phase 2: Flexibility and Soft Tissue Release

• Manual Therapy: Gentle soft tissue mobilization and myofascial release over the pes anserine region and hamstring tendons.
• Stretching Exercises:
  • Hamstring stretch (seated or standing).
  • Quadriceps and adductor stretches.
  • Calf stretch to maintain full lower limb mobility.
• Foam Rolling: To reduce tightness in surrounding muscles like the hamstrings and adductors.

Phase 3: Strengthening and Muscle Re-education

Once pain reduces, the focus shifts to strengthening the muscles supporting the knee:

• Quadriceps strengthening – Wall sits, straight leg raises, terminal knee extensions.
• Hamstring strengthening – Isometric holds progressing to curls and bridges.
• Hip abductors and core strengthening – Clamshells, side-lying leg lifts, and planks for pelvic stability.
• Functional strengthening – Step-ups, mini-squats, and controlled lunges.

At DMPhysios, therapists ensure exercises are performed under supervision to correct posture and prevent recurrence of pes anserine bursitis.

Phase 4: Correcting Biomechanics

• Gait training: For runners or walkers with poor alignment or foot pronation.
• Orthotics or insoles: If flat feet or genu valgum contribute to the problem.
• Postural retraining: Focus on improving hip-knee-ankle alignment.

Phase 5: Return to Activity

• Gradual return to sports or regular activity is supervised with progressive loading.
• Plyometric and agility training may be introduced for athletes to restore dynamic control.

Prevention

Preventing pes anserine bursitis involves maintaining flexibility, strength, and proper biomechanics. Key preventive strategies include:

1. Warm-up before exercise – Gentle stretching of hamstrings and quadriceps.
2. Maintain healthy body weight – Reduces stress on the medial knee.
3. Wear proper footwear – Supportive shoes minimize biomechanical strain.
4. Gradual progression in training – Avoid sudden increases in intensity or mileage.
5. Regular physiotherapy check-ups – At DMPhysios, periodic movement assessments help detect early signs of muscle imbalance or overuse.
6. Strengthen the lower limb muscles – Balanced strengthening prevents abnormal stress on the bursa.
7. Improve posture and gait mechanics – Correcting alignment issues reduces friction at the pes anserine region.

Conclusion

Pes anserine bursitis may seem like a minor inflammation at first, but if ignored, it can lead to persistent knee discomfort and limit mobility. Early diagnosis, proper rest, and targeted physiotherapy are crucial for recovery.

At DMPhysios, a premier physiotherapy clinic in Noida specializing in spine and sports conditions, treatment for pes anserine bursitis goes beyond just symptom relief. The expert physiotherapists at DMPhysios focus on comprehensive rehabilitation, emphasizing root-cause correction, muscle balance, and long-term prevention.

If you are experiencing pain on the inner side of your knee or suspect pes anserine bursitis, don’t delay seeking professional help.
Visit DMPhysios in Noida today for a detailed assessment and a personalized rehabilitation plan designed to help you move pain-free, restore function, and get back to your active lifestyle.