Pes Anserine Dysfunction
Updated: Jul 26, 2019
In this week’s blog article we are going to continue to discuss tendon problems that can occur around the knee. One of the less common conditions that can affect this area is known as ‘pes anserine tendinopathy’.
The Pes Anserine, also called the ‘Gooses Foot’ is the insertion of the sartorius, gracilis and semitendinosus muscles, which are conjoined on the medial side of the Tibial Tubercle.
The three tendons of the Pes Anserine are located superficial (over the top) to the medial collateral ligament (MCL) of the knee.
Pes anserinus tendonitis refers to inflammation of the gracilis, sartorius and semitendinosus tendons at their insertion on the tibia. Pes anserinus bursitis is the name given to inflammation of the bursa that sits under these tendons. Due to their close anatomical relationship, these conditions often occur simultaneously.
There are a variety of factors which can cause, or place you at a higher risk of developing, pes anserinus bursitis/tendonitis. These include:
· Activities or sports which involve repetitive use of the sartorius, semitendinosus and gracilis muscles such as: running, dancing and sports which require a lot of direction changes (e.g. soccer, basketball).
· Abnormal hip, knee or ankle biomechanics
· Underlying knee pathology (e.g. OA) which can change the bony alignment through the knee.
· Inadequate warm-up and stretching prior to and following exercise
· Muscle imbalances around the knee.
Symptoms of Pes Anserine tendinopathy or bursitis can include:
· Pain through the inner knee when bending or straightening
· Inner knee pain when going up or down stairs
· Weakness or feeling of giving way through the inside of the knee
· Swelling over the inside aspect of the knee
· Reduction in knee range of motion due to pain along the inside of the knee.
Pes Anserine tendinopathy is an overuse injury and, once accurately diagnosed, can be easily treated in a conservative manner. Treatment includes:
· Reduction of pain and inflammation
· Normalisation of joint range of motion
· Restoration of muscular flexibility around the knee
· Restoration of strength around the knee: especially through the quadriceps and hamstrings
· Correction of contributing biomechanical factors at the ankle, knee and hip to minimise the risk of recurrence.
As always, tendinopathies are easier to prevent than to treat as they are generally caused by either overuse or trying to do too much too soon. So a couple of things you can do to minimise the risk of developing pes anserine tendinopathy are:
1. Make sure you wear good, supportive shoes and replace these regularly à i.e. every 1000kms.
2. Engage in a progressive (not excessive) increase in your training load, such that when you return to training you don’t increase the load by more than 10% per session.
3. Maintain good muscular balance around the knee and hip to minimise the risk of biomechanical imbalances causing an overload at the knee.
So that’s an overview of how pes anserine dysfunctions occur. If you have any questions or comments please e-mail us at firstname.lastname@example.org and we will be happy to answer them for you.
If you suffer with pain through the inside of the knee during or following exercise, feel free to call us on (08) 9486 8653 and our therapists will be happy to chat with you about the best management plan.