Pes anserines tendinopathy is a type of knee pain that is located on the inner side of the knee. The pain is the result of injury to one or more of the 3 tendons that form the pes anserines.
What is Pes Anserinus Tendinitis?
What is Pes Anserinus?
- Pes Anserinus refers to the region of the knee formed by the attachment of 3 muscle tendons ( Sartorius, Gracilis and Semitendinosis)
- Sartorius is involved in the movement to bring your leg into a cross legged sitting position
- Gracilis helps to bring your leg into midline
- Semitendinosis is part of the hamstrings that bends your knee backwards
What is Pes Anserinus Tendinitis?
- Pes Anserinus tendinopathy refers to damage or degeneration of any of the 3 (one or more) tendons forming the pes anserinus
- It results from overuse of the muscle and tendons. When the tendon is overused, small microscopic tears occur. In order for the body to repair these tears it creates inflammation, causing pain, stiffness and swelling. It can also occur due to the inflammation of the bursa that lies between the 3 tendons and the tibia bone
- Injury can be acute, when there is swelling, pain and tenderness in the region
- Injury can be chronic, when there is pain on movements especially with running down slopes/stairs
What are the common causes?
- Traumatic such as direct impact to the area
- Overuse due to
- Poor hip control
- Flat foot
- Weak or tight muscles
- Inappropriate training regime
- Inefficient running gait
- Muscle or tendon pulls/ strains
What are the signs and symptoms?
- Pain presents on the inner side of the leg just below the knee
- Noticeable swelling and tenderness at knee
- Pain upon ascending and/or descending stairs
- Pain may be noted when arising from a seated position or at night. Patients typically have no pain when walking on level surfaces
What are the risk factors?
- You are at risk of pes anserinus tendinopathy if:
- You involve in sports that require side-to-side movement or cutting
- You are overweight
- You have muscle imbalance (strength, length, tone, etc)
- You have inadequate warm up
- You have not been training consistently for some time
What types of treatment are available?
- Refrain from activities which increase symptoms
- Pain and inflammation management
- Advice on activities moderation
- Modalities can be used for reduction of pain
- Ultrasound therapy
- Ice therapy
- Improve flexibility
- Hamstring stretch
- Strengthening exercise
- Quadriceps/hamstring/hip muscles strengthening
- Massage/soft tissue mobilization
- Joint mobilization
What can I do to help myself?
- Wearing the correct footwear to fit your foot type and sporting activites
- Modifying your training regime to avoid stressing the injured area
- Cross training to maintain your cardiovascular fitness, e.g. elliptical stepper, running in water
- Adopt a sensible training regime with adequate warm up and cool down
1. What else can I do if it hurts?
- Stop or limit the activity that brings on the pain
- If the area is tender, warm and swollen, apply ice to the area for 15-20 min. Repeat the procedure a few times if necessary
2. Can I still run?
- If the pain is not severe, yes
- If the pain is severe, no
3. 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.