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 What is it? A bursa is a fluid-filled sac, and they are located throughout the body between bone and the surrounding soft tissue. It acts like a cushion at areas of friction and is named based on its location. Bursitis is a general term for inflammation or irritation of a bursa, which may be painful. Pes anserine bursitis is inflammation of the pes anserine bursa, located along the upper inner part of the lower leg, 2-3 inches below the knee joint, between the shin bone (tibia) the three conjoined tendons of the hamstring muscle.
Symptoms • Pain and/or swelling along upper part of inner leg, 2–3 inches below the knee joint • Pain when pressing this region • Pain with exercise, bending or straightening the knee, rising from a chair, stairs or laying on your side
Risk Factors • Overuse • Direct injury • Sports that involve running, cutting and side-to-side motions • Tight hamstrings • Incorrect training techniques • Knee Osteoarthritis • Obesity
Sports Medicine Evaluation A sports medicine physician will review your history in order to understand your symptoms. The questions asked focus on whether there was an injury, the treatments you have tried so far, if anything helps to relieve the symptoms and the activities or exercises you normally engage in. The next step is an examination of the knee and surrounding region to help make a diagnosis and develop a treatment plan. Your physician may order knee x-rays or perform an ultrasound evaluation to rule out a fracture or other abnormality. If symptoms persist despite trying the treatment options, then an MRI may be ordered, however it is often not necessary.
Treatment • Rest • Applying ice to the pes anserine bursa for 15-20 minutes, 3-4 times a day • Oral or topical anti-inflammatory medications, such as ibuprofen or diclofenac • Avoidance of activities that make symptoms worse (stairs, climbing, squats) • Compressive wrap or pull-on knee sleeve • Using a pillow between legs when sleeping • Physical therapy for hamstring stretching and quadriceps strengthening exercises • Corticosteroid injection (steroid injection) • Surgery to remove the bursa (in rare cases)
Injury Prevention • Learn correct knee positioning when participating in athletics • Correct any training errors • Hamstring stretching and quadriceps strengthening exercises • Avoid sudden increases in running mileage or uphill running • Wear shoes that are in good condition and fit well • Maintain a healthy weight
Return to Play Exercise and sports can be continued as symptoms allow, with the above treatment recommendations. A rest period is recommended if symptoms are causing a limp, not improving or getting worse. A compressive wrap or pull-on knee sleeve can be used with activity, and protective padding can be worn in contact sports. With a conservative treatment program, symptoms usually resolve within 6-8 weeks. AMSSM Member Authors References Category: Leg and Thigh, Overuse Injuries, [Back] |
