What is Pes Anserine Bursitis?

Pes anserine bursitis is an inflammatory condition of the bursa located on the inside of the knee, just below the joint. The bursa lies between the shinbone (tibia) and the tendons of the hamstring muscles (sartorius, gracilis, semitendinosus). When irritated, it can cause pain and swelling in the inner aspect of the knee.

What happens in Pes Anserine Bursitis?

The bursa becomes inflamed due to repetitive friction, overuse, or direct trauma. This leads to pain, swelling, and difficulty with movements like climbing stairs, running, or kneeling.

Common causes

  • Overuse from running or climbing stairs
  • Obesity and increased load through the medial knee
  • Osteoarthritis of the knee
  • Improper footwear
  • Muscle tightness in the hamstrings or quadriceps
  • Direct trauma to the inner knee

Who is most affected?

  • Runners and athletes in sports with repetitive knee flexion
  • Middle-aged and older adults, especially women
  • People with knee osteoarthritis
  • In Australia, pes anserine bursitis is commonly seen in recreational runners and netball players with underlying alignment issues.

Symptoms of Pes Anserine Bursitis

  • Pain and tenderness on the inner side of the knee, 2–3 inches below the joint
  • Swelling in the area of the pes anserine bursa
  • Pain worsens when climbing stairs, running, or rising from a chair
  • Stiffness after prolonged sitting or inactivity

📞 If you have persistent inner knee pain and swelling, book an assessment at Spinal and Sports Care Bella Vista or Parramatta.

Diagnosis of Pes Anserine Bursitis

Clinical Tests:

  • Palpation of the pes anserine area for tenderness
  • Functional movement tests to reproduce symptoms

Imaging:

  • Ultrasound can confirm bursal swelling
  • MRI may help rule out meniscus tears or other intra-articular pathology
  • X-rays are generally normal, but may show osteoarthritis

Treatment options

Most cases of pes anserine bursitis respond to non-surgical care.

Non-surgical:

  • Rest and activity modification
  • Ice to reduce swelling and pain
  • Physiotherapy for stretching hamstrings and strengthening quads and glutes
  • Weight management strategies in overweight patients
  • Corticosteroid injections in persistent cases

Surgical:

  • Very rare, only considered in severe, chronic, unresponsive cases

Role of physiotherapy

  • Stretch tight hamstrings and quadriceps
  • Strengthen glutes and hips to reduce stress on the knee
  • Correct biomechanics and footwear issues
  • Guide a gradual return to activity

Recovery timeline

  • Mild cases: 2–4 weeks
  • Moderate: 4–6 weeks
  • Chronic: 2–3 months with physiotherapy

Injury grading

  • Mild: Occasional pain after activity
  • Moderate: Pain during daily activities, some swelling
  • Severe: Persistent pain and swelling interfering with sport and function

Prevention of Pes Anserine Bursitis

  • Maintain flexibility in hamstrings and quadriceps
  • Strengthen hips and core
  • Avoid sudden increases in training
  • Use proper footwear with cushioning
  • Weight management to reduce load on knees

Taping and bracing

  • Kinesiology taping may support medial knee structures
  • Soft knee sleeves can reduce swelling and provide comfort

When to see a physiotherapist or chiropractor

📞 If inner knee pain persists for more than 2 weeks or interferes with daily activities, see Spinal and Sports Care for expert treatment.

Frequently Asked Questions

An inflammation of the bursa on the inner side of the knee below the joint.

Common in middle-aged women, overweight individuals, and athletes with repetitive knee use.

Running, netball, and sports involving repetitive knee flexion.

Yes, mild cases often improve with rest and physiotherapy.

Clinical assessment supported by ultrasound if necessary.

Very rarely, only in chronic cases resistant to conservative care.

Usually 2–6 weeks for mild to moderate cases. 

Yes, reducing body weight can lower stress on the knee.

Corticosteroid injections may relieve persistent inflammation.

Through stretching, strengthening, proper footwear, and weight management.