Pes Anserine Bursitis: Anatomy, Symptoms and Diagnosis
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Pes anserine bursitis is an inflammatory condition of the bursa that sits beneath the pes anserine, the insertion point of three tendons. The three tendons are the sartorius, gracilis, and semitendinosus muscles. The insertion of these tendons looks like a goose’s foot, hence the Latin name, pes anserine. The best treatments for this condition include physical therapy, gait assessment, massage, taping or using a brace, and anti-inflammatory medication or cortisone injections. We cover this in more detail in our article: Pes Anserine Bursitis: Treatment.
Stretches can be effective around the pes anserine area, with caution not to apply more pressure to the bursa. Holding a static stretch for 30 seconds or longer reduces the tone of the muscle so that it will feel more relaxed or loose. The relaxation of the muscles will reduce the pressure and compression on the pes anserine bursa. In addition to stretches, you can foam roll or have massage therapy for these muscles for the same benefits.
For the following static stretches, each can be held for 30-45seconds and should be repeated every 2-3 hours for optimal effect.
Stand with one leg forwards, with a straight knee and your foot flat on the floor. Bend forwards from your hips with a straight back while keeping your chest up. You should feel this stretch at the back of your thigh.
Stand on one leg holding the wall with your hand for support if needed. Bend your knee to raise your heel towards the back of your hip, and hold your ankle with your hand to pull the heel closer. Make sure to stand straight, keep your knees parallel, and your hip pushed forward. You should feel this stretch at the front of your thigh.
Kneel on the floor on one knee with your other leg stepped forward. Keep your body upright and move your hip forwards. You should feel a stretch at the front of your hip.
Stand on a step with your heels hanging off the back edge. Hold onto the wall for balance. Lower your heels as far as they can go. You should feel this at the back of your calves.
Strengthening exercises are a good way to address areas of weakness and load the tendons of the pes anserine to help them build a tolerance to load. The specific exercises that you should do will depend on your strength and therefore an assessment with a healthcare professional such as a physical therapist is advised. Here are a few common exercises that are prescribed to help recover from pes anserine bursitis.
These should be done 3 times per week, 8-12 repetitions for 3 sets, taking a 2-3 minute break between sets.
Lying on your side with a resistance band around your ankles. Tip your pelvis forwards and have your top leg in line with your body and straight at the knee. Raise your leg up and backward into the resistance of the band. Hold for 2-3 seconds then lower your leg and repeat.
Lying on your back with a soft ball between your ankles, squeeze your ankles together pushing into the ball. Hold this pressure for 2-3 seconds then release and repeat.
Lying on your back with a band around your lower thighs and knees bend to 90º. Push firmly out against the resistance band while you tilt your pelvis backward to flatten your back against the floor then raise your pelvis high off the floor. Hold for 2-3 seconds then lower and repeat.
Lying on your side with your feet and knees stacked on top of each other. Tip your pelvis forwards and make sure the bend at your hip is about 20-30º. Lift your top knee to open your legs, without rolling backward with your pelvis. Hold for 2-3 seconds then lower your leg and repeat.
Stand with your feet hip-width apart with a slight bend in your knees, and holding a weight in your hands. Bend forward from your hips while keeping a straight back and your chest lifted. Bend until you feel tight in your hamstrings at the back of your thighs, hold this for 2-3 seconds then return to standing by squeezing your glute muscles and pushing your pelvis forwards, then repeat.