Our knowledge of orthopaedics. Your best health.

Bursitis usually develops as the result of overuse or constant friction and stress on the bursa. Pes anserine bursitis is common in athletes, particularly runners. People with osteoarthritis of the knee are also susceptible.

Several factors can contribute to the development of pes anserine bursitis, including:

• Incorrect training techniques, such as neglecting to stretch, doing excessive hill running, and sudden increases in mileage
• Tight hamstring muscles
• Obesity
• Being duck-footed or having knock knees
• Osteoarthritis in the knee

The symptoms of pes anserine bursitis include:

• Pain slowly developing on the inside of your knee and/or in the center of the shinbone, approximately 2 to 3 inches below the knee joint.
• Pain increasing with exercise or climbing stairs
• Puffiness or tenderness to the touch in this area

Your doctor will examine your knee and talk to you about your symptoms.

Symptoms of pes anserine bursitis may mimic those of a stress fracture, so an X-ray is usually required for diagnosis. Symptoms may also mimic those of a medial meniscus tear.

Treatment of pes anserine bursitis is almost entirely non-operative.

Athletes with pes anserine bursitis should take steps to modify their workout program so that the inflammation does not recur.

Other treatments include:

• Rest. Discontinue the activity or substitute a different activity until the bursitis clears up.
• Ice. Apply ice at regular intervals three or four times a day for 20 minutes at a time.
• Anti-inflammatory medication. Non-steroidal anti-inflammatory medication (such as aspirin, ibuprofen, and naproxen) may ease the pain and reduce the inflammation. You can also use topical NSAIDs, like over-the-counter diclofenac gel.
• Injection. Your doctor may inject a solution of anesthetic and steroid into the bursa, which often provides prompt relief.
• Physical therapy. Your doctor may recommend physical therapy for specific stretching exercises, and ice and ultrasound treatments.