Pes Anserine Tendonitis or Bursitis


Pes Anserine Tendinitis is also known as Goosefoot Tendinitis


The pes anserine tendon group is found on the inside of the knee joint. The pes anserinus is the area where the tendons of 3 hamstring muscles (sartorius, gracilis, and semitendinosus) come together. The three tendons merge together on the inside surface of the shinbone. These three muscles are the dominant knee flexors that function to allow movement of the leg towards the body and control rotation of the tibia, protecting the knee against rotary stress.

The pes anserine bursa lies beneath these tendons close to the shinbone, providing cushioning between the tendons and the tibia. The term, pes anserinus means "goose's foot" in Latin - owing to the webbed-foot pattern the three tendons make when they meet. Hamstring muscles are powerful and are capable of exerting tremendous stress and friction on the pes anserine tendons.

Pes anserine tendonitis is a painful, inflammatory condition affecting the tendons between your shinbone and the hamstring tendons at the inside of your knee. Pes anserine bursitis is a painful, inflammatory condition affecting the bursa that lies between the pes anserine tendon group and the shinbone.

Inflammation of the pes anserine bursae or tendons usually develops due to overuse, trauma, or degradation. The most common cause of pes anserine bursitis is hamstring tightness due to a lack of warming up and stretching properly before activity, particularly long distance running or excessive climbing.

Pes Anserine Tendinitis is often accompanied by pes anserine bursitis. It is possible to have both bursitis and tendonitis at the same time in any joint in the body.

pes anserine tendon anatomy

The term, pes anserinus means "goose´s foot" in Latin - owing to the webbed-foot pattern the three tendons make when they meet.



Symptoms of Pes Anserine Tendonitis

If you are suffering from Pes Anserine Tendonitis you will experience pain and tenderness below the kneecap in the inside (medial) area of the knee. Pain may radiate to the back and inside of the thigh. The pain will increase with exercising, climbing stairs, bending or straightening the knee. You may notice swelling in front and/or underneath the kneecap as well as often warmth and tenderness when touched. The condition is gradual rather than one traumatic event.

*In general, you may experience one or more of the following:

  • Pain in the inner knee with knee bending and/or straightening
  • Inner knee pain when going up or down stairs
  • Weakness or a feeling of giving way around the knee
  • Swelling over the inside aspect of the knee
  • Decrease in knee range of motion due to pain
  • Interrupted Sleep Patterns. Simply bending your knee or rolling over during sleep can cause pressure on the goosefoot tendons, increasing your pain. The pain can range from mild to very sharp - this generally depending on the amount of inflammation. Many have found that placing a pillow between your knees/thighs while you sleep will help reduce pain throughout the night.
  • You may have Limited Range Of Motion And Weakness In Your Leg And Knee. The pain is often limiting as you stop performing motions that make the pain worse. If left untreated the inflammation can increase, causing more pain, limiting movement even more. Eventually, weakness in the leg muscles and and tendons around the knee can set in. As you lose strength in your quadriceps, your legs may begin to give out during daily activities.

*"Pes Anserinus Bursitis & Tendinitis". 2019. Physioworks.Com.Au. Accessed May 20 2019. https://physioworks.com.au/injuries-conditions-1/pes-anserinus-bursitis-tendinitis.


It is important to goosefoot tendonitis in the early stages to reduce symptoms, minimize damage and maintain motion and strength in your knee. Eliminate any squatting, repetitive knee bending, crossing your legs, kneeling or any other activities that add pressure to the tendons. By treating your pes anserine tendinitis in the early stages with conservative treatment methods, you are more likely to prevent long-term damage and chronic conditions from setting in.

under the kneecap pain for bursitis


Causes of Pes Anserine Tendonitis?

Pes anserine tendonitis is common in athletes (particularly runners), overweight individuals, and often, people with osteoarthritis of the knee. Inflammation of tendons serving these muscles usually develops due to overuse, trauma, or degradation typically from:

  • Weak hamstring muscles
  • Tight quadricep muscles and sudden increase in running intensity or change the terrain running on, excessive hill work and/or increased mileage
  • Obesity
  • *Activities/sports which involve repetitive use of the sartorius, semitendinosus and gracilis tendons such as: running, dancing and sports which require a lot of direction changes (e.g. soccer, basketball)
  • *Abnormal hip, knee or ankle biomechanics
  • Poor sport techniques that include improper warm-up
  • Bio-mechanical issues, such as foot rolling, out-turned knees
  • *Inappropriate footwear
  • Osteoarthritis
  • A medial meniscus tear

*"Pes Anserinus Bursitis & Tendinitis". 2019. Physioworks.Com.Au. Accessed May 20 2019. https://physioworks.com.au/injuries-conditions-1/pes-anserinus-bursitis-tendinitis.

pes anserine bursa pain patterns

It is generally agreed that muscle weakness or tightness is the most common cause of pes anserine tendonitis (pes anserine bursitis). Prolonged sitting at a desk job will lead to tightness in the quadriceps and further weakness of the hamstring muscles.



Pes Anserine Tendonitis Diagnosis

The only way to truly diagnose any type of knee pain is to go and see your physician. To help your doctor achieve a proper diagnosis, he/she will begin with a medical history about you, your current condition and symptoms. He/she will inquire about the intensity of your present pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.

There is one very signification test your doctor should be performing. The 'valgus stress test', is a set of movements of your knee while the ankle is stabilized and/or you knee is in full extension with a slight 30 degree rotation. This test helps narrow down the type of injury your are suffering from. The doctor may look closing at your hamstring muscles, ask you to bear weight with a slight squat, pain produced is a sign of the pes anserinus is the area of injury.

If the tests do not help discover the source of your pain after your examination. Then diagnostic testing will ordered help discover your source of knee pain. Often used to rule out other conditions.

X-rays will provide a two-dimensional image of the overall structure of your knee. They are helpful in identifying knee instability, abnormal bone shapes (bone spurs or bone cysts, fractures, wear and tear on the joints).

pes anserine knee mri

MRIs (magnetic resonance imaging) will provide more detailed information and will help to evaluate the soft tissues in and around your knee (muscles, tendons, ligaments, and other connective tissues). An MRI can identify ligament or tendon damage, and can help to determine the extent of your injury, the displacement and degree of your tear or inflammation, as well as other associated knee conditions.



Prevention or Risk Reduction of Pes Anserine Tendinitis

Athletes and non-athletes alike need to ensure their hamstrings are properly warmed-up and stretched before they place any stress on their knee; from extensive hill running to simply climbing stairs.

To prevent pes anserine tendonitis, it is important to first eliminate any of the underlying factors contributing to the condition. Ask your doctor or physical therapist to take a look at your gait and your posture to see if there any bio-mechanical issues that need to be addressed. Secondly, get advice from your physical therapist or trainer on setting a training schedule that fits your ability. Thirdly, but most importantly, warm up your hamstring and then stretch prior to activity!

pes anserine injuries can keep you from the activities you enjoy


Pes Anserine Tendonitis Home Conservative Treatment Options

Step 1 - Reduce Pain and Swelling with Cold Compression

The first step for conservative treatment of tendonitis in the knee is to reduce the swelling to "open up" the area for more blood flow. Anyone in the health-care business knows that your blood supplies the oxygen and much needed nutrients required to heal knee tendonitis injuries. This is why for years, doctors, trainers, and other medical professionals have recommended RICE (Rest, Ice, Compression, Elevation) to treat the pain and swelling of fresh injuries, chronic pain, and after any re-injury.

This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood to your damaged tendon and tissues begin to break-down. Without cold compression, tissues break down further because they can't get the oxygen they need to survive. By limiting the amount of damage done to your tendons, you also limit the amount of healing that needs to occur. This is a very important step to heal acute or chronic tendon injuries faster and with less pain.


Use a Cold Compress or Ice Pack:

  • 24 to 72 hours after your initial injury or when you first notice pain and swelling in your knee to stop tissue damage at the microscopic level, relieve pain, and decrease swelling.
  • After exercise, workouts or activity of any kind to prevent re-injury of your knee.
  • Before and after surgery during rehabilitation to control pre and post-surgery pain and swelling.
  • Anytime you feel your knee is painful or you're having a flare-up of an old patellar tendon injury.
  • Anytime you have swelling, sharp throbbing pain or inflammation in your knee.
  • Any other situation where you need to draw the pain and inflammation out of your knee.

Step 2 - Improve Circulation, Soften Scar Tissue & Prevent Re-Injury with a T•Shellz Wrap®

After the inflammation in your knee has been reduced, providing extra blood flow and strengthening the tissue around your knee is recommended.

healing your patella tendonitis
  • When treating any soft tissue injury, an effective treatment will increase blood flow to the injury while the joint is immobile.
  • This increase in blood flow will improve the efficiency of the body's own ability to heal itself.

What Else Makes the T•Shellz Wrap® So Special?

We believe the T•Shellz Wrap® to be one of the most effective treatments to stimulate blood flow to tissue in the treatment area.

We can promise that you will receive a product that is designed to be safe and does what it is supposed to do...quickly relieve pain and aid in the recovery from tendon, muscle and other soft tissue injuries.

The unit plugs into a standard wall outlet to get its power. The nice thing about the power supply is that the same unit can be used in North America and overseas as well. It has the capability to operate between 110v and 230v. It has a special signal controller that can be set for 3 different power levels of application (3=High, 2=Medium, 1=Low). The cord is long so you can sit or lie comfortably and watch TV, read or surf the net while you're using it.

We recommend 5 to 10 minute treatments to start; the safety shutoff controller is set to max 30 minutes in duration. The device can be worn over clothing and allows you to use the device at work, at home, or really anywhere you have access to an electrical outlet.



A Recap of the Benefits of the Knee T•Shellz Wrap®..

  • Our Knee T•Shellz Wraps® can fit ANYWHERE on the knee - side, back and front.
  • It can be used before activity or exercise to warm up tissue in the knee to reduce the risk of further injury
  • knee T•Shellz Wrap
  • FDA Registered medical device for use in home or clinics - very high quality
  • Temporarily increases flexibility and length of soft tissue (reducing the re-injury factor)
  • It soothes pain and whisks away toxins
  • Carbon fiber Energy Pad is strong, lightweight, and flexible - contours very easily
  • A boost in blood flow helps maximize the body's ability to recover from soft tissue damage. This can be beneficial in saving time and money when associated with doctor or physical therapist visits
  • A boost in blood flow will maximize the body's ability to recover quickly. This can be beneficial in post-surgery rehabilitation, getting you back to work faster. Do not use until at least 6 weeks after surgery, and only after approval from your doctor.
healing your patella tendonitis

When Should I Use My T•Shellz Wrap® During the Day?

The most common question we receive from individuals prior to purchasing is - how many times a day should I be using my wrap and when should I be using them? While treatment plans will differ for each individual and their specific injury, there are general guidelines that should be adhered to.

  • Use a Cold Compress or Ice Pack when you are experiencing inflammation (usually after exertion or movement of the injury area).

The T•Shellz Wrap® would then be used:

  • Right after rising from bed in the morning (as this is when your knee is often stiff)
  • Prior to going to bed at night (to relax the area and allow for better sleep)
  • Before you know you will be using your injured joint (going to work, driving, typing, etc).

Use a Circulatory Boost Knee T•Shellz Wrap®:

  • After swelling and inflammation have been reduced with cold compression.
  • Before exercise or workouts to warm up your knee to reduce your risk of re-injury.
  • Before and after surgery during rehabilitation to warm up soft tissue in your knee before physio, exercising or stretching.
  • Anytime you feel the tissue in your knee has stiffened up, is tight and your mobility is reduced causing you more pain.
  • Any other situation where you need to increase blood flow to your knee to relax tissue in the treatment area, relieve pain, prevent re-injury and enhance flexibility of your tissue.
healing your patella tendonitis

Stage 3 - In Between Treatments With T•Shellz Wrap®, Apply Our New Fast Acting Pain Relief Cream Called ARNICA INFUSION

Dealing with aches and pains affecting the foot, ankle, leg, knee, hamstring, hip, back, arm, shoulder, elbow, wrist, or hand? If so, then applying the Arnica Infusion to any of these targeted areas will bring about fast relief from the pain and sore tissues. Simply apply a small amount of cream to the body and moments later, you will experience a soothing and comforting sensation over the area.

Arnica Infusion is specially designed to relieve pain due to sore muscles and joints associated with arthritis, backaches, sprains, strains, and bruises. No matter if you are dealing with an acute injury, chronic pain, or a general "flare-up" - you will experience fast relief from pain and inflammation.

mendmeshop arnica pain relief cream

This is a product that many of our current MendMeShop customers asked us to develop. So we focused our time and resources over the past few years and came up, with we believe, will be one of more effective, fast acting, topical pain relief creams on the market.

You are likely familiar with some of the standard topical agents on the market as most of our customers use them. The are mass marketed and even found in most department stores now.

Well, we are here to say that Arnica Infusion goes many steps beyond what they offer.

Made in the USA at an FDA registered manufacturing facility, you can be assured that Arnica Infusion is both safe and effective. We only source top grade ingredients while implementing strict quality control checks during every step of the production process. Expect the same high quality that MendMeShop customers have been accustomed to since we started the company in 2005.

The "Cool Blue" formula is the perfect balance between the smooth application of a cream and the effective absorbing factor of a gel. It is not too thick and not too thin - just the right texture. Best of all, it feels very nice on the skin!

Each application of Arnica Infusion feels so comforting and soothing, we are certain it will become an item you will not want to live without.


Arnica Infusion Ingredients

The Arnica Infusion formula is based on a combination of scientific research and the use of high quality ingredients. The properties within the formula were chosen for their pain relief, anti-inflammatory, and soothing qualities.

The acting ingredients within the formula include ones many of us are familiar with; along with ones that have not received a lot of publicity (only in research circles). Extensive testing resulted in a blending of ingredients that provides the most synergistic of benefits.

The notable ingredients in the Arnica Infusion formula include:

  • Arnica - powerful anti-inflammatory, speeds recovery, enhances circulation
  • Menthol - provides deep penetrating pain relief with a nice cooling sensation
  • Vitamin B6 - promotes normal nerve function
  • MSM - supports healthy connective tissues, anti-inflammatory
  • Ilex Leaf Extract - increases circulation, skin conditioner
  • Vitamin E - anti-inflammatory, enhances circulation, hydrates the skin
  • Aloe - anti-inflammatory properties, soothes the skin
  • Tea Tree - enhances penetration of ingredients

Extensive quality control procedures during the manufacturing process ensure the ingredients and final product are both safe and effective. We would not stake our reputation on anything but the best.

When Do I Apply the Arnica Infusion?

While At Work

Apply Arnica Infusion at work to help reduce acute discomfort associated with overuse of muscles and joints. No matter if you are in a physical demanding job or work within an office environment, you will be placing stress on different parts of the body and aches and pains will result.

Before Or After Work, Sports, & Activity

If you suffer from a sprained ligament, pulled muscle, strained tendon, or even bruising - apply Arnica Infusion for quick relief of the pain.

Chronic Pain Suffering

Application of Arnica Infusion can be done up to a maximum of 4 times per day on a consistent basis to help bring about relief from various pains and aches.

In-between Treatments With the T•Shellz Wraps®

Follow up your T•Shellz and Cold treatments with an application of Arnica Infusion. Combine the pain relieving benefits of Arnica Infusion along with the therapeutic benefits of the wraps to make your recovery go much more smoothly.

Do not apply Arnica Infusion within a 2 hour timespan before a T•Shellz Wrap® treatment.

Whether you decide to use the Arnica Infusion in conjunction with the T-Shell and other treatments - or if you decide to use the cream as a stand-alone product - you will not be disappointed with the results. We guarantee it.

Conservative Treatment Tools Our Clients Have Used to Help
Limit Damage & Boost The Body's Soft Tissue Repair Process at Home:

  • A Cold Compress or Ice Pack to reduce inflammation wherever there is pain and/or swelling (as soon as possible).
  • A TShellz Wrap to increase blood-flow to the treatment area (Circulatory Boost).
  • MendMeShop Arnica Pain Cream for temporary relief of pain due to sore muscles and joints.
  • An Exercise & Stretching Plan to prevent muscle atrophy and shortened tendons in the leg. A proper plan will increase elasticity and strengthen the muscles and tendons in the problematic joint area as well as tissues in the surrounding joints.

Conservative treatment tools just like these have been used successfully by thousands of soft tissue injury sufferers - just like you.




T•Shellz Wrap® = Enhanced Blood Flow in the Treatment Area

 

We believe the use of T•Shellz Wraps® for boosting blood flow to soft tissue in the area of application is one of the most under-utilized home treatment options available on the market today. We have client after client that have tried many options out there and have been amazed at how effective and fast the TShellz Wrap treatment can relieve pain and increase blood flow in the treatment area.

With regular use of the TShellz Wrap:

  • Your pain will be reduced*.
  • Due to increased blood flow, soft tissue in the treatment area will be expected to recover at an accelerated rate with reduced potential for re-injury*.
  • Tissue in the treated area should experience a larger range of motion and increased extensibility of collagen tissue* due to the heat effect on soft tissue. This should translate into a reduced rate of re-injury occurrence as soft tissue is known to lengthen and become more flexible when exposed to warm temperature. (*Chapter 9 of "Therapeutic Heat and Cold", 4th edition. (amazon.com link - Ed. Justus F. Lehmann, M.D., Williams, and Wilkin)

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The Key Points To Keep in Mind When Treating Your Injury

Make Sure That Complete Healing is Your #1 Goal

We all know that if the injury was healed, the pain would go away but what about the opposite situation? If the pain is gone, does that mean the injury is better? Unfortunately, this is not always true.

Too many people only focus on suppressing pain symptoms while providing less attention to the true healing aspects of the body. Experiencing less pain, while obviously a good short-term goal, does not equate to underlying healing. Scar tissue can remain for months after one gets to a point of being relatively pain-free. However, as long the weak and brittle scar tissue remains, you are susceptible to re-injury or re-aggravation. Certain motions or movements can cause the weaker tissue to easily tear - resulting in some reversal of the recovery up until that point.

This is why we recommend for people to continue with their doctor or therapist recommended exercises and to continue with mild treatments of the T•Shellz Wrap® for a period of time - to better ensure complete recovery.

Ongoing treatments to enhance circulation are intended to soothe, relax and promote healing of damaged soft tissue in the application area. T•Shellz treatment also results in the ability of soft tissue to extend further due to the effect of heat on soft tissue. The more extensible your tissues are, the less likely they are to strain or sprain.

Resting The Area of Your Injury Will Help, But Only Temporarily

People tell us all the time, "I was told that if I stay off my feet for a few weeks, my pain will disappear for good."

The truth is, tendonitis pain is usually a culmination of numerous factors, such as repetitive stress, poor posture, acute injuries, and overcompensation issues resulting from other muscle and soft tissue ailments.

It may take weeks or months for these pain triggers to surface. When they , however, merely resting will solve the underlying issues. You need to utilize actions and options that actually treat the source of the pain and help reverse the damage that has been done.

Resting has a role to play, but it is only one small factor in a recovery plan.



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During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort at the location of your soft tissue injury until the pain and inflammation settle. Always consult your doctor and/or Physical Therapist before using any of our outstanding products, to make sure they are right for you and your condition. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!


 
 

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