Pes Anserine Bursitis (Knee Pain)
Knee pain is a very common ailment across a range of the population, be it sporting, immobile, young or old. Many knee issues only occur when you try and engage in an activity, but Pes Anserine Bursitis can be very painful with even the slightest of movement, which makes it a very frustrating issue to have. Secondly, don’t confuse it with tears to the cartilage.
So, who are the people more likely to develop it? Research shows overweight, middle-aged women with Genu Valgus (knock-knees, pictured right) are the patients most likely to suffer from it. There is also a significant rate of associated symptomatic knee Osteoarthritis (between 20% and 46%) (2). This is due to inflammation and ligament laxity caused by the Osteoarthritis. Sporting groups are also at risk, especially if female, due to the wider female pelvis. As a result of this, a female’s knees move closer together to compensate for the wider hips. This again results in strain in the Pes Anserine muscles.
So, why does it happen?
The reasons Pes Anserine Bursitis occurs could be either gradual or traumatic. Gradual Pes Anserine Bursitis can result from overuse of the muscles that pull the knee inwards, which includes the Sartorius, Gracilis and Semimembranosis muscles (see picture above) (2). With muscle overuse, as a result of knock-knee syndrome, poor running gait or crossing your legs too much, they pull on the common attachment site, which is the Bursa. Constant pulling of a tendon can irritate the structures around the Traumatic Pes Anserine Bursitis. When there is a direct blow to the Bursa, such as a hockey ball or kick hitting the area. This also occurs with significant sustained pressure on the area, as with kneeling. If Pes Anserine Bursitis coincides with knee Osteoarthritis, it’s due to the mechanical changes the Osteoarthritis puts the knee into. This is when bow legs occur.
Interestingly, there are a considerable number of patients coming to the Clinic saying that they have knock-knees, or that their knees are too bent, and it needs to be addressed. Honestly speaking, the phrase, ‘if it ain’t broke don’t fix it’ springs to mind when it comes to knees. If you have an ominous deformity, it doesn’t necessarily mean you’ll eventually suffer pain. If anything, an Osteopath or Physiotherapist making mechanical alterations to painless knees may create pain!
How do we fix it?
Because the muscles pulling on the Bursa bring the knee inwards, the body needs to be taught to do the opposite. Osteopaths can do this when treating your knee. Alongside we can provide an exercise programme to keep the body functioning correctly. Both of these modalities will provide better results, more quickly.
Furthermore, re-training the muscles in this way maintains the knees in good shape. This can prevent issues from occurring in the future. You can also fall back on the exercises at a later date, should problems arise once again.
Should you have any questions concerning this common knee ailment, please don’t hesitate to contact the Clinic on:
info@movementandwellbeingclinic.co.uk
0161 209 3980
References
- Alvarez-Nemegyei J, Peláez-Ballestas I, Goñi M, Julián-Santiago F, García-García C, Quintana R, Silvestre AM, García-Olivera I, Mathern NA, Loyola-Sanchez A, Conti S, Sanabria AJ, Pons-Estel BA. Prevalence of rheumatic regional pain syndromes in Latin-American indigenous groups: a census study based on COPCORD methodology and syndrome-specific diagnostic criteria. Clin. Rheumatol. 2016 Jul;35 Suppl 1:63-70.
- Hubbard MJ, Hildebrand BA, Battafarano MM, Battafarano DF. Common Soft Tissue Musculoskeletal Pain Disorders. Prim. Care. 2018 Jun;45(2):289-303.
