Pes Anserine Bursitis

Pes anserine bursitis is a pretty common cause of medial knee pain, especially in runners, cyclists, and athletes with repetitive stress or poor mechanics. Here are evidence-based solutions you can pass on to athletes or clients:

Immediate Relief

• Activity modification: Reduce mileage, avoid hills/stairs, and cut back on aggravating movements until pain calms.

Corrective & Preventive Strategies

1. Address muscle imbalances

   • Weak glutes and core often lead to knee valgus and stress on the pes anserine.

   • Add exercises like clamshells, side planks, and hip thrusts.

2. Stretch tight muscles

   • Hamstrings, adductors, and hip flexors often contribute to extra pull on the pes anserine tendons.

   • Gentle static stretching, 20–30 sec holds, 2–3x/day.

3. Strengthen the medial stabilizers

   • Single-leg step-downs

   • Terminal knee extensions

   • Lateral band walks

4. Bike/RUN fit check

   • Over-pronation of the foot → extra stress at the pes anserine. Consider orthotics or supportive footwear.

   • On the bike: check cleat angle and saddle height (too high = hamstring/adductor overload).

Recovery Techniques

• Soft tissue release: Foam roll adductors, hamstrings, quads (but avoid rolling directly on the bursa).

• Taping/Bracing: Some find relief with medial knee support or kinesiology tape to unload the area.

• Gradual return: Once pain decreases, reintroduce activity with lower volume and slower build.

When to Refer Out

• If pain persists >2–3 weeks despite load reduction.

• If swelling is significant or walking becomes difficult.

• Corticosteroid injection or guided PT may be needed in chronic cases.