About pes anserine bursitis
The pes anserine is the spot on the upper inner shin where three tendons from the thigh attach together. A small fluid-filled sac called a bursa sits between these tendons and the bone to reduce friction. When this area becomes irritated, the result is pain and tenderness just below the inner knee.
This problem is common in runners and in adults with knee arthritis, where changes in how the knee moves put extra stress on the inner side. It can be mistaken for a meniscus tear or for arthritis itself, which is why a precise diagnosis matters.
The good news is that pes anserine pain usually responds well to targeted treatment, even when arthritis is also present.
Common symptoms
- Pain and tenderness on the inner shin a few inches below the knee joint
- Pain when climbing stairs or getting up from a chair
- Pain at night, especially when the knees press together while lying on your side
- Mild swelling over the tender spot
- Stiffness in the morning or after sitting
Common causes and risk factors
- Knee osteoarthritis, which often occurs alongside it
- Tight hamstrings or weakness in the hip and thigh muscles
- A sudden increase in running, especially on hills
- Knock-knee alignment or flat feet that stress the inner knee
- Excess body weight
How we diagnose it
Our physicians pinpoint the tender area on exam and check the rest of the knee for arthritis or a meniscus problem. Diagnostic ultrasound at the exam table shows whether the bursa is swollen and whether the tendons are thickened or irritated, and it helps separate this condition from other causes of inner knee pain. When arthritis is suspected as a contributor, we may order X-rays to see how much joint wear is present.
How Propel treats pes anserine bursitis
We start with a rehabilitation program that stretches the hamstrings and strengthens the hip and thigh muscles, along with activity changes such as easing hill running or deep squatting for a period. A pillow between the knees at night can help sleep. If arthritis is part of the picture, we address it at the same time, since treating one without the other often leads to lingering pain.
When pain persists, an ultrasound-guided injection places medication precisely into the bursa rather than guessing by feel. For tendon irritation that keeps coming back, PRP or shockwave therapy may support healing and allow a more durable return to activity.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about pes anserine bursitis
- Is my inner knee pain arthritis or pes anserine bursitis?
- It can be either, and often it is both. Pes anserine pain sits a little lower than the joint line, on the upper shin. Our exam and ultrasound help sort out which structure is driving your pain so treatment is aimed at the right spot.
- Will an injection fix pes anserine bursitis?
- An ultrasound-guided injection can calm a painful bursa, often for a meaningful stretch of time. Pairing it with strengthening and activity changes gives the best chance that the pain stays away.
- Can I keep running with pes anserine pain?
- Often yes, with adjustments. Reducing hills and total mileage for a while, while building hip and thigh strength, usually lets runners keep training as the area settles.