Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, we describe the most common causes of pes anserine bursitis and the most effective ways to treat it, including an advanced technique called Prolotherapy.
Table of Contents
- What is Pes Anserine Bursitis?
- Causes of Pes Anserine Bursitis
- Symptoms
- Diagnosis
- Treatment Options
- Other Conditions Mistaken for Pes Anserine Bursitis
- Frequently Asked Questions
- Case Studies
- References
- Contact ProHealth Clinic
- Author Bio
What is Pes Anserine Bursitis?
Pes Anserine is a term used to refer to the insertion of three muscles at the proximal end of the Tibia, namely: Gracilis, Sartorius and Semitendinosus. Between the insertion of these muscles and the medial collateral ligament of the knee joint, lies a bursa which is prone to inflammation due to overuse or repetitive friction. This inflammation of the bursa is known as Pes Anserine Bursitis.
What is the Cause of Pes Anserine Bursitis?
The most common causes include overuse injuries in athletes, particularly runners, obesity, poor biomechanics, osteoarthritis, trauma to the inside of the knee, or tight hamstring muscles. Conditions such as valgus knee deformity may also predispose individuals to this bursitis.
What are the Symptoms of Pes Anserine Bursitis?
The hallmark symptom is pain on the inner side of the knee, typically below the joint line. This pain may worsen with climbing stairs, rising from a seated position, or during exercise. Swelling and localized tenderness may also be present.
How is Pes Anserine Bursitis Diagnosed?
Diagnosis is primarily clinical, based on symptoms and physical examination. The physician palpates the area of tenderness just below the medial joint line. Imaging such as MRI or ultrasound may be used to confirm diagnosis and rule out other conditions.
The Recommended Treatment Options for Pes Anserine Bursitis
Treatment may vary depending on the severity and persistence of symptoms. Initial management usually includes rest, ice application, anti-inflammatory medication, and physical therapy. Resistant cases may benefit from injections or regenerative treatments such as Prolotherapy.
Medical Treatment
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often prescribed to reduce pain and inflammation. In some cases, corticosteroid injections may be used for short-term relief, although these carry risks when used repeatedly.
Physical Therapy
Physiotherapy focuses on stretching tight muscles, strengthening the quadriceps and hamstrings, correcting biomechanical issues, and improving flexibility. Weight reduction is also advised for overweight patients.
Surgical Treatment
Surgery is rarely required but may be considered if conservative management fails. Procedures typically involve bursectomy or addressing underlying structural causes.
Prolotherapy
Prolotherapy is an advanced regenerative injection treatment that stimulates the body’s natural healing response to strengthen weakened ligaments and tendons. It has shown promising results in treating chronic pes anserine bursitis when conventional therapies have failed.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Other Conditions That Pes Anserine Bursitis May Be Confused With
Pes anserine bursitis can mimic or be confused with conditions such as medial meniscus tears, medial collateral ligament injuries, stress fractures, and medial compartment osteoarthritis. Proper diagnosis is essential to avoid mismanagement.
Frequently Asked Questions
How Do You Treat Pes Anserine Bursitis?
Treatment includes rest, ice, NSAIDs, physiotherapy, and in resistant cases, regenerative therapies like prolotherapy.
What Does Pes Bursitis Feel Like?
It feels like a dull ache or sharp pain on the inner side of the knee, worsened by activities like climbing stairs or prolonged walking.
How Long Does It Take For Pes Anserine Bursitis To Heal?
Most cases resolve within 6–8 weeks with conservative treatment. Chronic cases may take several months.
What Aggravates Pes Anserine Bursitis?
Activities such as climbing stairs, squatting, or excessive running often aggravate symptoms. Obesity and poor biomechanics may worsen it.
How Do You Stretch Pes Anserine?
Stretching the hamstrings, adductors, and sartorius muscles helps relieve tension on the pes anserine. Physical therapists often recommend specific routines.
Is Walking Good For Bursitis?
Moderate walking may be tolerated, but excessive walking or uphill walking can worsen symptoms. Always follow medical advice.
Can Pes Anserine Bursitis Come Back After Treatment?
Yes, recurrence is possible if underlying causes such as obesity, poor biomechanics, or untreated arthritis remain unaddressed. Prolotherapy has shown promise in reducing recurrence rates.
Who is Most at Risk of Developing Pes Anserine Bursitis?
Middle-aged women, athletes (especially runners), overweight individuals, and people with type 2 diabetes or osteoarthritis are at higher risk.
Can Pes Anserine Bursitis Be Prevented?
Yes, prevention includes weight management, strengthening exercises, proper footwear, stretching, and avoiding repetitive strain.
Case Studies
Case Study 1: Runner with Medial Knee Pain
A 32-year-old long-distance runner developed medial knee pain after increasing her weekly mileage. Diagnosis confirmed pes anserine bursitis. With rest, physiotherapy, and prolotherapy, symptoms resolved within 6 weeks, and she returned to training pain-free.
Case Study 2: Overweight Patient with Diabetes
A 56-year-old overweight male with type 2 diabetes presented with chronic knee pain. Imaging ruled out meniscus tears. Conservative therapy failed, but prolotherapy injections resulted in significant pain relief and improved function within 3 months.
Case Study 3: Osteoarthritis-Linked Bursitis
A 64-year-old female with medial knee osteoarthritis reported worsening bursitis symptoms. Combined treatment with physiotherapy, weight management, and regenerative prolotherapy significantly reduced pain and improved mobility.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let Pes Anserine Bursitis control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
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Author Bio
Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating Pes Anserine Bursitis, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with Pes Anserine Bursitis and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
References
- Shah A, Busconi BD. Pes anserine bursitis: a review. J Knee Surg. 2012;25(4):303–308.
- Rennie WJ, Saifuddin A. Pes anserine bursitis: incidence in symptomatic knees and clinical presentation. Skeletal Radiol. 2005;34(7):395–398.
- Wright AA, et al. Conservative management of pes anserine bursitis: a case report. Physiother Theory Pract. 2010;26(6):408–416.
- Krogh TP, et al. Injection therapies in the treatment of pes anserine bursitis: a systematic review. Scand J Med Sci Sports. 2013;23(6):e359–e366.
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.