Pes Anserine Bursitis

[@btugrul]

What I really appreciate a lot in Dr. A Ozello is that apart from highly instructive and informative videos he uploads, he also speaks slowly and in an understandable manner, so that we foreign followers whose mother tongue is different from English actually get every single point he underlines and be well informed. Unfortunately, in most other cases, doctors or physiotherapists do not show this sensibility and speak the way they normally do with their friends and colleagues, and we sometimes miss some important details or misunderstand some crucial points. So, I congratulate you doctor and thumbs double up for the attention and care you show on this matter. All the best from Turkey.

[@drdozellodc]

Thank you. I appreciate the compliments.

[@sigmatau8231]

a comprehensive explanation

[@drdozellodc]

Thanks for the feedback. Please let me know if you have any questions.

[@moulin680]

Great explanation and tips! Thank you!!

[@drdozellodc]

You're welcome.

[@shogo10]

Hello Your video has been the most informative I have seen on this. I have been trying to deal with pes anserine for almost two years now possible due to a trauma injury to it. I had hit my knee hard and hadn't done much immediately without realizing how bad it could get. I was later diagnosed with pes anserine tendonitis and have been trying to deal with it via physical therapy and exercises. My main issue with this is that the pain gets worse at night it is not so bad during the day but sleep is very difficult for me. The pain can get so bad I wake up several times throughout the night or sleep very little. I have been applying ice before I try to go to bed as well as heat during the day however I still wake up from pain and icing afterwards helps minimally. I usually wait out the pain after that. I have also been trying to rest the knee in order for it to heal as well as doing some exercises however I have been getting contradicting information on how much exercises I should be doing and how long I should just let it rest. Sorry about the long explanation it has just been very frustrating dealing with this. I have a few questions if you don't mind: 1. How long should I be resting my knee or should I be exercising it even if the pes anserine persists? 2. Is there anything I can do about the night pain other than just icing it? I have been avoiding nsaids as I don't want to take them long term. 3. What is your advice if this still persists? Many thanks for your informative video. If anything I at least understand this condition better.

[@drdozellodc]

Thanks for watching & thanks for the questions. If I were you I would take two weeks off from all training. During those two weeks I would focus on recovery. I would perform mild stretching and foam rolling for the hamstrings, hip flexors, spine and muscles that attach to the Pes Anserine (sartorius, gracilis and semitendinosus). I would get Chiropractic treatment, massage & fascial stretch treatment. After those two weeks I would continue the treatment. I would sleep on my back with a wedge pillow under my knees or sleep on my side with a pillow between my knees. I would restart my training at a mild intensity and would avoid all exercises that elicit and/or intensify my symptoms. I would continue the stretching and foam rolling while focusing on strengthening the muscles that attach to the pes anserine and gluteal muscles. Before going to sleep I would perform mild stretching exercises. Recovery is key, I would ensure that I give my body ample time to rest and recover between training sessions and I would utilize nutritional and supplementation strategies that decrease inflammation and promote joint health.

[@shogo10]

@@drdozellodc Thank you very much for the response. I will definitely put more emphasis on stretching especially before going to bed as well as finding a massage treatment. Hopefully I can at least get the pain down.

[@drdozellodc]

You're welcome. Let me know if you have any further questions.

[@UdhayChatha]

Hey now that it’s been over two years are you better now? I just really curious, I wish you all the best

[@shogo10]

@@UdhayChatha Unfortunately no. Although it is certainly not pes anserine at this point. I am getting it investigated that it could be bone related but it has been slow.

[@stephenhiker9807]

you are a hero doc

[@drdozellodc]

Thank you. Please let me know if you have any questions.

[@jamesdutton7142]

Dr. Ozello, I am a runner and I lift weights several times a week as well. I have never had any knee problems with running until recently. I sort of over worked my legs in a hard leg workout a few weeks ago. Now when I run I am having symptoms of what I think is pes anserine bursitis. I am following some of your rehab techniques from other videos and was wondering when I should return to running. Should my symptoms be completely gone or is it ok to run when the pain is bearable? Thanks in advance, your videos are very informative.

[@drdozellodc]

Hi James. Thanks for watching & thanks for the compliments. If I were you I would continue to rehab the condition on a consistent basis. I would start with walking on a flat surface then very gradually progress to running. Increase your intensity in small calculated increments. If an exercise elicits or intensifies symptoms stop immediately and find a viable substitute.

[@MrJimYves]

very informative. thanks!

[@drdozellodc]

Hello Jim. thanks for the compliment. Let me know if you have any questions

[@metalhead00xx]

Hi. Sweet video! I think I got this condition while kneeling for an extended period of time a few years ago. When I stood up, I had horrible pain by pes anserine. I've been to physical therapists and osteopath who said it was pes anserine tendonitis. I've had ice, "voodoo flossing," graston, physical therapy, still didn't quite go away. It doesn't bother me generally, but if I squat, it will hurt the next day and hurt for about a week. The pain is above and below the knee at the tendon insertion, on the medial side and posterior. MRI showed normal results before doctors thought it was meniscus tear. Thoughts on what would be a nice manner to proceed?

[@drdozellodc]

Thank you, I appreciate the feedback on my video. Here is a playlist of my videos that may provide you useful information on exercises to help your recovery. Start at your current health and fitness level. If an exercises elicits or intensifies symptoms stop immediately and find a viable substitute. Always work through a pain free range of motion. kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@RodneyisGodney]

Also, I planted a flower in my front garden right next to my front porch and I had to stand in an awkward position to dig the hole as there was no room for me to kneel on the ground, my left knee was hurting while I did that. Maybe that could be the cause of the pain?

[@drdozellodc]

Yes, that can be a main contributing factor.

[@benjaminmiller3890]

Add disc golf as a contributing factor to pes anserine bursitis.

[@drdozellodc]

Hi Benjamin. Thanks, I appreciate the information. I will do research on disc golf injuries.

[@stephencsaplar6382]

I did mine swimming breaststroke but think my running has agitated it. It is taking a long time to heal completely. Been about 2 months now.

[@drdozellodc]

Keep working constantly on your rehab. It will take time.

[@laurentaylor9874]

Hi Dr, do you think that it could be caused or related to interarticularis spondylolysis? Thanks!

[@drdozellodc]

Great question. It is possible the two can be related, If there is one area that is injured or not functioning properly, a greater demand is placed on other areas. This can lead to the other areas becoming injured,

[@andyroos5090]

With this issue, is it more important to stretch (lengthen) the three connected thigh muscles or to strengthen (shorten) them? Thanks!

[@drdozellodc]

You're welcome. Stretching & strengthening are equally important. If I were you I would focus on performing mild stretches throughout the entire rehab program & I would focus on strengthening exercises in the middle & later phases of the rehab program. I would avoid any stretch or exercise that elicits or intensifies symptoms. I would move into the stretch slowly and hold a mild comfortable stretch.

[@RodneyisGodney]

Hi Dr, can standing for hours at a time, like say working as a cashier at a grocery store and turning on one foot and leaning forward (on the same foot) to place items further down on belt cause pes anserine bursitis? Curious as I have pain in that exact area in my left knee. I'm not an athlete or a runner and I don't do squats.

[@drdozellodc]

Thanks for the question. The muscles that insert into the Pes Anserine perform motions that turn the hip inward (Medial rotation) & bring the thigh toward the center of the body (Adduction). Perform these motions repeatedly can contribute to the develop of Pes Anserine Bursitis.

[@palakahuja80]

Hello doc, will the collection of fluid or inflammation go away completely? Or will the goosefoot remain the way it has become ? And how ?

[@drdozellodc]

The inflammation should slowly go away as the injury recovers.

[@phylsmith3965]

I have pain and inflammation in this area in both knees, and I have difficulty standing even for short periods of time when symptoms are present. Is that consistent with this condition? Also, I am a swimmer, but swim the crawl, not breast stroke. Would the crawl cause this injury?

[@drdozellodc]

Pes anserine bursitis is common among swimmers. If I were you I would get a professional evaluation to get the proper diagnosis then start rehab immediately.

[@teodorabirda2938]

Hello! Is MLS Therapy Laser helping? And also, usually how long it takes to recover?

[@drdozellodc]

Hello Teodora. Thanks for watching my video & for the questions. I apologize for the delayed reply. Laser therapy is definitely worth trying. It is usually an effective type of treatment for several sports injuries. Recovery time is almost impossible for me to answer. Each case is individual. It depend on severity, if priors episodes existed, contributing factors, overall health & if other conditions exist. Be consistent with your rehab and a full recovery should occur. Work hard but give your body time to recover between training sessions.

[@drdozellodc]

Best of luck & please feel free to contact me with further questions.

[@drdozellodc]

Here is a playlist of exercises that may be helpful in your rehab. kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@michelesullivan359]

Mine is the result of a TKR

[@drdozellodc]

Thanks for the information. Let me know if you have an questions.

[@nikitajulien5409]

A pillow feels so good under my knee.

[@drdozellodc]

Hi Beauty Queen. Thanks for commenting. Placing a pillow under your knees while you in a supine position will benefit the lumbar spine, hips & knees.

[@liewmunling3866]

Hi Dr, I have a bump in front of my knee cap and the symptoms are consistent with pes anserine injuries. If I keep on stretching and strengthening of the leg, will the bump disappear? Am feeling achy with the bump with sometimes 'moves' on its own. Do I need to see a doctor to drain the fluid out?

[@drdozellodc]

Hello Liew Mun Ling. Thanks for watching my video & for the question. I recommend you see a medical professional to get a proper diagnosis & treatment plan. If your condition is Pes Anserine Bursitis, the stretching & strengthening should help.

[@liewmunling3866]

Thank you Dr for your reply. Am doing stretches & strengthening exercises. Guess all my muscles are tight with no proper stretches in a year. FYI, I dislocated my knee cap since last Nov and my knee has been in pain since then. I know something was wrong with my gait & biomechanics. Now that I know it's bursitis, I hope to be able to diagnose my pain.

[@drdozellodc]

Hello Liew Mun Ling. Be consistent with your stretching & strengthening exercises. Always work through a pain-free range of motion & never perform an exercise that elicits symptoms of any kind.

[@Jamal-gl7zi]

Thank you doctor for the video Ive been dealing with this issue for a very long time and as you mentioned in my case its the weakness of the gluteus along with the hamstring The main issue i have is that every time i try to shorten my hamstring to strengthen it i aggravate pain in the pes anserine area Even eccentric work like stiff leg deadlift can cause irritation Any advice Thank you

[@drdozellodc]

Hi Jamal. Thanks for watching my video & for asking a question. Have you tried the Isometric Pelvic Bridge? It may be helpful. You can hold the top position for 2 to 6 seconds. I will send you a playlist I created for Pes Anserine Bursitis that includes the pelvic bridge & other exercises that may be beneficial. Please let me know if you have any questions.

[@drdozellodc]

Here is the Pes Anserine Playlist kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@snickerstorino]

i starting trying to get into shape about 4 weeks ago, ive changed diet and starting playing rugby and running everyday i didnt have practice. i started off 1/2 mile and dying and worked up to 1 3/4 miles feeling better then bang my knee set off with this issue on an afternoon run. i was pretty out of shape prior to this and still am but not nearly as bad thankfully, i changed to some basketball shoes a couple weeks prior to the issue arising. i've been resting it for about 5 days now and its feeling better but im not sure how long to wait to try again. i have physical therapy next week, this said i appreciate your video and if you have any more advise please let me know. im not going to give up, i need to stay active but its hard when your right knee is in terrible pain. i need to get back into getting into shape asap, hopefully this heals soon.

[@drdozellodc]

Hello Wyoming Elkoholic. Congratulations on restarting a lifestyle of health, fitness & activity. Thanks for watching my video & for commenting on it. It sounds like you started doing too much too soon. Don't worry, it a common mistake, almost everyone has done it. The Physical Therapist should help. Also, you may want to receive Chiropractic care. When you are getting treatment ask as many questions as you can to educate yourself on proper rehab & proper training techniques. The more knowledge you have that you can apply, the better your chances for a complete recovery. My biggest piece of advice is to be patient, Do not rush back into activity until your body is ready. Gradually increase your intensity. When your injury is healed, you may want to start with walking then slowly progress to running. In the mean time, you can try bike riding or swimming. Take your time & stay positive. The consistent hard work, patience & drive to live a healthier lifestyle will produce results and be well worth it.

[@mohammadalihydari7189]

Sir...Can u tell me different between bone and muscle pain

[@drdozellodc]

Hi Mohammad. Thank you, great question. Bone pain is described as deep, dull & achy. Muscle pain is sore, stiff & tight.

[@drdozellodc]

Thanks for watching my video & please let me know if you have any other questions.

[@cliffburton5696]

I notice that sitting with my knees crossed causes discomfort on the pes anserine area on the top leg. The pain is about 2 finger widths medial to the patellar tendon which I am assuming this is where the sartorius inserts. Any idea why this position cause problems in the top leg (possibly from the stretch caused by the hanging leg or maybe even pressure pushing on superior portion of the gastrocnemius. Is the pes anserine that close to the patella tendon?

[@drdozellodc]

Hi Cliff. Thanks for watching my video & thanks for the question. Here is a link to my video Two Minutes of Anatomy: Pes Anserine kzbin.info/www/bejne/ZoOaqp2hqNyJis0

[@drdozellodc]

I tried to send you a picture but it would not send. If you look at the picture near the end of the Two Minutes of Anatomy video you can see that the Pes Anserine is slightly inferior to the patellar tendon.

[@drdozellodc]

Most likely the muscles that attach at the Pes (Sartorius, Gracialis & Semitendinous) are being stretched when you are sitting with your legs crossed and they are creating an abnormal pull on their attachment site.

[@jonathanstiles9999]

I'm a competitive runner and I have this injury! Where do I find the exercises to help it? Thanks :)

[@drdozellodc]

Hi Jonathan. Thanks for watching my video & thank you for the question. Here is a link to a playlist of my videos I created with exercises to strengthen the medial thigh & the hamstrings. kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@drdozellodc]

Please feel free to contact me with further questions. I will be glad to help.

[@emmal9047]

Thankyou so much for this video it's helped so much. I am not an athlete but I am over weight and I've been in so much pain last few days. How long does it take to rehabilitate it because I can't even walk up the stairs 😭😭😭

[@emmal9047]

I can't take any ibuforen because of my kidney disease after chemo so I am in agony I've been icing it too. I am laying on my bed now and I have just put a pillow under thigh and knee and it feels alot less painful.

[@drdozellodc]

The rehab time depends on severity. Can be as short as 3-4 weeks or as long as 6-12 months. If I were you I would continue to educate myself on this condition, continue using pillow under my knee and begin a rehab program. If an exercise elicits or intensifies symptoms, forego that exercise and use a viable substitute. Here is a playlist of my videos that may provide you useful information. kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@liewmunling3866]

Thanks Dr. It seems that I can't get my motion right. I think I might be using my thigh muscle to pull my leg forward ie drag. Can you please make a video on the proper technique of walking? Thanks a lot.....

[@drdozellodc]

Hello Liew Mun Ling. Thanks for the suggestion on a video topic.

[@liewmunling3866]

Dr Donald A Ozello DC Thx Doc...

[@drdozellodc]

You're welcome

[@VLombardi01]

My docter gave me a physical diagnoses saying I have a mild meniscus tear. He dident give me an MRI. Are the symptoms of this the same as Pes Ancerine Bursitis? I'm beginning to wonder if my diagnosis was right.

[@drdozellodc]

Hello Mr Lombardi. Thank you for watching my Sports Medicine video and thank you for the question. The symptoms of Pes Anserine bursitis are located lower than the symptoms of a meniscus injury. The location of pes anserine bursitis symptoms is about 2 to 3 inches below the knee cap on the upper inside aspect of the front of the shin. The location of symptoms of a medial meniscus tear are located along the inner joint line of the knee.

[@VLombardi01]

Ok thank you very much! Right now after rest and strengthening exercises I went to a different doctor and she tested my knee out with putting pressure on different spots. She said I have knee tendinitis and referred me to a sports medicine doctor for next week. The pain has decreased a lot in the last three weeks. I cant wait to start running again.

[@drdozellodc]

Hi Mr Lombardi. That is great news. I'm very glad to hear it. He consistent with your strengthening exercises & please let me know how you progress.

[@VLombardi01]

Ok I'll stay in touch. Thank you!

[@drdozellodc]

You're welcome

[@linguanav2548]

I am multiligament surgery 8 months post op..but my mcl side pain is not going.i think it is due to pes anserine...pls tell me what should i do

[@linguanav2548]

And also my leg is not going forward 90°

[@drdozellodc]

Here is a playlist of my videos that may provide you useful information about the anatomy and exercises for Pes Anserine Bursitis. Please let me know if you have any questions kzbin.info/aero/PLqvttwjy17BlYKhbwFqAtolkrA-qgfq_T

[@bakerstreet101]

Great video except that the doctor should wear leggings or just uncover his leg for this kind of explanation.

[@drdozellodc]

Thanks for the feedback

[@nikitajulien5409]

Will it stop cruncy noises inn my knee?

[@drdozellodc]

Hi Beauty Queen. Thanks for the question. The crunchy sound in the knees can occur for a variety of reasons including but not limited to Patello-Femoral Pain Syndrome (AKA Runner's Knee) & Osteoarthritis