Pes Anserine Pain – What Physical Therapists Should Know

By dpope2020

September 27, 2024

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Pes Anserine Pain - What Physical Therapists Should Know

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In today's video we go over Pes Anserine Pain - What Physical Therapists Should Know: FPF Show Episode 147

  • 0:00 Introduction
  • 1:35 What is the relevant anatomy of the pes anserine muscles and tendons?
  • 4:41 Anatomy of the pes anserine bursa
  • 7:16 Mechanism of injury for pes anserine pain
  • 11:38 What is the prevalence of pes anserine pain?
  • 15:11 What are risk factors for pes anserine pain?
  • 21:10 What is the pathophysiology of pes anserine pain?
  • 25:08 How do we diagnose patients with pes anserine pain?
  • 29:44 What objective measures are important for patients with suspected pes anserine pain?
  • 33:57 Differential diagnosis for pes anserine pain
  • 40:52 What is the prognosis of patients with pes anserine pain?
  • 42:23 What physical therapy treatments have shown to be effective for pes anserine pain?
  • 51:59 What treatments can be helpful when physical therapy fails? (Cortisone, PRP, shockwave, surgery)

Man, my pes anserine is on fire!

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Thank you!

Dan Pope DPT, OCS, CSCS

References: 

  1. Pes Anserinus Tendons. Image shows the distance between the insertion of the pes anserinus and the knee joint, which should be considered in the physical examination. Helfenstein Jr M, Kuromoto J. Anserine syndrome [in Portuguese]. Rev Bras Reumatol. 2010;50(3):313-327.

  2. Medial View of the Knee. The image shows the relationship between the tendons that form the pes anserinus and the anserine bursa, implying a difficult clinical and imaging diagnosis. Helfenstein Jr M, Kuromoto J. Anserine syndrome [in Portuguese]. Rev Bras Reumatol. 2010;50(3):313-327.

  3. Mohseni M, Mabrouk A, Li DD, et al. Pes Anserine Bursitis. [Updated 2024 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532941/

  4. Pes Anserine Bursitis Copyright © 2024, StatPearls Publishing LLC. This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

  5. Alvarez-Nemegyei J. Risk factors for pes anserinus tendinitis/bursitis syndrome: a case control study. J Clin Rheumatol. 2007 Apr;13(2):63-5. doi: 10.1097/01.rhu.0000262082.84624.37. PMID: 17414530.

  6. Helfenstein M Jr, Kuromoto J. Anserine syndrome. Rev Bras Reumatol. 2010 May-Jun;50(3):313-27. English, Portuguese. PMID: 21125167.

  7. Rennie, W. J., & Saifuddin, A. (2005). Pes anserine bursitis: incidence in symptomatic knees and clinical presentation. Skeletal Radiology, 34(7), 395–398. doi:10.1007/s00256-005-0918-7

  8. Safran MR, Fu FH. Uncommon causes of knee pain in the athlete. Orthop Clin North Am 1995; 26:547–549

  9. Atici A, Bahadir Ulger FE, Akpinar P, Illeez OG, Geler Kulcu D, Unlu Ozkan F, Aktas I. Poor Accuracy of Clinical Diagnosis in Pes Anserine Tendinitis Bursitis Syndrome. Indian J Orthop. 2022 Jan;56(1):116-124.

  10. Khosrawi S, Taheri P, Ketabi M. Investigating the Effect of Extracorporeal Shock Wave Therapy on Reducing Chronic Pain in Patients with Pes Anserine Bursitis: A Randomized, Clinical- Controlled Trial. Adv Biomed Res. 2017 Jun 6;6:70. doi: 10.4103/2277-9175.190999. PMID: 28626745; PMCID: PMC5468784.

  11. Yoon HS, Kim SE, Suh YR, Seo YI, Kim HA. Correlation between ultrasonographic findings and the response to corticosteroid injection in pes anserinus tendinobursitis syndrome in knee osteoarthritis patients. J Korean Med Sci. 2005 Feb;20(1):109-12. doi: 10.3346/jkms.2005.20.1.109. PMID: 15716614; PMCID: PMC2808555.

  12. Finnoff JT, Nutz DJ, Henning PT, Hollman JH, Smith J. Accuracy of ultrasound-guided versus unguided pes anserinus bursa injections. PM R. 2010 Aug;2(8):732-9. doi: 10.1016/j.pmrj.2010.03.014. Epub 2010 Jul 3. PMID: 20598959.

  13. Sarifakioglu B, Afsar SI, Yalbuzdag SA, Ustaömer K, Bayramoğlu M. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis. J Phys Ther Sci. 2016 Jul;28(7):1993-7. doi: 10.1589/jpts.28.1993. Epub 2016 Jul 29. PMID: 27512249; PMCID: PMC4968491.

  14. Babaei-Ghazani A, Eftekharsadat B, Soleymanzadeh H, ZoghAli M. Ultrasound-Guided Pes Anserine Bursitis Injection Choices: Prolotherapy or Oxygen-Ozone or Corticosteroid: A Randomized Multicenter Clinical Trial. Am J Phys Med Rehabil. 2024 Apr 1;103(4):310-317. doi: 10.1097/PHM.0000000000002343. Epub 2023 Oct 2. PMID: 37752656.

  15. Homayouni K, Foruzi S, Kalhori F. Effects of kinesiotaping versus non-steroidal anti-inflammatory drugs and physical therapy for treatment of pes anserinus tendino-bursitis: A randomized comparative clinical trial. Phys Sportsmed. 2016 Sep;44(3):252-6. doi: 10.1080/00913847.2016.1199251. Epub 2016 Jun 22. PMID: 27276165.

  16. Saggini R, Di Stefano A, Dodaj I, Scarcello L, Bellomo RG. Pes Anserine Bursitis in Symptomatic Osteoarthritis Patients: A Mesotherapy Treatment Study. J Altern Complement Med. 2015 Aug;21(8):480-4. doi: 10.1089/acm.2015.0007. Epub 2015 Jun 17. PMID: 26083769; PMCID: PMC4522948.

  17. Gouda W, Abbas AS, Abdel-Aziz TM, Shoaeir MZ, Ahmed W, Moshrif A, Mosallam A, Kamal M. Comparing the Efficacy of Local Corticosteroid Injection, Platelet-Rich Plasma, and Extracorporeal Shockwave Therapy in the Treatment of Pes Anserine Bursitis: A Prospective, Randomized, Comparative Study. Adv Orthop. 2023 Sep 30;2023:5545520. doi: 10.1155/2023/5545520. PMID: 37810418; PMCID: PMC10560108.

  18. Allen MF, Allen DE. Pes Anserinus Bursitis: A Case Report. Cureus. 2022 Nov 11;14(11):e31354. doi: 10.7759/cureus.31354. PMID: 36415475; PMCID: PMC9674038.