Pes Anserine - Medial (Inside) Knee Pain – Symptoms & Treatment in Bromley

Key Points​

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The pes anserine is the point where three tendons (hamstring and inner thigh muscles) attach to the inside of the shinbone, just below the knee.

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Irritation of this area can lead to pes anserine bursitis or tendonitis, causing pain on the inner side of the knee.

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It’s common in runners, athletes, and people with arthritis.

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At Bromley Sports Injury Clinic, we provide osteopathic care, ultrasound imaging, blood tests, and personalised rehabilitation to diagnose and treat pes anserine pain effectively.

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What is Pes Anserine Pain?

The pes anserine (“goose’s foot”) is formed by the tendons of:

• Sartorius

• Gracilis

• Semitendinosus

These tendons join at the inside of the knee and insert into the shinbone (tibia). Beneath them lies a small fluid-filled sac called the pes anserine bursa.

Pain occurs when this bursa or the tendons become irritated due to overuse, poor biomechanics, or inflammation.

👉 Related: Medial Knee Pain | Ligament Sprains | Tendinitis

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Symptoms of Pes Anserine Bursitis/Tendonitis

• Pain on the inside of the knee, about 2–3 inches below the joint line

• Pain worse when climbing stairs or getting up from a chair

• Localised tenderness at the pes anserine area

• Swelling or warmth in more inflamed cases

• Pain with resisted knee flexion or adduction

• Stiffness in the morning or after sitting

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Causes & Risk Factors

• Overuse injuries from running, cycling, or climbing stairs

• Sudden increase in training load

• Tight hamstrings or weak quadriceps

• Poor biomechanics (flat feet, knock knees)

• Obesity or rapid weight gain

• Arthritis (especially knee osteoarthritis)

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Diagnosis of Pes Anserine Pain

At Bromley Sports Injury Clinic, diagnosis may include:

• Osteopathic assessment – testing for tenderness, strength imbalances, and movement restrictions

• Ultrasound imaging – to detect bursal swelling or tendon inflammation, and to rule out other causes of medial knee pain

• Blood tests – to identify systemic contributors such as vitamin D deficiency or arthritis markers

• Referral – for MRI if additional cartilage or ligament injury is suspected

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Self-Help for Pes Anserine Pain

• Rest and avoid aggravating movements (stairs, deep squats)

• Apply ice to reduce inflammation in flare-ups

• Stretch hamstrings, quads, and hip adductors

• Strengthen hip and glute muscles to improve knee mechanics

• Use supportive footwear or orthotics for flat feet

• Weight management to reduce knee load

• Apply the POLICE Principle for acute injuries

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Treatment Options at Bromley Sports Injury Clinic

✅ Osteopathic treatment – soft tissue therapy and joint mobilisation to reduce irritation
✅ Exercise rehabilitation – progressive strengthening of quads, hips, and hamstrings
✅ Sports massage – targeted release for hamstrings, adductors, and pes anserine region
✅ Ultrasound imaging – confirms diagnosis and monitors improvement
✅ Blood testing – detects metabolic or systemic factors slowing recovery
✅ Activity advice – training modifications and return-to-sport planning

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Prevention

• Warm up before running or sport

• Regular stretching of hamstrings and adductors

• Strengthening of hip and glute muscles for stability

• Use well-fitting footwear and orthotics if needed

• Avoid sudden spikes in training volume

• Maintain a healthy weight to reduce knee stress

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FAQs – Pes Anserine Pain

Q: How do I know if my knee pain is pes anserine bursitis?
The pain is usually localised on the inside of the shin just below the knee joint line, and is tender to touch.

Q: Do I need a scan?
Ultrasound is very useful for confirming bursitis or tendon irritation and ruling out ligament or meniscus issues.

Q: Can I keep exercising?
Yes, but avoid aggravating activities. Modify training and focus on rehab exercises.

Q: Why are blood tests relevant?
They can reveal systemic factors (e.g. vitamin D deficiency, inflammatory arthritis) that slow healing.

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Book Your Appointment

Don’t let pes anserine pain limit your movement. Book your pes anserine assessment in Bromley today for accurate diagnosis and effective treatment.

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📍 Bromley Sports Injury Clinic | Same-week appointments available

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