Pes anserine bursitis
|Pes anserine bursitis|
|Pes anserine is on the lower right side of image (Pes anserine bursa lies beneath)|
The pes anserinus is the insertion of the conjoined tendons sartorius, gracilis, and semitendinosus into the anteromedial proximal tibia. Theoretically, bursitis results from stress to this area (e.g. stress may result when an obese individual with anatomic deformity from arthritis ascends or descends stairs). An occurrence of pes anserine bursitis commonly is characterized by pain, especially when climbing stairs, tenderness, and local swelling.
The etymology of the name relates to the insertion of the conjoined tendons into the anteromedial proximal tibia. From anterior to posterior, the pes anserinus is made up of the tendons of the sartorius, gracilis, and semitendinosus muscles. The tendon's name, which literally means "goose's foot," was inspired by the pes anserinus's webbed, footlike structure. The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee.
- Sartorius aids in knee and hip flexion, as in sitting or climbing; abducts and laterally rotates thigh; innervated by the femoral nerve.
- Gracilis adducts the hip; flexes and medially rotates tibia at knee; innervated by the obturator nerve.
- Semitendinosus flexes knee; medially rotates tibia on femur when knee is flexed; medially rotates femur when hip is extended; counteracts forward bending at hips; innervated by tibial nerve and common fibular nerve.
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Pes anserine bursitis can be treated with a variety of physical therapy treatments, steroids to reduce inflammation, or surgery if necessary. Physical therapy treatments include therapeutic ultrasound, electrical stimulation (E-stim), rehabilitative exercises, and ice. Therapeutic ultrasound and E-stim deliver medication deep to the bursa to reduce inflammation. The rehabilitative exercises are done with the intention of stretching and strengthening the hip abductors, quadriceps, and hamstrings. These stretches have the potential to significantly reduce the tension over the pes anserine bursa.
- Glencross, P. Mark (20 January 2017). "Pes Anserine Bursitis". Medscape. WebMD LLC. Retrieved 3 May 2018.
- K. Saladin, Anatomy & Physiology 5th Edition, 2010, McGraw-Hill.