Are you suffering from pain on the inside of your knee? And you think that it might
be coming from pes anserine bursitis? And are you wondering what the heck is this thing? What
kind of medical terminology are we talking about? Your peasants are in bursitis. Well,
I'm gonna explain this all to you in detail and give you a thorough explanation of what
pes anserine bursitis is and why it's causing your inner knee pain. My name is Dr. David Middaugh,
and I'm a specialist physical therapist at El Paso manual physical therapy.
and this channel is dedicated to helping people stay healthy active and mobile
while avoiding unnecessary surgery injections and pain medications please subscribe to our
channel so that you don't miss out on any of the helpful videos that we post every single
week well let's get into today's explanation i'm gonna tell you exactly what pes anserine
bursitis is and i've got this drawing here to help me explain so to orient you here this is the thigh
bones and the shin bones here's the knee joint that's the kneecap right there here's the thigh
bone and the shin bone down here these three muscles that i've drawn in different colors all
converge at the inside of the knee and this green little circle sack thing right here is the bursa
now these muscles just in case you're wondering what they're called this is a sartorius muscle in
red the semitendinosus muscle in orange that's one of the hamstring muscles and the gracilis muscle
in purple um the purple one is the uh groin muscle it's an inner thigh muscle all these muscles come
together and and their tendons kind of merge right on the inside of the knee just past
the knee joint line below there and you have this bursa there that's designed to reduce the
friction between all those tendons and the bone so that you can move your knee freely
without the tenon rubbing against the bone or the tendon wearing itself down so the point of
the bursa is to reduce friction in the area so you can have the best possible motion the bursa
gets inflamed that's why we call it bursitis itis means inflammation of whatever its attached to
so bursa bursitis inflamed bursa the bursa gets inflamed whenever there is excessive pressure on
it more than its designed to take it lets you know so we have to ask the question what the heck's
giving us too much pressure and i've written it over here you've got short and tight muscles from
from the pes anserine muscles the the sartorius the semitendinosus and the gracilis all these
thigh muscles that attach here are too short and too tight and they get like that for a variety
of reasons so i'll explain here in a second but that pressure is what sets off the bursa
now you might think short tight muscles well i need to go stretch them out and that's what a
lot of people will do and that might give you some short temporary relief but if you're looking for
long-term relief you really need to strengthen certain muscles and resolve the pressure issue
which i talked about in other videos which i'll link in the description here so you can go check
that out as far as like how to solve a bursitis problem like this i'm going to tell you next the
symptoms of pestering bursitis some of the most common symptoms are increased swelling in the
area and you've got to know exactly where it is so i'm going to show you my knee where that is if you
look at your leg and if you just hold your knee just like this and move your leg back and forth
if you just bend and straighten your knee you should be able to feel the bones moving inside
keep moving like this and slide your fingers onto the joint so you can detect exactly where
the movement occurs for for me it's right here that's my joint line so just like i showed you
in the picture that burst is on the inside of the knee on either side if it's your other knee it's
going to be on on this side and then you've got to walk your fingers down under the edge of the bone
where you can feel a little ridge there that's where the burst is at if all of a sudden you're
like oh i found it you've got bursitis you've located the bursa and that's a good diagnostic
tool if you can poke the bursa and it hurts you probably have bursitis but the trick is finding
the exact spot there's a bunch of other things that could be hurting in the area but the burst
is lower than the knee joint line stuff that could hurt the knee joint line could be the
meniscus the ligament right here the mcl ligament and there's muscles that attach near the area as
well that could bother you the cartilage itself of the knee joint arthritis as well and you
could have overlapping conditions you could have this bursitis problem with a meniscus problem or
an arthritis problem so just keep that in mind as well another common symptom is a repetitive
motion that you've been doing so if you've recently picked up cycling or running or some
sort of cardiovascular gym exercise where you're moving your legs consistently for a period of time
you know at least 10 minutes 15 30 minutes or more and you started to develop this inner knee
pain right at that area that we just covered then likely you've irritated the pes anserine bursa
this does tend to affect younger people so we're talking people like teenagers people in their 20s
and 30s and even 40s usually people that are older than 40s people that are into their 50s 60s and
beyond tend to get more arthritis like symptoms and meniscus problems when it comes to pain on
the inside of the knee but it can certainly happen in somebody that's in their 50s 60s 70s and beyond
personally what i found is pez answering bursitis tends to affect the person that
starts a new exercise program so somebody who's maybe not been as good at exercising over the past
months years decades and they start to get into exercise and they just overdo it they feel good
maybe running or walking even and they just go and they do a lot more than they
thought they could do and they tend to feel good at the beginning doing it but
several weeks into it maybe even several months into it they start to develop this inner knee pain
this tenderness and potentially even swelling in the area it's usually very focal swelling when
we're talking about meniscus or ligament problems there's swelling all around the knee on the back
of the knee with bursitis swelling is just in that spot the spot where the burst is at so if
you found that you started exercise recently you're on the younger side in your 20s or 30s
typically you've got that swelling that's right there and you've found your knee joint line
and walked off the edge of the bone on the inside and you poked your bursa and it hurts
you can be pretty certain that you've got pes anserine bursitis now let's talk about
the causes of presence from bursitis the number one thing is overdoing it as i just described so
you if you think you overdid it then good news you probably just need to rest this let it calm down
back off of exercising completely until it fully calms down and then return to the exercise that
you were doing very gradually you might cut the volume of exercise you were doing in half to start
so in other words if you're walking five days a week for 30 minutes at a time maybe just do
15 minutes for 30 minutes at a time or do every other day some version of that so that you can
reduce the amount of stress and tension to your muscles now that might solve your problem just
like that just reducing the amount of exercise that you do and then gradually wrapping it up
over time say the next week after that add a few minutes each day or add an extra day and see what
your body tolerates without increasing that inner knee pain that peasant serene bursitis another
situation that could be playing a role in your inner knee pain in your penis answering bursitis
is weak glute muscles and improper use of your glute muscles it's not always that the muscles are
weak back there sometimes it's just that you're not using them at the right time and this sets you
up for excessive pressure into the inside of the knee joint now let me just explain one thing here
i'm going to stand up on the table so that you can see my legs here and that peasant serene bursitis
the bursa is right here so if your legs tend to collapse inwards like this when you walk if you
turn your foot in if your feet are pointed in when you walk or your knees tend to come together when
you move then that means that you're tensioning these muscles that i was telling you about on
the picture and you're adding more pressure to the bursa but if you can turn your feet out when
you walk or stand or run or whatever activity that you're doing and be more glute dominant use these
butt muscles more then it's going to put you in a position where you can turn your knees out and
shorten the distance here which makes the pressure on that pes anserine a lot less and it saves your
bursa this is a condition called hip anterior glide medial rotation syndrome which is a big
mumbo jumbo for you've got your your leg coming inwards too far and is tensioning up on the inside
of your knee the everything that's on the inside of your knee is getting excessive pressure this
leads to things like mcl injuries um the ligament here acl injuries arthritis meniscus problems it
sets up a bunch of problems it's likely just that the weakest link in the chain of joints
and tissues in your body was that pes answering burst so that's what's falling apart first what's
getting hurt first so that's the root cause of pes answering bursitis now fixing it there's a little
treatment procedure that i've developed in another video i've linked it here in the description
and you've got to set your expectations right this is not something that just goes away overnight
it can go away relatively quickly compared to things like pain from arthritis or meniscus tear
more chronic conditions this does tend to improve quite fast more on like the weeks to month scales
rather than several months to a year scale so if you've been dealing with this peasant serene
bursitis for several months now then that's just too long you're not doing something correctly
to address this problem you've got to figure out the right treatment plan now go check out that
video if that's you or if you're just coming to this video right now for the first time
you just started having pes answering bursitis recently in the past few weeks here jump on
that video right away before it gets worse on you and you have it way longer than you should
i hope this video was helpful for you please give us a thumbs up and don't forget to subscribe to
our channel so that you don't miss out on any of our helpful videos have a great day bye