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Knee Tendon Bursitis - "Goosefoot"

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Introduction

Knee tendon bursitis can develop at the inner (medial) knee. Knee tendon bursitis results from trauma, overuse, and degenerative joint disease.  The painful inflammatory condition develops most frequently in athletes, middle-aged women with obesity, and older adults with arthritis.  Knee tendon bursitis rarely requires surgery.  Conservative measures, including rest, physical therapy, and medications provide symptom relief for most people.
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Anatomy

Tendons are fibrous tissues that attach muscles to bone.   The pes anserinus tendons secure the muscles that flex and rotate the knee. Pes anserinus means "goosefoot," which describes the appearance of the conjoined tendons that attach to the inner side of the leg bone (tibia bone).  Beneath the pes anserinus tendons is a bursa (pes anserine).  The bursa is a small cushion-like sac that creates fluid to allow the pes anserinus tendons to glide over the bone.
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Causes

Knee tendon bursitis is an inflammation of the bursa.  Athletic overuse, trauma, chronic arthritis, degenerative joint disease, and obesity, especially in middle-aged women, are frequent causes of knee tendon bursitis.

The incidence of knee tendon bursitis is highest among:
• Middle-aged women with obesity
• Young athletes who participate in sports that require abrupt side-to-side motions or cutting.  Such sports include basketball, tennis, and soccer.
• Older adults with arthritis
• People with flat feet
• People with bowlegged knee deformity
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Symptoms

Knee tendon bursitis causes swelling, tenderness, and pain with certain movements, such as when climbing stairs or getting up from a chair. 
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Diagnosis

A doctor diagnoses knee tendon bursitis by examining the knee and reviewing your medical history.  Your doctor may order medical imaging tests, such as ultrasound or MRI scans to confirm the diagnosis. 

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Surgery

Surgery is rarely necessary for knee tendon bursitis.  Surgery may be used to treat people, such as athletes, with disability.  Surgery involves removing the bursa and any bone growths.
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Treatment

Knee tendon bursitis is treated first with rest and non-steroidal anti-inflammatory medications (NSAIDS) to relieve pain.  Physical therapy modalities, such as icing, therapeutic ultrasound, and exercise can help relieve pain and restore functional movement.  Muscle wasting is a concern from disuse of the knee, especially in older adults and people with obesity. People with obesity should discuss healthy weight loss and weight management plans with their physician.  If symptoms persist, injections of local anesthetics, corticosteroids, or both medications help to provide some immediate relief.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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At Orion Physical Therapy in Lake Orion, Michigan and Active Orthopedics Physical Therapy in Midland and Lake Orion, Michigan, our licensed physical therapists have expertise in treating orthopedic, sports-related, and work-related conditions and injuries affecting the back, neck, shoulder, elbow, hand, wrist, hip, knee, foot, and ankle. Our therapists provide manual therapy, pre- and post-surgical rehabilitation, and treatment for balance disorders and gait training.