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Pain usually starts gradually and develops over a few days or even months. The pain often radiates to the back and inside of the thigh.īursitis pain becomes worse during exercise or when you are climbing stairs, but can also increase by simply bending and straightening your knee. If you suffer from pes anserine bursitis you will feel pain or tenderness over your tibia, approximately 2-3 inches below the patella (kneecap). Pes Anserine Bursitis Symptoms Pain, Tenderness and Swelling Overuse or traumatic injury during athletics.Bio-mechanical issues, such as foot rolling, out-turned knees, or limping.Carrying excess load due to obesity over-stressing the knee joint.Poor technique or improper warm-up in sports.The most common cause of pes anserine bursitis is hamstring tightness due to a lack of warming up and stretching properly before activity, particularly long distance running or excessive climbing. Inflammation of the pes anserine bursae or tendons usually develops due to overuse, trauma, or degradation. The term, pes anserinus means "goose's foot" in Latin - owing to the webbed-foot pattern the three tendons make when they meet. The pes anserine bursa lies beneath these tendons close to the shinbone, providing cushioning between the tendons and the tibia. These three muscles are the dominant knee flexors that function to allow movement of the leg towards the body and control rotation of the tibia, protecting the knee against rotary stress. The three tendons merge together on the inside surface of the shinbone. Specifically, the pes anserinus is the area where the tendons of 3 hamstring muscles (sartorius, gracilis, and semitendinosus) come together. Any actions that put pressure on the inflamed bursa can increase irritation and cause further inflammation and pain. When a bursa becomes inflamed, moving your knee becomes very painful and movement can be difficult. With too much pressure or friction on a bursa, excess fluid can build up in the sac and/or the the lining of the sac can thicken, causing inflammation.