Pes Anserinus Bursitis

October 2, 2025

Causes, Symptoms & Physiotherapy Treatment | Weaver Physiotherapy Northwich

Pes anserinus bursitis is a painful knee condition that affects many athletes, runners, gym-goers, and even people who don’t consider themselves particularly active. If you’ve been struggling with pain on the inside of your knee, especially when climbing stairs, squatting, or running, pes anserinus bursitis may be the culprit.


At Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire, our experienced physiotherapists regularly help patients recover from pes anserinus bursitis using evidence-based treatment, rehabilitation, and injury prevention strategies. This comprehensive guide explains what pes anserinus bursitis is, what causes it, the symptoms to watch out for, and how physiotherapy can get you back to moving pain-free.


What Is Pes Anserinus Bursitis?


The pes anserinus (“goose’s foot” in Latin) refers to the area on the inner side of the shinbone (tibia) where three major muscles of the thigh insert:

    •    Sartorius

    •    Gracilis

    •    Semitendinosus


These muscles converge and attach at the upper inner tibia, just below the knee joint. Beneath this tendon junction lies a small fluid-filled sac called a bursa, which reduces friction between the tendons and the bone.


Pes anserinus bursitis occurs when this bursa becomes irritated and inflamed, leading to pain and swelling at the inner knee.


Common Causes of Pes Anserinus Bursitis


Pes anserinus bursitis often develops due to overuse, biomechanical issues, or direct stress on the area. Contributing factors include:

    1.    Overuse & Repetitive Stress

    •    Long-distance running, football, cycling, or any repetitive knee flexion can irritate the bursa.

    2.    Poor Biomechanics

    •    Flat feet (overpronation), knock-knees (genu valgum), or weak hip stabilisers increase stress on the inner knee.

    3.    Muscle Tightness or Imbalances

    •    Tight hamstrings or weak quadriceps can overload the pes anserinus tendons.

    4.    Obesity & Deconditioning

    •    Carrying extra bodyweight puts greater pressure on the knee joint and bursa.

    5.    Previous Knee Surgery or Injury

    •    Patients recovering from meniscus surgery or knee arthritis may develop bursitis due to altered movement mechanics.

    6.    Sports Injuries or Trauma

    •    A direct blow to the inner knee can inflame the bursa.


Symptoms of Pes Anserinus Bursitis


The pain from pes anserinus bursitis is usually very specific. Patients typically report:

    •    Pain & tenderness on the inner side of the knee, about 2–3 inches below the joint line

    •    Pain when climbing stairs, squatting, or rising from a chair

    •    Stiffness or swelling around the inner knee

    •    Pain when lying on the affected side with knees together

    •    Discomfort during running, especially uphill


Unlike arthritis, the pain of pes anserinus bursitis is usually localised and does not involve the entire joint.


Diagnosing Pes Anserinus Bursitis


At Weaver Physiotherapy, diagnosis begins with a comprehensive clinical assessment. This includes:

    •    Patient history – When the pain began, activities that aggravate it, medical background

    •    Physical examination – Palpation of the inner knee reveals tenderness at the pes anserinus insertion

    •    Functional testing – Squats, step-ups, and gait analysis to identify contributing movement issues

    •    Differential diagnosis – Excluding conditions like medial meniscus tears, medial collateral ligament (MCL) injury, and knee osteoarthritis, which can mimic similar pain


In some cases, imaging such as ultrasound or MRI may be recommended to rule out other knee conditions.


How Physiotherapy Helps Treat Pes Anserinus Bursitis


Physiotherapy is the gold-standard treatment for pes anserinus bursitis. At Weaver Physio, our Chartered Physiotherapists combine hands-on therapy, exercise rehabilitation, and education to treat both the symptoms and the underlying causes.


1. Pain Relief & Inflammation Reduction

    •    Manual therapy techniques, gentle massage, and modalities such as ice or heat therapy

    •    Electrotherapy or shockwave therapy (if indicated for chronic bursitis)

    •    Advice on activity modification to avoid aggravating movements


2. Restoring Flexibility

    •    Stretching tight hamstrings, adductors, and hip flexors to reduce stress on the bursa

    •    Guided physiotherapy stretches to maintain knee mobility


3. Strengthening Weak Muscles

    •    Targeted exercises for the quadriceps, glutes, and hip stabilisers to improve biomechanics

    •    Gradual progression from bodyweight to resistance-based rehab


4. Gait & Biomechanical Correction

    •    Video gait analysis at Weaver Physio helps identify faulty running or walking patterns

    •    Customised rehab plans to address overpronation, knee valgus, or muscle imbalances


5. Return-to-Sport Rehabilitation

    •    Functional training for athletes including running drills, agility work, and sport-specific conditioning

    •    Education on warm-up, cooldown, and load management to prevent recurrence


Self-Management Tips for Pes Anserinus Bursitis


Alongside physiotherapy, patients can take steps at home to support recovery:

    •    Apply ice packs for 10–15 minutes after activity to reduce inflammation

    •    Use supportive footwear or orthotics if you overpronate

    •    Avoid sudden increases in training volume or intensity

    •    Incorporate regular stretching & strengthening exercises into your routine

    •    Maintain a healthy bodyweight to reduce knee stress


Recovery Timeline


Recovery varies depending on severity, but with the right physiotherapy plan, most patients improve significantly within 4–6 weeks. Chronic cases may take longer, especially if biomechanical corrections are required.


Key to recovery is consistency – sticking with your physiotherapy exercises and avoiding activities that aggravate symptoms until your knee has healed.


Preventing Pes Anserinus Bursitis


Prevention focuses on reducing stress to the knee and correcting risk factors:

    •    Strengthen hips and core to support knee alignment

    •    Stretch hamstrings and adductors regularly

    •    Progress training gradually rather than increasing mileage or intensity too quickly

    •    Wear well-fitted shoes and replace old trainers before they lose support

    •    Book a Runner’s MOT at Weaver Physio for a full biomechanical and gait assessment to catch issues before they become injuries


When to Seek Professional Help


If your knee pain is persistent, worsening, or interfering with daily life, it’s important to see a physiotherapist. Ignoring pes anserinus bursitis may lead to chronic pain, reduced mobility, and compensatory injuries elsewhere.


Why Choose Weaver Physiotherapy for Pes Anserinus Bursitis Treatment?


At Weaver Physiotherapy & Sports Injury Clinic in Northwich, we pride ourselves on being Cheshire’s Sports Injury Specialists. Patients trust us because:

    •    🏥 70+ years combined clinical experience in physiotherapy and sports injury care

    •    🎯 Expert assessment, diagnosis, and treatment tailored to your unique needs

    •    🏃 Specialised services for runners, gym-goers, athletes, and active individuals

    •    ⚡ Access to advanced treatments including shockwave therapy, acupuncture, deep tissue massage, rehabilitation, and gait analysis

    •    🌍 Trusted by clients across Northwich, Knutsford, Winsford, Middlewich, Tarporley, Frodsham, and the wider Cheshire area


Whether you’re an athlete chasing performance or someone simply wanting to live pain-free, Weaver Physio is your trusted partner in recovery.


Book Your Physiotherapy Appointment


Don’t let knee pain hold you back. Pes anserinus bursitis is highly treatable with expert physiotherapy. The sooner you seek help, the faster you’ll recover and return to the activities you love.


📞 Call 01606 227484 or visit 🌐 http://www.weaverphysio.com to book your appointment today.


Weaver Physiotherapy – Your Trusted Partner in Recovery, Performance & Pain-Free Living



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Knee pain is one of the most common musculoskeletal complaints we see at Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire. From runners and athletes to office workers and retirees, knee problems can affect anyone. While many people are familiar with conditions such as arthritis, meniscus tears, or ligament injuries, one often-overlooked cause of knee swelling and discomfort is a Baker’s Cyst. Also known as a popliteal cyst, this condition can cause swelling behind the knee, stiffness, and reduced mobility – and if untreated, it may lead to ongoing pain or limit your ability to exercise, walk comfortably, or perform daily activities. In this in-depth guide, we’ll explain what a Baker’s Cyst is, the symptoms to look out for, why it develops, and most importantly – how physiotherapy can help you manage, treat, and prevent it. What is a Baker’s Cyst? A Baker’s Cyst is a fluid-filled swelling that develops behind the knee, in the popliteal space. It occurs when excess joint fluid (synovial fluid) escapes from the knee joint and collects in a small sac behind the knee. This fluid build-up is often a result of an underlying knee problem, such as: • Osteoarthritis (wear and tear of the knee joint) • Rheumatoid arthritis • Meniscus injuries (cartilage tears) • Ligament injuries • Knee joint inflammation The cyst itself is not dangerous, but it can be painful, restrict movement, and cause the back of the knee to feel tight – especially when bending or straightening the leg. Symptoms of a Baker’s Cyst Some people with a Baker’s Cyst may not experience symptoms at all, especially if the cyst is small. However, when symptoms do occur, they may include: ✔️ A noticeable lump or swelling behind the knee ✔️ Tightness or stiffness in the back of the knee ✔️ Pain or aching, particularly when straightening or bending the leg ✔️ Reduced flexibility and mobility ✔️ Swelling in the calf (if the cyst bursts and fluid leaks down the leg) In rare cases, a ruptured Baker’s Cyst can mimic the symptoms of a blood clot (deep vein thrombosis – DVT), with sudden calf swelling, pain, and redness. If you experience these symptoms, urgent medical assessment is required. Causes: Why Do Baker’s Cysts Develop? A Baker’s Cyst does not develop in isolation – it usually results from knee joint changes or injury that causes excess fluid production. Common causes include: 1. Arthritis • Osteoarthritis is a major cause. As the cartilage wears down, the joint becomes inflamed, leading to fluid build-up. • Rheumatoid arthritis, an autoimmune condition, can also trigger joint swelling and cyst formation. 2. Sports Injuries • Damage to the meniscus (cartilage) can irritate the joint and lead to cysts. • Ligament injuries (ACL, MCL) may also increase fluid build-up. 3. Overuse or Repetitive Strain • Runners, cyclists, and people who frequently squat or kneel may place repetitive stress on the knee joint, contributing to cyst formation. 4. Underlying Inflammation • Any condition that causes inflammation within the knee joint (including gout) can lead to synovial fluid leakage and cyst development. Diagnosis of a Baker’s Cyst At Weaver Physiotherapy & Sports Injury Clinic, our Chartered Physiotherapists carry out a detailed assessment to identify whether your knee pain and swelling are caused by a Baker’s Cyst, or another condition. The process may include: 🔹 Clinical assessment – checking your symptoms, medical history, and examining the back of the knee for swelling. 🔹 Ultrasound scan – often recommended to confirm the diagnosis. 🔹 MRI scan – if an underlying injury such as a cartilage tear is suspected. Early diagnosis is key. Many patients believe they just have “knee swelling” without realising it’s linked to an underlying joint issue. How Physiotherapy Helps Baker’s Cyst Physiotherapy is one of the most effective ways to manage and treat a Baker’s Cyst. While draining the cyst or surgery is sometimes required in severe cases, the majority of patients benefit from conservative treatment that targets the root cause. At Weaver Physio, our approach focuses on: 1. Pain Relief & Swelling Reduction • Manual therapy to ease stiffness • Ice, compression, and elevation strategies • Advice on activity modification to avoid aggravation 2. Improving Knee Mobility • Gentle stretching exercises to restore range of movement • Targeted flexibility work for the hamstrings and calf muscles 3. Strengthening Exercises • Quadriceps strengthening to improve joint support • Glute activation to reduce stress on the knee • Core stability to enhance overall lower-limb mechanics 4. Correcting Biomechanics • Video Gait Analysis and biomechanical assessment (part of our Runner’s MOT service) • Identifying imbalances in walking or running that may contribute to knee overload 5. Treating the Underlying Cause • If arthritis is the cause, we’ll develop a long-term joint management plan • If it’s due to a sports injury, we’ll provide a tailored rehabilitation programme Home Management Strategies Alongside professional physiotherapy, patients can often manage symptoms at home with: ✔️ Rest & Activity Modification – avoiding deep squats or repetitive knee strain ✔️ Ice Therapy – applying ice packs to reduce swelling ✔️ Compression Supports – knee braces can help control fluid build-up ✔️ Gentle Exercises – as advised by your physiotherapist When is Surgery Needed? Surgery is rarely the first option for Baker’s Cyst. It is usually only considered if: • The cyst is very large and painful • Conservative treatments have failed • The underlying cause (such as a meniscus tear) requires surgical repair In such cases, a surgeon may drain the cyst (aspiration) or repair the damaged structures inside the knee. Can a Baker’s Cyst Burst? Yes. In some cases, the cyst can rupture, releasing fluid into the calf. This can cause sudden pain, swelling, and bruising in the lower leg. It may resemble a DVT (blood clot), so it’s important to seek urgent medical advice to rule this out. Recovery Timeline Recovery depends on the underlying cause: • Minor cases: Symptoms may improve in a few weeks with rest and physiotherapy. • Arthritis-related cases: Long-term management is required, but physiotherapy helps control pain and mobility. • Sports injuries: Recovery may take 6–12 weeks, depending on the severity of the meniscus or ligament damage. At Weaver Physio, we’ll give you a personalised recovery plan so you know exactly what to expect at each stage. Preventing Baker’s Cyst While not all cases can be prevented, you can reduce your risk by: 🔹 Maintaining strong quadriceps, hamstrings, and glutes 🔹 Avoiding repetitive high-impact activities without proper recovery 🔹 Wearing appropriate footwear for your activity 🔹 Seeking physiotherapy early if you experience knee swelling or stiffness Why Choose Weaver Physio for Knee Pain? At Weaver Physiotherapy & Sports Injury Clinic in Northwich, Cheshire, we are specialists in diagnosing and treating knee injuries and conditions such as Baker’s Cyst. Here’s why patients across Cheshire – including Northwich, Knutsford, Winsford, Middlewich, Tarporley, and Frodsham – choose us: ✔️ 70+ years of combined clinical experience ✔️ Experts in sports injuries, arthritis, and musculoskeletal pain ✔️ Access to advanced services such as Shockwave Therapy, Acupuncture & Video Gait Analysis ✔️ Tailored rehabilitation plans that get to the root cause of your pain ✔️ Trusted by runners, athletes, and the local community Our goal is simple: to help you recover faster, prevent future injuries, and get back to living pain-free. Book Your Appointment If you’re struggling with knee pain or suspect you may have a Baker’s Cyst, don’t ignore the symptoms. Early treatment can make a huge difference in your recovery and long-term knee health. 📞 Call us today on 01606 227484 🌐 Visit us at http://www.weaverphysio.com Weaver Physiotherapy & Sports Injury Clinic – Your Trusted Partner in Recovery, Performance & Pain-Free Living.
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