Pes Anserinus Syndrome: 3 Exercises to Treat Medial Knee Pain

Pes Anserinus Syndrome Location

Do you feel pain on the inner side of your knee? You may suffer from pes anserinus syndrome. Here you can find tips and helpful exercises to treat the problem.

What is pes anserinus syndrome (medial knee pain)?

The pes anserinus, also called โ€œgoose footโ€, is where three tendons are conjoined on the inner side of the shin. It is a complex structure of tendons susceptible to injury. Located below the knee, it is the starting point of three muscles. These muscles are responsible for the inward rotation and bending of the knee joint.

Pain in the middle of the knee - Pes Anserinus Syndrome

The pain occurs on the inner side of the shinbone directly below the knee.

Pain develops from overexertion, friction, or trauma (e.g. direct hit) in the transition zone from muscles and tendons into the bone. There is also a bursa located here that can cause problems.

What causes overexertion or friction?

Pes anserinus syndrome is caused by walking for an extended period on uneven or sloped surfaces, muscular imbalances, worn out running shoes, one-sided training, pelvic instability, or gait problems (knock knees).

Symptoms of medial knee pain

The first symptom is often initial pain at the beginning of the workout, which then fades. Later on, a lasting pain will develop along with a limited range of motion, swelling, and tenderness below the inner side of the knee. There may also be a crunching sound in the knee (also called crepitus).

Time for first aid

If you feel medial knee pain, it is important to cut back on your training. Resting and cooling the area (e.g. with an ice pack) is also helpful. If the pain goes away, you can continue low impact active exercise with a full range of motion (cycling). It is also recommended that you replace your worn out sneakers.

Expert tip:

In order to prevent pes anserinus syndrome, it is important to stretch your quads regularly and use a foam roller. Balanced workouts for all muscle groups (e.g. through bodyweight training) is also helpful.

3 effective exercises for medial knee pain

If you are in pain, the following exercises can help:

Foam Rolling:

  1. Relaxation of the hamstrings

Foam rolling hamstrings for Pes anserinus Snydrome

Sit on the floor with your legs extended in front of you. Place the foam roller under your hamstrings on the affected side. Lift your butt to shift the weight to your thigh. Now roll along the length of your hamstrings. Make sure you roll very slowly. Do this exercise as many times as you are able.

  1. Relaxation of the quadriceps

Foam Roll Quadriceps for Pes anserinus syndrome

Get down on all fours. Stretch out the leg in which youโ€™re feeling pain. Place the foam roller under your quad. Now roll it along the entire length of your thigh. Make sure you roll very slowly. Do this exercise as many times as you are able.

  1. Foam rolling directly on the pes anserinus

Foam rolling the Pes anserinus directly

Get on all fours. Lift the affected knee. Position the foam roller below the pes anserinus (= inner side of shin directly below knee). Roll back and forth very slowly.

Caution:

This exercise can hurt โ€“ do not go beyond your pain threshold. Do this exercise as many times as you are able.

Stretching:

  1. Stretching the hamstrings

Hamstrings stretch for Pes anserinus syndrome

Get into the hurdle stretch. Extend the leg that hurts in front of you. Bend your upper body toward your foot. You should feel the stretch in your hamstrings. Keep your back straight. Hold this stretch for 60 to 90 seconds.

  1. Stretching the quads

Quadriceps stretch for the Pes anserinus syndrome

Lie on your side with the leg you want to stretch on top. Slightly bend the bottom leg to stabilize your pelvis. Grab the foot on your top leg and pull it toward your butt. You should feel the stretch in your quads (= front of thigh). Be careful not to arch your back. Hold this stretch for 60 to 90 seconds. ย 

  1. Cobblerโ€™s pose

Cobbler's pose stretch for Pes anserinus syndrome

Get in the cobblerโ€™s pose. Bend your upper body forward. For an effective stretch, push your knees down toward the floor with your elbows. You should feel the stretch in your inner thighs. Be careful not to arch your back. Hold this stretch for 60 to 90 seconds.

Please note:

If you do not see any improvement after treating the problem yourself, you should definitely consult a doctor for an accurate diagnosis. Manipulative (fascial) therapy, leg axis training, ultrasound, anti-inflammatory medication, shockwave therapy, and knee injections can provide additional relief. Specialists may also be able clarify other causes of the problems.

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Dr. Matthias Kirchmayr Dr. Matthias Kirchmayr is a general practitioner who specializes in the treatment of the musculoskeletal system. He mainly works according to the fascia distortion model. View all posts by Dr. Matthias Kirchmayr »