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How to Resolve the Bursitis in Your Knee

By Dr. Molly Casey

Bursitis in the Knee

Nagging pain around the knee can be incredibly irritating beyond the physical symptoms. It can wreak havoc with getting in and out of a seated position, standing for long periods of time, and doing your daily chores. Nagging knee pain can blow up your exercise routines which, for many, can negatively impact mental health.

All of these factors can wear on your ability to get regular tasks done and drive you a little bit crazy. One often overlooked reason for nagging knee pain is pes anserine bursitis.

If you have nagging knee pain, see if this fits the bill and discover what can be done to help you help yourself.


Taking a trip down the leg, the sartorius and the gracilis muscles of the adductor group (inner thigh) and the semi-tendinous muscle of the hamstring converge over the medial (inside) aspect of the knee and attach into the top medial portion of the tibial bone (shin bone.)

The pes anserine bursa, a small fluid-filled sac, sits beneath the area where these three tendons converge and attach. It sits on the tibia, so it is between the bone and the tendons. The purpose of the bursa is to promote proper and smooth motion of the tendons over the bone. It helps proper gliding by offering a bit of a cushion and decreasing friction between the surfaces.

Bursitis Causes and Symptoms

Pes anserine bursitis is a condition that occurs when the bursa itself becomes irritated and produces too much fluid and swells. It then puts pressure on the tendons of the three muscles that cross it and the surrounding structures. This condition, and why it occurs, can be caused by a variety of reasons. One of the most common reasons is chronic overuse of the muscles; runners can experience this, especially if they are increasing training before races.

Other causes can include, but are not limited to, poor hip and knee movement or coordination, improper form during exercise, tight hamstrings, weak adductors, muscle imbalances, trauma to the knee, and obesity. The main symptoms are tenderness over the inside portion of the knee that often increases with getting up from a seated position, climbing stairs, and/or fully bending or straightening the knee.


Chiropractic care improves the overall function of the body through optimizing nervous system function and improving communication between the brain and the body. The chiropractic adjustment increases and/or restores spinal joint range of motion, which in turn relieves structural interference with the master communication system of the body. Nerves that exit the spine to innervate the sartorius, semitendinosus, and gracilis muscles, and the knee joint itself, exit the lumbar and sacral areas of the spine. Chiropractic adjustments to these areas to improve brain/body communication is a wise choice in the healing process.

Rest from activity that aggravates the area is important, at least to the greatest degree that it’s possible or reasonable to rest the knee. Because the area is irritated, even “normal” activity can irritate it further. This does not mean you must immobilize the area. You don’t want muscles to atrophy, so movement is good; however, too much movement or stress from physical loading or repetitive exercises can increase symptoms.

Manual therapy and rehabilitation exercises are often necessary to fully recover. Physical therapy is a great option and will address the tight and overworked muscles, as well as assist proper activation, strengthen weak muscles, and promote proper form during function. When the anatomical structures in the area are functioning properly, the bursa can settle and healing can occur.

Pes anserine bursitis can be quite painful and irritating to daily life. However, it is very much treatable through chiropractic. Your body can heal given the opportunity and right environment.

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