Pes anserine bursitis or tendonitis (PATB)

What is it?

Pes anserine bursitis/tendonitis is a painful, inflammatory condition affecting the tendons and/or lubricating sac (bursae) between your shinbone and the hamstring tendons at the inside of your knee; typically caused by stress to the area. Specifically, the pes anserinus is the area where the tendons of 3 muscles (sartorius, gracilis, and semitendinosus) come together. The three tendons merge together in the skin of the bone on the inside surface of the shinbone. The term, pes anserinus means "goose´s foot" in Latin - owing to the webbed-foot pattern the three tendons make when they meet.

About the Pes Anserine

These three muscles are the dominant knee flexors; they influence the rotation of the tibia and protect the knee against rotary stress. Inflammation of the bursae or tendons serving these muscles usually develops due to overuse, trauma, or degradation typically from:

• Tight hamstrings
• Obesity
• Poor sport technique, including improper warm-up, excessive hill work, increased mileage
• Biomechanical issues, such as foot rolling, out-turned knees
• Osteoarthritis
• A medial meniscus tear

Causes

Pes anserine bursitis and tendonitis is common in athletes (particularly runners), overweight individuals, and often, people with osteoarthritis of the knee. The symptoms of pes anserine bursitis include:

• pain located 2 to 3 inches below the kneecap
• swelling in front of the kneecap (prepatellar) or underneath the kneecap (infrapatellar)
• Pain increasing with exercise or climbing stairs
• Pain and often warmth and tenderness when touched
• Pain when bending or straightening the knee.
• Pain that radiates to the back and inside of the thigh
• Visible swelling and/or redness of the tendon sheaths (tendonitis)

It is generally agreed that hamstring tightness is the most common cause of pes anserine bursitis/tendonitis. Athletes and non-athletes alike need to ensure their hamstrings are properly warmed-up and stretched before they place any stress on their knee; from extensive hill running to simply climbing stairs. If you are susceptible to PATB or are suffering from it now, you need to take steps to prevent re-injury or ensure recovery.

Prevention

To prevent pes anserine bursitis/tendonitis, it is important to first eliminate any of the underlying factors contributing to the condition. Ask your doctor or physical therapist to take a look at your gait and your posture to see if there any biomechanical issues that need to be addressed. Secondly, get advice from your physical therapist or trainer on setting a training schedule that fits your ability. Thirdly, but most importantly, warm up your hamstring and then stretch prior to activity!

Treatment

Ultrasound is an excellent tool for reduction of swelling and pain when treating pes anserine tendonitis. When inflammation occurs, rest the area, apply ice for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day up to 3 days. Blood Flow Stimulation Therapy may be used after the acute swelling is improved. Ice will reduce initial inflammation and swelling and Blood Flow Stimulation Therapy increases blood flow through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area, helping the tendon heal more quickly.

If stitching of the tendon is required, do not use ultrasound on the area until all scabbing or wounds on the skin surface are gone. As well, allow 60-90 minutes between cold therapy treatments and ultrasound therapy or Blood Flow Stimulation Therapy to return the area to normal body temperature before beginning a different treatment.

The trick to any tendon injury is getting it to heal with minimal scar tissue formation and with as much realignment of tendon fibres as possible - something both Blood Flow Stimulation Therapy and therapeutic ultrasound are great at! Even with optimum healing there is always less elasticity in a previously injured tendon. The trick is to make sure you heal this the best you can, that way your chance of reinjury down the road is much lower than average.

Therapeutic Products

Blood Flow Stimulation Therapy

You can help your body repair itself by speeding its natural healing process using an Inferno Wrap™. The Inferno Wrap's patented design delivers the most effective Blood Flow Stimulation Therapy you can find. During normal activities, the movement promotes blood flow through our body. Our body responds to the movement by sending oxygen and nutrient-rich blood to the muscles, joints, tendons and other soft tissue in the body. When at rest, the blood flow to your tendons is greatly reduced. Unfortunately, when your tendon is injured it requires rest but it also needs the blood flow to promote the healing process. Since you can't work your tendon without danger of further injury, you need to stimulate the blood flow another way. Our innovative Inferno Wrap™ gives you the best Blood Flow Stimulation Therapy available. The Inferno Wrap™ creates energy waves that stimulate blood flow by penetrating through the outer layers of your body. The energy waves reach deep into your muscles, tendons and cartilage, reducing your pain as they heal the inner tissue.

An Inferno Wrap™ gives you unparalleled blood flow stimulation to your injured tendon. You simply won’t find a comparable product on the market. Other therapy products can not come close to offering the comfortable, contoured fit and targeted energy treatment an Inferno Wrap™ provides. You will experience a soothing, penetrating warmth deep in the tissue as it works to stimulate your blood flow, we guarantee it. Now you can reduce your pain and heal yourself with the comfortable, light weight Inferno Wrap™.

The Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief with no side effects.

When your tendon has healed somewhat and it comes time for more aggressive rehabilitation, stretching and activity, Blood Flow Stimultation Therapy warms the muscles in the injured area which increases range of motion and allows for a safer more thorough stretch.

Therapeutic Ultrasound

Ultrasound Therapy is also a great tool for pain prevention of tendonitis or healing a tendon tear, and having a therapeutic ultrasound device at home can be a powerful and convenient treatment tool. If you have symptoms of tendonitis or are recovering from a tendon injury, using ultrasound on a regular basis before your activity or throughout the day will help relax your tendons and muscles, diminish pain and inflammation, soften scar tissue and contribute greatly to the healing of your injury.

Therapeutic Ultrasound heats and massages your soft tissue giving you three primary benefits. First, it increases blood flow in the treated area which speeds your body's natural healing process. Second, it reduces swelling and edema which are the main sources of pain. Third, ultrasound softens existing scar tissue and minimizes the build up of new scar tissue resulting in reduced pain while healing and greater flexibility once healing is complete.

Eucalyptus...
It's in our Gel!

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with Phonophoresis is rapidly becoming more popular than Ultrasound Therapy alone.

Peppermint...
It's in our gel too!

Our MendMeShop Lavender Infusion Gel is the only topical therapeutic gel that is also a Phonophoretic Ultrasound Gel. It is made with natural medical ingredients including eucalyptus, peppermint, Bulgarian lavender and menthol. These effective ingredients have anesthetic, anti-inflammatory, analgesic, decongestant, and circulatory stimulant properties. When applied topically and massaged into the skin, MendMeShop Lavender Infusion Gel relieves pain and speeds healing without any side-effects.

Cold Compression Therapy

Our cold compression wraps work by interrupting and slowing nerve and cell function in the area of your injured tendon. Once blood vessels are damaged they can no longer carry oxygenated blood to the damaged tissue and therefore cells begin to break-down. The deep cold provided by our cold compression wraps slows cell function thereby reducing cellular break-down. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain!

Our Cold Compression Wraps are recommended as the top wrap by Leading Health Institutes like, Cleveland Clinic, several professional sports organizations, and countless medical professionals. That's why we sell them, because they are the best. We have noticed over time that our customers are so fond of our cold wraps that they are frequently coming back and ordering a second one - this way they can cool one while wearing the other.

Always allow the injured area to return to normal body temperature between hot and cold treatments by waiting 60-90 minutes before applying a different therapy.