Skip to content
Knee & Sports

Pes Anserine Bursitis: inner-knee pain just below the joint.

Pes anserine bursitis is irritation of a small fluid sac on the inner side of the knee, a few centimeters below the joint line. It causes inner-knee pain and almost always settles without surgery.

Written bySteven J. Lee, MD · Double Fellowship-Trained · Hand & Sports Medicine
Last reviewed · May 2026

The pes anserine bursa cushions the tendons that attach on the inner side of the shinbone, just below the knee. When it becomes irritated, it produces pain and tenderness in that spot, often mistaken for a problem inside the knee joint itself.

It is common in runners, in people with knee arthritis, and in those carrying extra weight. It is a benign, self-limiting problem that responds well to simple measures.

Symptoms

Typical complaints include:

  • Pain and tenderness on the inner shin a few centimeters below the knee
  • Pain with stairs, rising from a chair, or at night
  • Sometimes mild swelling over the tender spot

How it is diagnosed

The diagnosis is clinical, based on tenderness localized to the pes anserine area rather than the joint line. Imaging is used mainly to rule out other inner-knee problems, such as a meniscus tear or arthritis, when the picture is unclear.

Dr. Lee's approach

Pes anserine bursitis is treated without surgery. Dr. Lee starts with activity modification, addressing any underlying cause such as tight hamstrings, gait, or knee arthritis, along with anti-inflammatory measures and a stretching and strengthening program.

A corticosteroid injection into the bursa relieves stubborn cases. Because the bursitis is often a symptom of something else, like arthritis or a training error, treating that underlying factor is what keeps it from returning.

Non-surgical treatment

The condition responds to simple measures:

  • Activity modification and addressing the underlying cause
  • Stretching and strengthening, especially the hamstrings
  • Anti-inflammatory measures and ice
  • A corticosteroid injection for stubborn cases

Recovery timeline

Recovery is usually steady over a few weeks:

  1. Weeks 0 to 4
    Activity modification, stretching, and anti-inflammatory measures.
  2. Weeks 4 to 8
    Progressive strengthening and a graded return to activity, addressing the underlying cause.

What patients commonly misunderstand

Two things to recognize:

  • It is not a problem inside the joint. The pain is from a surface bursa on the inner shin, not from inside the knee. Confirming that avoids unnecessary worry about a meniscus or cartilage problem.
  • It often points to something else. Pes anserine bursitis frequently accompanies knee arthritis, tight hamstrings, or a training error. Treating that underlying factor is what prevents it from coming back.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

Patient questions

Pes anserine bursitis, answered.

  • Is this a knee joint problem?

    It is not. Pes anserine bursitis is irritation of a small fluid sac on the inner shin, a few centimeters below the knee joint, not a problem inside the joint. The tenderness is localized to that spot, which is what distinguishes it from a meniscus or cartilage issue.

  • How is it treated?

    Without surgery. Activity modification, stretching and strengthening (especially the hamstrings), and anti-inflammatory measures resolve most cases, and a corticosteroid injection helps stubborn ones. Addressing the underlying cause, such as arthritis or a training error, keeps it from returning.

Next step

Tender, achy inner knee? A benign problem with a simple fix.

Pes anserine bursitis is a benign, self-limiting cause of inner-knee pain that responds to activity modification, stretching, and, when needed, an injection. The evaluation also confirms it is not a problem inside the joint.