The pes anserinus or "goose foot" hurts, so now what?

Roman Koch 14. September 2021

Foto: Adobe Stock/travnikovstudio

The pain on inside of your knee, which was bearable at the start, is now radiating upwards and downwards, forcing you to stop. Here you can discover how «goose foot» pain develops and how to make it disappear again.

This article is brought to you by Spiraldynamik

The goose foot lies on the inside of the knee on the tibial plateau. It is the conjoined insertion of the tendons of three muscles (sartorius, gracilis, and semitendinosus). The inflammation of this tendon insertion and the associated bursa is referred to as Pes Anserine Bursitis. Or colloquially, goose foot pain.

When the direction of rotation is critical

The leg axis determines the development of Pes Anserine Bursitis. The thigh is normally in an external rotation position and the lower leg in an internal rotation position. This «rotates» the leg axis in such a way as to create stability. However, if the lower leg is rotated too tightly outwards and the thigh too tightly inwards, this pulls on the insertion point of the above mentioned muscles. This results in inflammation at the tendon insertion, the goose foot pain. What’s more, there is now functional instability since the leg axis has become «unrotated». With each step the irritation increases. Each flexion and extension places more tension on the structures, whereby the pain soon makes movement impossible. Will good advice now be expensive? Maybe not. Because the rotation position in the knee is the key to solving goose foot pain.



External above and internal below

First of all, the thigh needs a slight external rotation, so that the knee is facing forward. The small deep gluteal muscles rotate the thigh outwards. Secondly, the lower leg needs to have a slight internal rotation, so that the foot points in the same direction as the knee and thigh. The crux of the matter is this: the knee joint itself is often fixed in a rotational misalignment and first needs to be mobilised. It is the shortened and tense outer knee and thigh that cause the lower leg to have external rotation. This structure must therefore be relaxed so that the lower leg has internal rotation again.