Just been diagnosed with Pes Anserine tendinitis and am now in a funk with IMFLA 7 months away. Anyone have experience with this? Success?
Thanks
Tendinitis or bursitis?
Went through this in November after returning from my vasectomy and ramping up too quickly.
I will reply in more detail later today… On my phone currently
MRI results will be reviewed this thursday but initial diagnosis is tendonitis, not bursitis
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Thanks
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Interesting. The pes anserine is three tendons that come together at you medial knee. Did they isolate which tendon it was, or is it all three?
Anyway, not wanting to derail the thread.
Yes I have had it pretty bad - I got PES after a second knee surgery from imbalances. There is a very good stretch you can do for this which helped me a lot.
Standing, spread your legs as far apart as humanely possible without busting your groin! With your legs spread wide, turn your two feet outwards as far as you can, then bend over at the hips and hold for 10 seconds. You will be able to isolate the pes this way.
I also did a lot of hamstring and quad stretching during this process.
Tri…They have not yet isolated which tendon, but based on what I have read, one that is inflamed will aggravate the other two. I am not a radiologist so I have no idea if an MRI will show enough detail to identify the exact tendon
titemple…How long were you off from running? how often would you perform that stretch? Any strengthening exercises?
Thanks
Any way, not likely to matter. How acute are your symptoms? Is it a constant ache or just pain following activity? Do you respond to Ice, anti-inflammatories currently or not?
OK, here’s what helped me when i went through this when it started in November.
I was diagnosed with Pes Anserine tendonitis (incredibly tight/tender/sore to the inside/beneath each knee). I went through ridiculous tightness in my inner thighs, it was very painful (the sartorius muscle/tendon was the culprit).
I made an idiot move of adjusting my cleats at the end of last season and forgot I did it when i started this season after time off from vasectomy and general end of season - my inner thighs could not keep up with the demand of my cycling
November 1st: First sign my inner knees were sore
November 10th: Thought it was a running injury, stopped running
November 17th: It got much worse, realized it was both cycling and running doing this. Stopped them both.
November 20th-ish, diagnosed
I took until the first couple weeks of december completely off running and biking and did a massive swim volume.
Sure my swim was reaching all time highs, but my legs were not getting any better.
Here’s what helped:
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Foam rolling with a traditional roller did absolutely nothing.
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It was not until i got a lacrosse ball that really dug into my inner thighs that i started to feel improvement. It really hurt. Any type of really hard and small ball will do. A tennis ball is a start in terms of shape but a bit too squishy.
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Never roll over the inside of your knee at the insertion point. That made it much worse. I’d get close to it and then go all the way up into my groin by laying on my stomach and rolling on the ball pushing my body forward in a push-up position
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I started doing inner thigh exercises. Sit on your couch, get a good thick pillow between your knees and squeeze 20, 50, 100 times, whatever you can. Then put it between your ankles and do the same.
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The day after these thigh exercises, my knees felt worse, but they would soon get better
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I started stretching my inner thights and my main quads very well. I was surprised at how much a traditional quad stretch helped.
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I started running again in January. Extremely carefully. Treadmill only, with a large incline 6%. The incline was because I felt almost no pain, because my knee was at a different flex and didnt straighten as much to aggravate it.
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When I started running, I would do 1 or 2km, stop, roll with the ball, walk for a bit, then do another 1 or 2km, repeat. If any pain while running, I stopped
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January cycling was very very careful. I started with two 15 minute rides, then next week two 30 minute rides, then two 45 minute rides, then two hour rides.
Once i got to february I felt confident i could ramp up a little bit and did.
I’m now in full swing (12-15 hours/week) and have gotten through this. My IM (Whistler) is in July so you have more time than I did when i started to take this seriously (january) and my training is very much on pace now. You can recover.
Other than the above, I would still recommend stopping everything for a week or two before starting to strengthen and stretch (perhaps you have already)… during this time, swim your ass off
I have chronic knee problems and can’t run, may never again and that is fine as I am a roadie anyway. It took about 6 months to full resolve, and during this time I also worke don strengthening my core as well as stretching my hip flexors. There is an awesome book I bought by Tom Danielson and Allison Westfahl "*Tom Danielson’s Core Advantage " *that has a lot of cyclist specific core, hip and back stretching/strenghening exercises that helped me a lot. Where I live there are not a lot of phsiotherapists who know a lot about cycling biomechanics so this book helped me a lot.
vancity…Thanks for all that feedback. My injury does NOT get worse with cycling. I can feel it occasionally while standing but never while sitting or after any of my rides. I guess i am a bit luckier in this sense- maybe my aggravator is a different tendon than yours…? Did you go to a physical therapist for this routine?
My pain is on the inside of the knee and lower (like yours). I also feel it behind the knee (inside) where the hamstrings tendons are so I’m guessing that the hamstrings are the culprit.
Yeah i went to a performance center / PT and did some massage therapy too (massage didnt do anything – if it was more ART style it would have been better)
In my research I definitely came across tight and weak hamstrings being a cultprit for pes anserine issues.
You should talk to a PT, atleast one discussion.
I failed to mention in my description that i’m also doing lots of hamstring work. I just didnt want to leave any stone unturned to get this fixed.
I started doing straight leg deadlifts holding dumbells, really focusing on pulling with the hamstrings on the way up. The first day I did these, my hamstrings cramped so bad. That was a big clue that my hamstrings were no good.
I bought 10lb ankle weights:
I’ll lift my foot to my butt 50 times each leg every monday now. It really burns but after 4 months of this and the deadlifts, my hamstrings have never been stronger.
Talk to a PT, but it will come down to: rest it a bit, find what’s weak and strengthen it, and stretch it/roll it. Like me, I wouldnt leave anything to chance. Do everything you can with your legs to strengthen and find out what’s weak and tight, from hips, glutes, hamstrings, quads, abductors/adductors, etc.
It’s pain after running that lessens daily with rest (from running). I ran last week on the TM for the first time in 4-weeks ( 1 minute on 1 minute walk X 20) and didn’t feel much during the run. The next day was another story altogether and the second day was even worse. The anti-inflammatories seems to work until I run again. I am afraid that I have a mechanical, flexibility, or imbalance issue that needs to be fixed
It’s pain after running that lessens daily with rest (from running). I ran last week on the TM for the first time in 4-weeks ( 1 minute on 1 minute walk X 20) and didn’t feel much during the run. The next day was another story altogether and the second day was even worse. The anti-inflammatories seems to work until I run again. I am afraid that I have a mechanical, flexibility, or imbalance issue that needs to be fixed
You likely do. There are specific stretching and strengthening exercise that help, however they need time, and time is not on your side. Find a good PT to teach you how to isolate the area with stretching. I would certainly be icing the area after each run, multiple times the night following etc.
One thing I have had success with (This is pure anecdote from my practice) that you can do yourself is a pes anserinue kinesio tape. You can find videos on line of how to do it. This is effective in cases of bursitis typically. You have nothing to loose but 10-15 dollars for a roll of tape and some time.
Tri…Oh no, there is no running these days- too painful after and it sets me back. Once i am able to do everything else (daily activities) I will start easy and ice afterwards. As for now, I’m cycling and running on the elliptical without issue. I have the MRI follow up tomorrow so we’ll see if there’s not more going on. If not I’ll be sent to PT.
What was your experience?
It’s pain after running that lessens daily with rest (from running). I ran last week on the TM for the first time in 4-weeks ( 1 minute on 1 minute walk X 20) and didn’t feel much during the run. The next day was another story altogether and the second day was even worse. The anti-inflammatories seems to work until I run again. I am afraid that I have a mechanical, flexibility, or imbalance issue that needs to be fixed
You likely do. There are specific stretching and strengthening exercise that help, however they need time, and time is not on your side. Find a good PT to teach you how to isolate the area with stretching. **I would certainly be icing the area after each run, multiple times the night following etc. **
One thing I have had success with (This is pure anecdote from my practice) that you can do yourself is a pes anserinue kinesio tape. You can find videos on line of how to do it. This is effective in cases of bursitis typically. You have nothing to loose but 10-15 dollars for a roll of tape and some time.
I am a PT. My experience is treating the condition. I have never had this particular pathology. Pain sounds bad… Let me know the MRI results.
As a note, I hardly ever give advice or talk about this stuff on the forum as it is never very useful to give advice on a pathology I can not physically assess. But I am interested in the MRI results
All…Thanks for the feedback. Unfortunately I got my results back this AM and found out that I have a torn meniscus- maybe some pes tendinitis as well 
I’ll prolly start a new thread on recovery for scoped meniscus.
Pm’ed this too you, but thought it would be good for all in forum interested.
http://www.ossur.com/injury-solutions/products/knee/ligament-braces/rebound-cartilage
I have fit a few patients with this brace and have good anecdotal experience with post knee surgery with this brace. It unloads the repaired compartment.