For a right-handed golfer, a significant amount of torque and valgus stress is generated at the left knee. The right hip extensors and abductors and left adductor magnus initiate left pelvic rotation during the forward swing. The left leg is the follow through or the finish leg. Let's take a brief look at what happens in the golf swing. He originally said "nothing that I can think of." So as a massage therapist going through the list of how and why did this happen, what would be a good question to ask next? You got it did he happen to change his stance or shoes? His answer was, "yes at the last minute I decided to change to my other golf shoes." What is different from the golf shoes you were wearing before and the ones you decided to play in yesterday? "Well they are stiffer, not as much give in them." Okay, now as a therapist, what are you thinking might have caused this injury? You got it again possible more torque at the knee joint was created by a stiffer golf shoe. I asked him what was different in yesterday's game of 18 holes of golf. Over time, his left hip has lost internal rotation and he has a chronic right SI issue contributed from playing too much golf.
PES ANSERINUS TENDINITIS PLUS
He had a previous lumbar surgery 20 plus years ago. He is in his mid-seventies and in great physical shape, with the exception of a few minor aches and pains.
This client has been with me for the past 18 years as both a training client and a massage therapy client. The first case was a golfer who presented with left Pes Anserine symptoms. They will experience pain when getting up out of a chair or when contracting the hamstring muscles against resistance. The client will also point to the inside of the knee, particularly the lower part just below the joint line. Pes Anserine Tendonitis is often difficult to distinguish from a medial tendon or ligament injury because the symptoms are similar and both are likely to be painful when stressing the inside of the knee joint.
This can result in bursitis and/or a tendinopathy otherwise known as a tendonitis. This bursa may become inflamed due to repetitive friction in sports such as golf, cycling, running and swimming.
In this area is a bursa called the anserine bursa which lies between this combined tendon attachment and the tibia bone underneath. The semitendinosus muscle, sartorius, and gracilis all attach together onto the tibia at the inner part of the lower knee joint. The Pes Anserine Bursa is also known as the goose's foot bursitis because the three tendon's that attach at the lower part of the knee and press on this superficial bursa resemble a goose's foot.
PES ANSERINUS TENDINITIS HOW TO
We will also look at how to differentiate a medial meniscus tear from Pes Anserine Tendonitis and we will also discuss what a treatment plan would look like. In this article, I want to give you some examples of how clients can develop Pes Anserine Tendonitis. To quote the physical therapist Gary Gray, "the knee is just the dumb guy in the middle." The knee is a devotee to every movement that is made well or poor by either the hip or ankle joint. What do you think stiff golf shoes, playing with a child, riding a bike, running and swimming breast stroke would all have in common? Well, they each require knee joint involvement.
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