Pes anserine tendinitis: symptoms and care

Three tendons meet near the inner side of the upper shin and help control the hip and knee. A sudden increase in running, walking hills, squats or other loading can exceed the tissue's current tolerance. Pain is usually local and may be reproduced when the muscles work against resistance. Ordinary [Muscle Soreness After Exercise](/symptoms/muscle-soreness-after-exercise/) tends to feel more diffuse and settles as the body adapts; focused pain that persists or changes your movement deserves assessment. A bursa lies nearby, so tendon and bursa irritation can overlap.

Reduce the most painful load without stopping every comfortable activity. A staged programme can restore hip, hamstring and thigh strength, coordination and tolerance for stairs or sport. [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) can tailor exercise and review technique. [Strength Training Rehabilitation](/treatments/physiotherapy-and-rehabilitation/strength-training-rehabilitation/) is usually progressed from controlled movements to the demands of your routine. Some clinicians discuss [Shockwave Therapy](/treatments/physiotherapy-and-rehabilitation/shockwave-therapy/) or a [PRP Injection](/treatments/non-surgical-orthopedics/prp-injection/) when symptoms remain persistent; suitability depends on the diagnosis and your health history.

Book an assessment when inner-knee pain persists, repeatedly returns, causes limping or prevents normal exercise. Seek prompt care for sudden severe pain, a clear pop with loss of strength, major swelling, inability to bear weight, fever, redness or a hot knee. Those findings may indicate a more substantial injury, infection or a problem inside the joint.

Which tendon or nearby structure is most tender? How should I adjust training while keeping fitness? What is the starting exercise and how will progression be judged? Would physiotherapy, shockwave treatment or an injection add value in my situation?