The ‘tightness’ and ‘achiness’ I’ve been feeling on my lower inner knee has been officially diagnosed by my sports chiropractor as a Pes Anserine Bursistis; which translates to inflamed bursa of inner knee. Quite frankly, I am at a loss for words. I don’t feel like I ‘earned’ this injury from doing something ‘glorious’ like training or racing. The irony is not lost on me.
Pes anserinus is the anatomic term used to identify the insertion of the conjoined tendons into the anteromedial proximal tibia. From anterior to posterior, the pes anserinus is made up of the tendons of the sartorius, gracilis, and semitendinosus muscles. The tendon’s name, which literally means “goose’s foot,” was inspired by the pes anserinus’s webbed, footlike structure. The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee. –MedScape
This is what MedScape says about Pes Anserine Bursistis pain symptoms and it pretty much describes me exactly (in addition to the fact I’ve noticed that it hurts/aches more in the afternoon/evening, while in the morning it just feels stiff):
Pes anserine bursitis can result from local trauma, exostosis, and tendon tightness. An occurrence of pes anserine bursitis commonly is characterized by pain, tenderness, and local swelling. Typical findings reported within the subjective examination may include the following:
Tenderness over the inner knee can occur, with pain upon ascending and, possibly, descending stairs. Patients typically deny pain with walking on level surfaces.
As I was ‘piecing together’ my workouts over the last few weeks (between little scribbles from workouts logged on calendar, journal and phone), I realized symptoms started showing up around the 12th of September (I originally wrote it off as ‘exercise soreness’). I don’t think that physical therapy visit was ‘the culprit’ because I didn’t feel any ‘acute’ pain during the visit. Only soreness later that day and that weekend.
9/2/12 Walk-Run #1: 2.77 mi (walked majority of that): felt twinges in left knee and hamstring area, iced, compression, no soreness later or next day.
9/4/12 Walk-Run #2: 2.75 mi same as above
9/5/12 Physical Therapy: filmed running gait, no soreness the following day.
9/9/12 Yoga-1hr: no pain during practice, no soreness after.
9/10/12 Walk-Run #3: 2.64 mi “fewer twinges than previously, again no soreness later or next day”
9/12/12 Physical Therapy: Last session. Achiness of area started occurring. Ice & comp
9/14/12 Yoga-1hr: No pain during practice, but achiness continued on/off that weekend. Ice & comp.
9/17/12 Home PT exercises: Did light warm up walk (no pain), tried to go through all exercises, but lunges aggravated it (so I only did things that didn’t hurt it)
9/19/12 Went to Chiro; told him about achiness, he stretched the area (felt stiff too and tender to touch) and did graston scraping. Sore for next few days.
9/21/12 Yoga -1hr: Lunge poses aggravated knee (better if I was on ball of back foot). Sore all weekend.
9/23/12 Walked 3mi: A little bit of twinge pain, but mostly achiness that night. Ice & comp.
9/26/12 Gym: 15 min walk (no pain), PT exercises (no pain), but in evening, achiness set in.
9/28/12 Yoga-1hr: modified all poses, no pain in area, but achiness on/off Sat. Sunday felt better.
*** October ***
10/1/12 Yoga-1hr: same as above. Less achiness in the evening
10/2/12 2mi Bike & 3/4mi Swim: Twinges of achiness during bike ride to pool (uphill), some achiness after 30min of swimming (went to pull buoy for last 8 min, arms only). LOTS of achiness in the evening. Wore compression socks to bed and felt better in the morning.
10/3/12 Chiro diagnosed me with PAB. Have to take it easy. He says I should be ok to walk 5k on Sunday, just wear compression socks or bandage.
Everyday: short dog walks (15 min or less) followed by 20min stretching 2x/day. (Now I stretch with foam roller, so it takes me longer to stretch than before ~ 10min). I also am in the habit of icing on/off a few times a day and practically living in my compression socks (as of 9/28).
Personally, I think a multitude of factors contributed to this:
1. Right leg got WAY more attention for stretching and exercising (aka left side neglected)
2. Probably should have foam rolled more often in general (since I found out my lower quads were SUPER AND PAINFULLY TIGHT, so I now do it religously every day)
3. I shouldn’t have relied more on my left leg while my right leg was healing (overcompensation).
For this injury, I do not need to go back to physical therapy, since my chiropractor can do many of the treatments to it (graston scraping, electro therapy, stretching). As with my R calf bursa (associated with hamstring strain), it will just take a few weeks to heal. And then I need to make sure I stretch, have balanced muscle groups and ease back into training slowly all over again. Of course I’m not happy, but there’s nothing else I can do. SOMEDAY I WILL GET BACK TO HAVING AN ACTIVE LIFESTYLE. My biggest regret is not knowing that letting myself have a haphazard workout schedule over the past year (pre May when I started training for half marathon) would be so bad for my body. During college, I never had any injuries, probably because I kept up an well rounded active lifestyle (swim, bike, run and yoga)… UGH! I am a sad bummed out gumball. Not sure what that means, but I identify with the Natalie Dee comic… 😦
Anyone else ‘lucky’ enough to have back to back injuries?