Massage therapy · Kitchener–WaterlooPes Anserine Bursitis

Other knee problems with similar symptoms, such as a stress fracture, a strain or tear of the medial collateral ligament, or a medial meniscus tear, should be ruled out (AAOS, n.d.a).

The anterior cruciate ligament (ACL) stops the tibia sliding forwards in front of the femur and helps keep the knee stable when it twists. The medial and lateral collateral ligaments, on the inside and outside of the knee, control side-to-side movement. The posterior cruciate ligament (PCL) stops the tibia moving too far backwards (AAOS, n.d.b).

1. Ice

Apply an ice pack to the affected area 3 or 4 times a day for 20 minutes at a time (AAOS, n.d.a). Wrap the ice in a thin towel and never put it directly on the skin, to avoid ice burns.

2. Rest

Take time to rest from any activities that are causing pain in the knee. Either stop the activity until the bursitis settles, or find an acceptable substitute (AAOS, n.d.a). Start by reducing the time you do the sport, how often you do it, or how hard you go, and see if that helps. Ask your healthcare provider when you can return to your normal routine (Cleveland Clinic, 2025).

3. Medication

AAOS OrthoInfo (n.d.a) says that anti-inflammatory medicines (NSAIDs), such as ibuprofen or naproxen, may ease the pain and reduce inflammation, and that an anti-inflammatory gel such as diclofenac gel can also be used. (This medicine information comes from AAOS OrthoInfo, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

4. Biomechanical Assessment

A podiatrist or physical therapist may look at your lower limbs to see if there is an alignment problem in the legs. I can also assess how your legs line up when you stand, walk and move. If your pain is linked to the alignment of your knee, wedge insoles may help keep your leg in a better position (Cleveland Clinic, 2025). I can help you work out whether insoles might help and how to get them, and point you to a chiropodist or podiatrist if you need custom orthotics.

Options outside my scope

• Steroid injection: a doctor may inject a mixture of a local anaesthetic and a steroid into the bursa, which often gives prompt relief; Cleveland Clinic describes this as being used in rare cases (AAOS, n.d.a; Cleveland Clinic, 2025).
• Platelet-rich plasma (PRP) injection: an injection made from a sample of your own blood, intended to promote healing (Cleveland Clinic, 2025).
• Scans: an X-ray may be needed to rule out a stress fracture, and sometimes an ultrasound or MRI scan (Cleveland Clinic, 2025).
• Surgery: rarely, in severe cases, the bursa may be removed surgically (Cleveland Clinic, 2025).

How I can help (see the My Approach tab)

Work on the inner thigh is only done with your informed consent and a signed consent form. If you also have knee osteoarthritis, I keep things gentler and build up more slowly. I'll look at your training habits and footwear, help you work out whether a wedge insole would help and how to get one, and point you to a chiropodist or podiatrist for custom orthotics. A hot, red, very swollen knee, especially with a fever, needs to be seen promptly by your family doctor or nurse practitioner.