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Knee Pain and the pes anserinus tendons
Ross Hauser, M.D.
 

The most common cause of knee pain is not ligament injury. (We realize that this is shocking, since we have been explaining in past newsletters that ligaments are normally the cause of chronic pain.) The most common cause of chronic knee pain is weakness in the pes anserinus tendons.         

Below the knee cap, on the inside of the knee, are the attachments of three tendons
semimembranous, semitendinosus, and gracilis. Together, these tendons create the pes anserinus area. 

Ross remembers coming across a classic pes anserinus case while on rounds as a new doctor in the hospital. A 35-year-old nurse, told him her rheumatologist diagnosed her with arthritis and had prescribed
anti-inflammatory medication. When he examined her knee, he found that she had full range of motion. Full range of motion of the knee makes it unlikely arthritis is the cause of knee pain. On further examination, Ross was able to elicit a positive "jump-off-her-chair sign" when he pressed his thumb into the pes anserinus area showing pes anserinus tendonitis. Ross told her about Prolotherapy but she never chose to have treatment. She probably still suffers from the pain, because "arthritis" was not the cause. Even in cases where arthritis is the cause, it is never caused by an anti-inflammatory medication deficiency. Interestingly enough, if someone takes 
anti-inflammatory medication long enough they will probably get arthritis. 

      Maybe her rheumatologist was talking about the future? 

When Ross gives a presentation, he enjoys asking the audience, "What is the number one reason for severe knee pain in the elderly?" The overwhelming response is arthritis, which is incorrect. The number one reason for severe knee pain in the elderly is pes anserinus tendonitis which, when left untreated, may contribute to developing arthritis. Even in cases of significant arthritis, crippling knee pain is most often due to pes anserinus tendonitis or
bursitis. This condition is easily treated with Prolotherapy. 

The pes anserinus tendon, also known as the inside hamstring muscles, flex the knee and stabilize the inside of the knee. Most of us have very, very, very weak hamstring muscles that are very short because we sit for a large portion of our day. Many patients, especially those with fallen arches are prone to strains in these muscles. The tibia tends to rotate outward to compensate for the fallen arch. This outward rotation of the tibia places additional stress on the pes anserinus tendons. Eventually, these tendons become lax and are no longer able to control the tibial movement, adding to the chronic knee pain. An arch support may be prescribed to reestablish the arch. 

Prolotherapy injections along the arch of the foot will also prove beneficial. Prolotherapy injections into the pes anserinus attachments to the bone strengthen the tendon attachments and resolve the chronic knee pain. 

Prolotheray and Knee Pain Part 1  
Prolotherapy and Knee Replacement
Knee Cap - Patella Disorders and Prolotherapy
Knee Injury and Cortisone

Knee Braces

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Ross Hauser, M.D.
Dr. Hauser received his M.D. from the University of Illinois, Chicago; completed his residency at Loyola-Hines VA-Marianjoy Hospitals in Physical Medicine and Rehabilitation; and received his Bachelor of Science degree from the University of Illinois, Urbana-Champaign. Dr. Hauser is the Medical Director and co-founder of the physician-run, comprehensive natural medicine clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy. He, along with his wife Marion, have written seven books on the topic of Prolotherapy, a comprehensive book on the natural medicine approach to cancer, as well as a myriad of articles and newsletters for the general public. Read more
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Caring Medical and Rehabilitation Services,
715 Lake Street Suite 600 Oak Park, IL 60301
708-848-7789

The information on this website is presented as information only and not a self-help guide NOR AS SPECIFIC HEALTH RECOMMENDATIONS. Never alter or change your health management or begin any new health plans without first consulting your personal health care provider. Some statements on this site regarding the value of nutritional supplements have not been evaluated by the FDA.

As with any medical technique, Prolotherapy may not be effective for every individual and there are risks involved, these risks should be discussed with your physician. Results achieved with some may not be typical of all. Please consult a physician. Please read Prolotherapy Risks

There is no known cure for arthritis. Prolotherapy and nutritional supplements can help alleviate, reverse, or end arthritic pain by treating an underlying cause that contributes to degenerative disease, ligament laxity. Strengthening ligaments and other connective tissue can help prevent bone on bone arthritis from developing.

Caring Medical and Rehabilitation Services 715 Lake Street Suite 600 Oak Park IL, 60301