having had chronic knee trouble supposedly caused by mild arthritis I have become quite attentive to how that area is feeling and have noticed that the tendons behind the knee ..particularly around the medial( inner side ) seem to give a feeling of being poorly aligned on full leg extension and kind of click / catch /clunk which seems to happen as they settle in place. If I pull them to one side with my hand they stop this and it only happens to my right leg/knee. I’ve read about “snapping pes syndrome?” and just wondered if others have had this trouble and whether you can do anything about it?
thanks in advance
Bill

This is interesting, I haven’t come across this before. Just to recap what you may well know already the pes anserinus (the goose’s foot) is where the tendons of three muscles share an insert on the posteromedial aspect of the knee. The three tendons together look a bit like a goose’s foot. So ‘Snapping Pes Syndrome’ is referring to this structure.

I’m guessing that because it has started now there has been some pysical change, either degenerative (everybody’s joint degenerate with age unfortunately, from the age of 25 onwards, and this is referred to a ‘osteoarthritis’) or muscle hypertrophy. Have you gained or lost weight or increased ot decreased your training in the last few months?

I have just had a quick read of this, it is very surgery happy but it looks like it was written by a surgeon so that explains that! 🙂

http://www.bjj.boneandjoint.org.uk/content/90-B/3/334

I have it in one leg, started after I snapped my femur, presumably as above due to muscle hypertrophy post injury. I’d assumed it would fix as my muscles returned, but still happens going up stairs.

Re: your diagnosis it does sound very likely because you are able to relieve your symptoms by changing the tendon allignment, however it is still possible that it may be something else such as a meniscal tear. My advice would be to see a physio, certainly mention the snapping pes syndrome- it is rare so they may need to do a little reading up! However this is better than hoping it will get better on it’s own. This article says that most cases are resolved with conservative treatment (ie physio) so that is promising.

I would advise against surgery unless as an absolute last measure, particularly as you are already experiencing some arthitic changes and pain! Removing the gracilus and/or the semitendinosus inserts are certainly unlikely to help this and have a high likelihood of making it worse unfortunately 🙁

I’ve had something similar to this, generally only running though. It was related to multiple hamstring injuries (in a roundabout way). My glutes aren’t strong enough and cause the hamstring to play up when its fatigued

Have been doing lots of squats and it seems to be getting better. Maybe go see a hamstring specialist?

I’d assumed it would fix as my muscles returned,

Often you need to target a muscle specifically rather than waiting for it to return to it’s previous condition through normal everyday use. This increases with age unfortunately.

Yes I’ve read the article ..tendon harvesting and all that!
I’ve lost a bit of weight but not changed things much and am currently trying to strengthen my knee with squats etc on a regular basis. I’m going to try some serious massage of the area /foam rolling etc but hopefully it’ll disappear on it’s own . doesn’t really hurt but is a little unsettling . I guess i could have had it for years and only just noticed ..particularly with the squat regime? When i feel the tendons they feel a bit rough whilst moving about ..difficult to explain and there’s none of that in the other leg .

any ideas what else i could try? I’m pretty sure i tore or squeezed the medial meniscus on that leg about 15 yrs ago ..bloody painful for a few weeks but the it seemed to resolve itself. I’m 53 btw
much appreciate all the advice

I guess i could have had it for years and only just noticed

You are likely to have noticed if you had noticed, if you know what I mean! 🙂

I’ve lost a bit of weight but not changed things much and am currently trying to strengthen my knee with squats etc on a regular basis.

I certainly wouldn’t want to discourage any of this!

Are you also taking care to also strengthen the hip adductors/abductors? They are often overlooked and have an important role in keep your knee moving efficiently and pain free.

No i have not done any work on the hips but will do following your advice!
From the sound of it I presume you’re a healthcare professional ?
getting older and the accompanying physical problems are frustrating but at least it/they didn’t start when i was young and i have much to be thankful for It’s so easy to focus on what’s wrong rather than what’s right! Bikes and biking are a big part of my life so anything that affects that like my knee troubles causes me anxiety but hey ho ..that’s life!