Bursae at the distal hamstring insertions — semimembranosus at the posteromedial tibia and biceps femoris at the fibular head — reduce friction at their bony attachments. The semimembranosus bursa at the tibial insertion contributes to the pes anserinus complex.
Semimembranosus insertion bursitis at the posteromedial tibia contributes to posteromedial knee pain, partially overlapping with pes anserinus bursitis. Biceps femoris insertion bursitis at the fibular head produces posterolateral knee pain near the LCL. Both are managed with injection targeting the specific tendon-bone interface and addressed as part of proximal tibiofibular or posteromedial corner pathology.
Bursal inflammation at the semimembranosus or biceps femoris tibial/fibular insertions producing posteromedial or posterolateral knee pain reproduced by resisted knee flexion and direct pressure over the insertion.
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