Here is my current enemy to consistent exercise.  Pes Anserine tendoniis/bursitis.  Those who say the stretching is not important are incorrect.  Improvements in strength and lack of flexibilty have brought this pain to light.

Essentially what is occurring is the Hamstring muscles tighten to a point where something has to give.  The insertion to the lower leg is where mine finally did.

I am working on flexibilty for my hamstrings and lower back and I am starting to see some improvements 

http://www.eorthopod.com/content/pes-anserine-bursitis-knee

What causes this problem?

Overuse of the hamstrings, especially in athletes with tight hamstrings is a common cause of goosefoot. Runners are affected most often. Improper training, sudden increases in distance run, and running up hills can contribute to this condition.

It can also be caused by trauma such as a direct blow to this part of the knee. A contusion to this area results in an increased release of synovial fluid in the lining of the bursa. The bursa then becomes inflamed and tender or painful.

Anyone with osteoarthritis of the knee is also at increased risk for this condition. And alignment of the lower extremity can be a risk factor for some individuals. A turned out position of the knee or tibia, genu valgum (knock knees), or a flatfootposition can lead to pes anserine bursitis.

Athletes are often instructed by their physical therapist or athletic trainer to perform an ice massage. A cup of water is frozen in a Styrofoam container. The top edge of the container is torn away leaving a one-inch surface of ice that can be rubbed around the area. The Styrofoam protects the hand of the person holding the cup while applying the ice massage. The pes anserine area is massaged with the ice for 10 minutes or until the skin is numb. Caution is advised to avoid frostbite.

Over-the-counter nonsteroidal antiinflammatory drugs (NSAIDs) such as Ibuprofen may be advised. In some cases, the physician will prescribe stronger NSAIDs. Your physical therapist can also use a process called iontophoresis.  Using an electric charge, an antiinflammatory drug can be pushed through the skin to the inflamed area. This method is called transdermal drug delivery. Iontophoresis puts a higher concentration of the drug directly in the area compared to taking medications by mouth. This process does not deliver as much drug as a local injection.

Improving flexibility is a key part of the prevention and treatment of this condition. Hamstring stretching is performed at least twice a day for a minimum of 30 seconds each time. Holding the stretch for a full minute has been proven even more effective.  Some patients must perform this stretch more often, even once an hour if necessary.

Do not bounce during the stretch. Hold the position at a point of feeling the stretch but not so far that it is painful or uncomfortable. Deep breathing can help ease the discomfort. Try to stretch a little more as you breathe out.

Quadriceps strengthening is also important. This is especially true if there are other areas of the knee affected. The quadriceps muscle along the front of the thigh extends the knee and helps balance the pull of the hamstrings.

A special type of exercise program called closed kinetic chain (CKC) is performed for six to eight weeks to assist with quadriceps strengthening. The CKC may include single-knee dips, squats and leg presses. Resisted leg-pulls using elastic tubing are also included. The exercise program is prescribed by a physical therapist and gradually progressed during the eight-week session.

If these measures are not enough, your physician may inject the bursa with a solution of lidocaine (an anesthetic or numbing agent) combined with a steroid (an antiinflammatory). The steroid injection can be diagnostic as well. If the symptoms are improved, it is assumed the problem was coming from the pes anserine bursa.