Medial Knee Pain

Written By: Chloe Wilson, BSc(Hons) Physiotherapy
Reviewed by: KPE Medical Review Board

Find out about the common causes of medial knee pain and how to treat them

Medial knee pain is pain that occurs on the inner side of the knee and can be due to a number of problems.

There are a number of structures on the medial side of the knee and problems in any one or more of these can cause pain.

Symptoms of inner side of knee pain may come on gradually over time or may develop suddenly after a knee injury. There may be a general inner knee pain, movement may be restricted or there may be a sharp pain.

It is very common to get pain on the medial side of the knee, because muscle weakness and/or tightness, which is very common, can subtly change the way the knee moves.

What Causes Medial Knee Pain?

Here we look at the most common causes of inner knee pain. See which one sounds most like your problem and then use the relevant links to find out loads more about each condition including symptoms and treatment options for each. 

MCL Tear

An MCL tear is the most common cause of medial knee pain in people under the age of 50. 

Medial knee pain is often the result of an MCL tear

What is it: Damage to some or all of the fibres of the medial collateral ligament on the inner side of the knee

Symptoms: Sudden onset from sudden twisting or a force through the outside of the knee. Medial knee pain with flexion, swelling, bruising, instability, stiffness

Aggravating Activities: Bending the leg, walking, stairs, sports

Features: There are three grades of MCL tear, depending on how severely you have damaged the ligament

Treatment Options: PRICE, knee brace, exercises

Find out more about MCL Tears

Medial Cartilage/Meniscus Tear

What is it: A tear in the cartilage lining on the inner side of the knee joint, known as the meniscus

A cartilage tear is a common cause of medial knee pain.

Symptoms: Sudden onset with awkward twisting or a force through the knee, or gradual onset through wear and tear. Causes medial knee pain, swelling, locking, instability and difficulty straightening the leg

Aggravating Activities: Walking, running, squatting, stairs especially going up

Features: There are four types of meniscus tear depending on how the cartilage has torn

TreatmentPRICE, exercises, surgery

Find out more about Meniscus Tears

Pes Anserine Bursitis

What is it: Inflammation of the pes anserine bursa, a small fluid-filled sac the reduces friction 

Pes Anserine Bursitis is one of the less common causes of medial knee pain

Symptoms: Gradual onset of medial knee pain approximately 2-3 inches below the knee joint, swelling, stiffness, weakness and affects sleep

Aggravating Factors: Climbing stairs, resisted knee flexion and exercise. Most common in overweight middle aged women or runners and swimmers

Treatment: Rest, ice, stretches, strengthening exercises, corticosteroid injections or occasionally surgery

Find out more about Pes Anserine Bursitis

Arthritis

What is it: Wear and tear most commonly to the cartilage lining the medial side of the joint

Osteoarthritis most commonly affects the inner side of the knee joint causing medial knee pain.

Symptoms: Typically come on gradually and include morning stiffness, inner knee pain, swelling, clicking/grinding, reduced leg movements. Most common over the age of 50

Aggravating Activities: Worse after prolonged rest or activity, cold weather

Features: There are three classification stages of osteoarthritis, mild, moderate and severe based on how badly the joint is affected.

Treatment: Depends on the severity but arthritis treatments include exercises, medication, heat/ice, acupuncture, injections and knee braces

Find out more about Arthritis

Medial Plica Syndrome

Medial Plica Syndrome causes inner knee pain

What Is It: Inflammation of a fold in the synovial membrane on the inner side of the knee

Symptoms: Anteromedial knee pain, tenderness, audible clicking sound when you move your knee

Aggravating Activities: Frequent knee bending and straightening, stairs, getting up after sitting or lying, squatting 

Treatment: Knee exercises, anti-inflammatories, rest, surgery

Find out more about Plica Syndrome

What Is Causing My Inner Knee Pain?

Let's have a look at the common symptoms associated with medial knee pain and what they typically indicate:

1. Pain On Inside Of Knee No Swelling: If there is no swelling with your inner side of knee pain, it is likely only a minor injury such as a small cartilage tear or a grade 1 sprain of the MCL

2. Inner Knee Pain Running: Knee pain medial side during or after running is most typically caused by a cartilage tear or Runners Knee

3. Inner Knee Pain When Straightening Leg: Pes Anserine Bursitis is the main culprit here as the bursa can easily get squashed when straightening the knee

4. Medial Knee Pain With Flexion: Most medial knee pain gets worse with knee flexion, especially when weight bearing through the leg. If it's worse when standing it may indicate MCL tear or meniscus tear, if it happens when you are sitting and bending, it may be pes anserine bursitis or plica syndrome

5. Anterior Medial Knee Pain: If your pain in inner knee is coming round to the front of the knee, it may actually be a problem with the knee cap or Runners Knee

6. Medial Knee Pain When Sitting Cross Legged: Pain in the inner side of knee when sitting cross legged is most likely due to a meniscus tear as this position places extra stress on the cartilage

7. Medial Knee Pain After Sitting or Lying: Inner knee pain that is at its worse when you first move the knee after sitting or lying down for a while tends to be due to knee arthritis. The pain usually eases once you are up and about. It could also be due to Plica Syndrome.

Why Is Medial Knee Pain So Common?

It is very common to get pain on the medial side of the knee, because muscle weakness and/or tightness, which is very common, can subtly change the way the knee moves.

This causes more force to go through the inner side of the joint, rather than distributing weight evenly through the whole joint, which results in damage to the inner side of the knee and therefore results in knee pain medial side. For example, it is much more common to get osteoarthritis on the inner side of the knee than the outer side.

How Do You Treat Inner Knee Pain?

Inner knee pain treatment will depend on what is causing the problem. In most cases, it helps to reduce any swelling and improve the strength and stability around the knee to take the pressure off the knee joint. In some cases, surgery will be necessary.

You can find out loads more about the best treatment for each cause of inner knee pain by reading the full articles list above.

Want to Know More?

Be aware that just because there is inner knee pain, doesn’t necessarily mean the problem is on the inner side of the joint. Pain can refer from different places such as the knee cap or even the back.

If your inside knee pain doesn’t sound quite like any of these problems, visit the Common Causes of Knee Pain section to find out about the most common knee problems.

Alternatively, if would like some guidance with working out what is causing your problem, visit the knee pain diagnosis section for help.

Remember, you should always see a doctor with any new onset of pain. To find out more about these common causes of medial knee pain, choose from the links above.

  1. Knee Pain Guide
  2.  ›
  3. Diagnosis
  4.  ›
  5. Medial Knee Pain

Page Last Updated: 09/16/19
Next Review Due: 09/16/21



Related Articles

Outer Knee Pain
September 14, 2018

How to make an accurate Knee Pain Diagnosis

Knee Pain Diagnosis
March 11, 2019

How To Treat Knee Pain

Knee Treatment
September 12, 2019

References

1. Journal of Orthopedics. Medial collateral ligament injuries. August 2017

2. The Surgery Journal. Synovial Plica Syndrome of the Knee: A Commonly Overlooked Cause of Anterior Knee Pain. February 2017

3. Arthritis Research & Therapy Journal. Functional electrical stimulation of gluteus medius reduces the medial joint reaction force of the knee during level walking. November 2016

4. Muscles, Ligaments and Tendons Journal. Meniscus tear surgery and meniscus replacement. May 2016


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