Common Causes And Presentation Of Inner Knee Pain

Causes Of Inner Knee Pain

Three of the most common causes of inner knee pain we see in our Randwick and Sydney physio practices all have slightly different presentations from each other. Difference with regard to their onset, the behavior of their symptoms, as well as the activities that aggravate the pain. Obtaining an accurate diagnosis as always is useful in helping ensure the appropriate management of any complaint and this is also the case with regard to inner knee pain. Information gained from understanding the subjective presentation of the issue specifically the nature of the onset of symptoms and the reaction to loading goes a long way towards establishing an accurate diagnosis. A few of the common causes of inner knee pain include medial meniscal complaints, medial collateral ligament injuries and osteoarthritis of the knee, these three causes of knee pain are discussed in more detail below.

Medial Meniscal Complaints

The onset of medial meniscal issues is a common cause of inner knee pain and can be the result of a sudden incident involving twisting of the knee in a bent position. Or of a more degenerative origin, whereby in these circumstances the onset of symptoms may come on more gradually over time more so than any specific traumatic event.

• Symptoms of medial meniscal complaints causing inner knee pain can include any, or all of the following… Swelling, clicking, catching, locking with movement with difficulty when attempting to fully straighten or bend the knee. Sometimes subjective feelings of instability will also be reported feelings as if the knee gives way, however this is often perceived instability more so than true instability of the knee.
• Aggravating activities with medial meniscal issues will often include (but not limited to) squatting motions, kneeling, going up and down stairs, running and sometimes walking.

Medial Collateral Ligament (MCL) Sprains

Medial ligament sprains of the knee occur as a result of a sudden trauma to the knee. Where the stress to the knee forces the foot laterally (outwards) with regard to the knee joint (or conversely sends the knee inwards with regard to the foot). Such injury can occur with the foot planted on the ground when landing awkwardly leaping or jumping, sudden twisting when running, or changing direction or as a result of an external force as occurs during a rugby tackle… MCL injuries can also occur with the foot off the ground, an ill-timed, or excessively forceful side footed tackle playing soccer tackle could be one such way an un-weighted MCL sprain can occur.

• Symptoms of medial ligament sprains may include some swelling and bruising around the inside of the knee. The presence of swelling and bruising often depends on the severity of injury and commonly a grade I injury will have limited swelling or bruising, and these signs are variable with higher grade injuries.
• An MCL injury is typically accompanied with reported feelings of instability often noticed with simple daily activities like getting in and out of a car and turning a corner when walking.
• In the acute phase there is often a feeling of mild stiffness in the knee with a painful limitation or movement into full bending and straightening of the knee. And in the acute stage simply walking and activities including navigating stairs may be painful and stiff causing inner knee pain.
• Following injury turning and twisting movements common place in sport will aggravate the knee often proving impossible in the short term due to pain and instability.

Osteoarthritis Of The Knee As A Cause Of Inner Knee Pain

Inner knee pain resulting from osteoarthritis typically will present as a pain coming on gradually. Generally, osteoarthritis of the knee is more common to occur in individuals in their late middle-age and beyond and the onset is regularly in the absence of any acute reportable trauma.

• Depending on the severity, symptoms of knee osteoarthritis can include “around-the-clock” pain. More continuous, not simply related to loading of the knee or stressful activities.
• The most commonly reported symptoms are joint pain and stiffness. Where any pain and stiffness may be worse with moving following being sedentary for a period of time. The stage and severity of the disease dictates severity however osteoarthritis will commonly limit movement at the knee joint both bending and straightening the knee relatively evenly as well producing sensations of clicking or grinding in the knee.
• It is also not uncommon individuals experiencing osteoarthritis will notice that cold weather aggravates their inner knee pain and makes the knee feel stiffer.
• Depending on the severity inner knee pain resulting from osteoarthritis of the knee will affect simple day to day activities as the disease progresses, including walking and climbing stairs and will almost always cause some element of discomfort with higher load activities such as running or squatting motions.
• Not always by frequently with osteoarthritis of the knee the individual will report a family history, previous high levels of loading activities in their younger years and/or a previous trauma to the knee followed with continued high levels of activity that “started” the disease process.

Symptoms Of Inner Knee Pain & Distinguishing The Underlying Cause

In summary inner knee pain is commonly accompanied with a number of other signs and symptoms, some of the more typical signs and symptoms associated with inner knee pain of the above causes include:

• Restricted Mobility: The mobility of the knee can be affected by a number of conditions, an acute MCL or medial meniscal injury can cause restricted movement and in the chronic situation osteoarthritis and/or a degenerative meniscus may also restrict the movement of the knee.
• Knee Instability: Instability described as the sensation that your knee may give out from beneath you, are a feature of some inner knee pain conditions. Specifically subjective instability is a symptom commonly associated with an MCL injury and to a lesser degree but still fairly common to be reported with a medial meniscal injury.
• Clicking Noises: Clicking, crunching, grinding noises whatever they may be is something more commonly associated with cartilage problems. This could be associated with osteoarthritis of the knee. As well as clicking and catching sensations are also reportedly associated with injury to the medial meniscus.
• Locking: Catching, or locking of the knee joint is a situation where the knee feels to lock in place and subsequently the individual struggles to bend or straighten the knee from said locked position. Locking like this is generally related to an internal mechanical block of the knee and is often regarded as a sign of meniscal tear. Other causes of locking may include a foreign body in the joint. These loose bodies can result from an osteoarthritic cartilage fragment floating in the joint, catching between the joint surfaces, blocking or locking normal motion. Worth noting is that pseudo locking may also be experienced this is the result of swelling or pain in the knee blocking normal knee motion without the mechanical block from a meniscal, cartilage based or bony fragment which is capable of causing “true” locking.
• Swelling: Swelling of the knee associated with inner knee pain following injury is potentially due to injury to the MCL or medial meniscus. With regard to experiencing immediate and significant swelling of the knee following acute injury then damage to the anterior cruciate ligament and fractures need to be ruled out. Chronically osteoarthritis may cause swelling, although this swelling often less substantial swelling and more generalized than is sometimes associated with acute knee injury to the medial ligament of meniscus.
• Pain: The behavior of inner knee pain is such that pain walking downstairs is often associated with (but not exclusive to) patellofemoral conditions which could include osteoarthritis of the patellofemoral joint. Whereas inner knee pain associated with twisting and turning is often regarded as being of MCL or medial meniscal origin. Pain moving following periods of sustained inactivity such as moving after long drive, rising from the sofa or pain rising first thing in the morning that then eases with gentle activity or a warm shower is a typical reported feature associated with early osteoarthritis (however, again this isn’t overly uncommon with a variety of other ailments).

If you have any questions regarding some inner knee pain, you have or have suffered a knee injury and wanted some advice then please contact our physio team and we will be happy to help by assessing your knee and providing the appropriate treatment and management plan.

Disclaimer: This information is provided as an educational service and is not intended to serve as a substitute for personalized medical advice. Sydney Physio Clinic does not endorse any treatments, procedures, products mentioned in this post. Anyone seeking specific advice, or assistance regarding a “Inner Knee Pain” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.