Common Causes Of Medial Knee Pain

What Is Medial Knee Pain?

In my Sydney and Randwick physio practices I find that medial knee pain is an extremely common location which patients experience symptoms. Anatomically the medial side of the knee is what the lay person would typically refer to as being the inside of the knee, the part of the knee closest to the other knee. Pain occurring on the inside of the knee can be the result of a traumatic incident causing immediate pain, or of more gradual onset where pain and any associated symptoms develop over days or weeks. There are a number of sources of medial knee pain that are relatively common, and all have different causative factors, presentations, behavioral traits. Not surprisingly medial knee pain of different onsets is managed differently in terms of what is the most appropriate care to achieve resolution of symptoms and a return to normal activity levels.

Common Causes Of Medial Knee Pain

Three of the most common causes of medial knee pain that I see in my CBD physio practice are medial meniscal complaints (both acute and degenerative meniscal complaints), medial collateral ligament (MCL) sprains and medial compartment osteoarthritis. Another common cause of medial knee pain are patellofemoral conditions, the kneecap and its associated tissues are structures that are capable of referring pain to the inside of the knee and therefore must be considered as another potential cause of medial knee pain when looking to diagnose the source of symptoms. Each of these common causes will be discussed in more depth below.

Medial Meniscus Disorders

The knee joint has two menisci, which sit either side of the knee (medially and laterally) between the articular cartilage surfaces of the knee joint. The role of the menisci is in increasing stability of the knee, as well as distributing forces through the knee. Menisci are referred to as being semi-luna shaped and have a wedged profile from outside to inside. The inner area of the meniscus is sometimes referred to as the “white zone” as it has no direct blood supply. This poses a problem when injury occurs in the “white zone” as the ability for the meniscus to repair itself here is limited, given that this inner part of the menisci lying deeper inside the joint is avascular. Common injuries to the menisci can be traumatic injuries, occurring typically but not exclusively in athletes. These traumatic menisci injuries are frequently the result of twisting actions of the knee when in a loaded and bent position. Due to the mechanism of acute meniscal injuries, it is common for them to occur in conjunction with other injuries to the knee. Injuries to tissues such as the ACL and MCL are two such injuries which commonly occur in conjunction with meniscal injury as often both these injuries are the result of stress and twisting of the knee when in a bent (flexed) position.
Another common cause of medial meniscal complaints results from a degenerative process. Degenerative meniscal injuries are more common in the older population and typically require less force than traumatic meniscal injuries. Degenerative meniscal symptoms may frequently be experienced as result of seemingly innocuous events or result from no clear and obvious trigger at all.

Medial Collateral Ligament Sprains

Medial ligament disorders occur when there is damage to part or all of the fibers of the medial collateral ligament (MCL). The MCL runs down the inside of the knee crossing the joint. A normal functioning medial ligament aids in providing stability of the knee specifically with regard to side to side motions and assists in dynamic balance control. Typically damage to the MCL is the result of a valgus stress to the knee. Anatomically when referring to the knee a valgus stress is the action whereby the foot moves laterally, or outwards in relation to the knee. Commonly this valgus motion can be the result of landing injuries from a jump, fall or stepping action, or the result of a poorly timed/executed tackle playing soccer or other contact sports. More minor, lower grade MCL injuries often regain stability and people can return to full activity sometimes in as little as 2-3 weeks. However more severe MCL injuries grade II and grade III sprains can easily take 3 and sometimes even 6 months for a full return to play. Just like traumatic medial meniscal tears, injuries to the medial ligament of the knee can commonly occur in conjunction with other injuries to the knee like ACL injuries. Although it is common for an MCL sprain to be an isolated injury following a valgus stress it is also important to assess for injury to other structures of the knee.

Osteoarthritis Of The Knee And Inner Knee Pain

Osteoarthritis is the most common form of arthritis and osteoarthritis is known as a degenerative joint disease. Osteoarthritis typically develops in late middle age, around the forties and beyond. However, it can occur earlier in life also depending on the loading and stressors the joint has been exposed to earlier in life. Specifically with regard to the knee, the knee is a very common location to suffer osteoarthritis, factors such as previous injury, obesity, excessive loading and kneeling over time will all increase an individual’s likelihood of suffering knee osteoarthritis. With osteoarthritis any onset of medial knee pain typically develops over time and seldom is there an acute incident a patient considers to be the single cause for their pain. Medial knee pain due to osteoarthritis is the result of the wear and tear of the articular cartilage on the medial side of the knee joint. As this articular cartilage starts to wear down the protective cushion between the body’s bones decreases, coupled with changes to the associated soft tissues of the joint. As this occurs some people will gradually develop discomfort around the knee.

If you have medial knee pain and are unsure regarding the tissues involved or what is the best approach to take in managing the pain, then book in with one of our physio team and we can help point you in the right direction.

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 “Medial Knee Pain” should consult his, or her physiotherapist, orthopaedic surgeon, general practitioner, sports medicine specialist, or otherwise appropriately skilled medical practitioner.