How To Fix Pain on Inside Of Knee

Do you have pain on the inside of the knee?

(Also referred to having “Medial Knee Pain”)

This Blog Post Contains:

• 5 Common Inner Knee Injuries
• Exercises to Fix Pain on the Inside of the Knee

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5 Common Injuries That Cause Pain On Inside Of Knee

The following are the 5 most common injuries that can cause pain to the inner region of the knee.

1. Knee Osteoarthritis

Osteoarthritis is a degenerative condition of the knee joint.

It is commonly referred to as the “wear and tear” of the joint.

(In regards to the inner side of the knee, this occurs in the Medial Tibiofemoral Joint.)

Causes: Over time – the articular cartilage in the knee joint will wear away which can eventually lead to pain on the inside of the knee.

2. Medial Meniscus Tear

The Medial Meniscus is a “C-shaped” piece of cartilage that is located between the Femur (Thigh bone) and Tibia (Shin Bone).

Its role is to act as a shock absorber as weight is placed on the leg.

Causes: A meniscal tear can occur with a combination of pivoting whilst weight bearing on the knee.

3. Medial Collateral Ligament (MCL) Strain/Tear

The MCL is tight band of connective tissue that is located on the inner side of the knee.

Its role is to stabilize the inside portion of the knee.

Causes: A strain or tear to the MCL usually occurs when the knee collapses inwards and over stretches the MCL.

4. Pes Anserine Bursitis/Tendonitis

This is inflammation of the tendon of the Sartorious, Gracilis and Semitendinosus where they converge at the inner knee region (called the Pes Anserine).

Irritation of these tendons in this region will also likely irritate the bursa (fluid-filled sac) that sits underneath the tendons. (Called Pes Anserine Bursitis)

Causes: Unaccustomed amount of Twisting/Pivoting of the knee

5. Distal Adductor strain

The adductors are a group of muscles that attach from the groin to the inside of the knee.

A strain can occur if these muscles are overloaded.

Causes: Sudden movement into abduction whilst the adductor muscles are active.

(Other medial knee pain causes: Medial Plica Syndrome, Contusion, Patellofemoral Pain Syndrome, Rheumotoid Arthritis, Fracture, Referred pain from Lumbar Spine)

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How To Fix Inner Knee Pain

Although there are different structures that can cause pain on the inside of the knee, the following steps can be applicable and beneficial for all causes.

(Note: Please seek medical advice before attempting the exercises on this blog post if you have any of the following serious symptoms: Unable to place full weight on the knee, Significant amount of Pain, Excessive Swelling, Knee giving way/locking and/or Missing full range of motion in the knee.)

STEP 1: Reduce Pressure On Knee
STEP 2: Reduce Inflammation
STEP 3: Range Of Motion Exercises
STEP 4: Perform Releases
STEP 5: Massage Painful Area
STEP 6: Gentle Knee Strengthening Exercises
STEP 7: Balance Exercises
STEP 8: Bodyweight Exercises
STEP 9: Strengthen in Non-Ideal Alignment
STEP 10: Increase Load On Knee
STEP 11: Other Things To Consider

STEP 1: Reduce Pressure On Knee

To avoid aggravating the symptoms, you will need to temporarily reduce the amount of pressure that is placed on the knee.

Here a few ways to achieve this:

a) Reduce The Amount Of Walking

As there may be a significant amount of pain in the inside of the knee, it is likely that your knee will not tolerate the amount of walking that you would normally do on a daily basis.

Consider temporarily reducing the amount of walking until your knee starts to improve.

(Keep in mind – This does not mean that you should completely avoid walking altogether as this can cause your muscles to get weaker.)

As a general guide line: Walk as much as you can comfortably tolerate without causing more symptoms.

b) Walk With Crutches

Walking with the assistance of using crutches can help reduce the amount of your body weight that is placed on your injured knee.

Suggestion: As your knee improves – aim to wean off the use of the crutches as soon as you are safely able to.

c) Wear A Knee Brace

A Knee Brace is a support that is worn on the knee to help compress and provide stability to the knee.

d) Reduce Exposure to Aggravating Activities

Reduce exposure to, modify or completely avoid activities/movements/positions that make the inside knee pain worse.

These activities may include:

• Running
• Using Stairs
• Squatting
• Sports

As the knee improves – gradually return to these activities at an appropriate pace.

e) Reduce Bodyweight

If you are over weight, the additional body weight can place an increased amount of pressure on the knee.

Any reduction in body weight will offload the structures of the injured knee.

STEP 2: Reduce Inflammation

A significant amount of inflammation in the knee can be very sensitive and painful.

This may limit the ability to perform the suggested exercises on this blog post.

Here are some simple ways to reduce inflammation:

a) Anti-Inflammatory Gel

Apply an anti-inflammatory gel to the inside of the knee.

Do this 3 times per day.

b) Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

It is recommended that you take an anti-inflammatory medication consistently for at least 7-10 days.

Keep in mind – there are different strengths/types of NSAIDs and is best used if the prescribed medication is appropriate to the severity of the inflammation.

Note: Please consult your Primary Care Provider before taking any medication.

c) Cold Therapy

Apply an ice pack to the inner knee region for at least 10-15 minutes.

Do this 3-5 times per day.

Note: Do not apply the ice pack directly to the skin as you may develop an irritation on the skin.

d) Try Natural Products

It is suggested that taking turmeric, ginger, chia seeds and/or fish oil capsules are natural ways to help reduce the inflammation.

(Although it is difficult to say how effective this is at reducing inflammation, it may be worth a try at least!)

e) Cortisone Injection

The cortisone injection consists of a steroid (cortisone) and an analgesic substance.

The aim of the injection is to reduce the inflammation and reduce the pain by numbing the area.

Talk to your Primary Care Provider to see if the cortisone injection is appropriate for your shoulder injury.

STEP 3: Range Of Motion Exercises

It is important to keep the knee moving through its normal range of motion.

This will help:

• Reduce stiffness
• Minimize loss of movement
• Improve circulation
• Encourage quicker healing

(Note: If you have pain whilst moving the knee, aim to move the knee as much as you can comfortably tolerate.)

a) Knee Flexion/Extension

Instructions:

• Lie down on your back on the floor.
• Bend your knee by sliding your heel towards the back of your hips.
• Then – Straighten your leg completely by sliding your foot away from you.
• Perform 30 repetitions.

b) Tibial Internal/External Rotation

Instructions:

• Sit down on a chair with your knee bent to 90 degrees.
• Keep your knee pointing forwards throughout this exercise.
• Pivot your foot in and out.
• Perform 30 repetitions.

STEP 4: Perform Releases

If you have tight muscles surrounding the knee, performing releases can help loosen them up.

(Note: If you do not have a lot of tightness in the knee, you do not need to spend a lot of time performing these releases.)

a) Thigh

Instructions:

• Lie down on the floor facing downwards.
• Place a foam roller under the lower thigh region.
• Apply an appropriate amount of body weight on top of the massage ball.
• Make sure to cover the entire region above the knee cap.
• Continue for 2 minutes.

b) Groin

Instructions:

• Lie down on the stomach with the knee out to the side.
• Place a foam roller underneath the groin region.
• Completely relax this leg.
• Roll inner side of your thigh up/down over the foam roller.
• Make sure to cover the area from the groin to the inner knee region.
• Continue for 2 minutes.

c) Hamstring

Instructions:

• Sit down on the floor.
• Place your hamstring muscles on top of a massage ball.
• Use your body weight to apply an appropriate amount of pressure.
• Make sure to cover the entire length of muscle.
• Duration: 2 minutes

d) Calf

Instructions:

• Sit down on the floor with both legs straightened in front of you.
• Place a foam roller underneath the calf muscle that you would like to release.
• Place the weight of the other leg on top of the leg that is on the foam roller.
• Keep the bottom leg completely relaxed throughout this exercise.
• Apply a firm downward pressure with the leg at the top.
• Rock your leg from side to side.
• Make sure to cover the entire length of the calf muscle.
• Continue for 1 minute.

e) Shin

Instructions:

• Sit down on a chair with your knees bent.
• Use the back of your finger knuckles to apply pressure to the outer shin region.
• Perform a downward stroke.
• Make sure to cover the entire length of the calf muscle.
• Continue for 1 minute.

STEP 5: Massage The Painful Area

The following massage technique is aimed to increase circulation, encourage healing and desensitize the injured area.

Note: If massaging makes your pain significantly worse, reduce the amount of pressure being applied.

a) Massage

Instructions:

• Identify the specific area of pain in the inside (medial) region of the knee.
• Use your finger tips to apply a firm pressure over the area.
• Perform a circular motion with your finger.
• Continue for 1 minute.

STEP 6: Gentle Knee Strengthening Exercises

As soon as your knee is able to, start the following exercises to strengthen the knee.

a) Extension

(This exercise will strengthen the Quadriceps muscle group.)

Instructions:

• Sit down on a chair.
• Straighten your leg completely.
• Aim to feel the contraction of the thigh muscles.
• Hold this position for 5 seconds.
• Repeat 20 times.
• Progression: Use an ankle weight or resistance band.

b) Flexion

(This exercise will strengthen the Hamstring muscle group.)

Instructions:

• Wrap a weight around the ankle.
• Stand up right.
• Hold onto something for balance.
• Keep your knees together throughout this exercise.
• Bend your knee as much as possible.
• Aim to feel a firm contraction in the back of the thigh muscle.
• Hold for 5 seconds.
• Repeat 20 times.
• Progression: Apply more ankle weight

c) Tibial Internal Rotation

(This exercise will strengthen the Popliteus and Inner Hamstring muscle group.)

Instructions:

• Sit down on a chair with your knees bent to 90 degrees.
• Keep your knee pointing forwards throughout this exercise.
• Loop a resistance band around the front portion of the foot.
• Tie to other end of the resistance band to a stationary object at ankle height.
• Move away from the anchor point to increase tension on the band.
• Pivot your foot inwards.
• Aim to feel a contraction on the inside of the knee.
• Slowly return to the starting position.
• Perform 20 repetitions.
• Progression: Apply more tension on the resistance band.

d) Hip Adduction

(This exercise will strengthen the Groin/Adductor muscle group.)

Instructions:

• Assume a side lunge position with the injured knee in the straightened position.
• Have the majority of your body weight on the knee that is bent.
• Push the inner side of the foot on the injured side firmly into the floor.
• Whilst pushing the foot into the ground, slide this foot towards the other foot.
• Aim to feel a contraction on the inside of the upper leg.
• Perform 20 repetitions.
• Progression: Increase the amount of pressure when pushing into the ground.

STEP 7: Balance Exercise

It is common for your balance to deteriorate following any injury to the inner knee region.

Make sure that you start addressing your single leg balance with this exercise:

a) Single Leg Balance

Instructions:

• Stand on the side that has the inside knee pain.
• Aim to keep your entire leg completely still.
• Hold for 30 seconds.

Note: If you are having issues with keeping the leg still when balancing on one foot, you may need to lightly hold onto something for support.

Progression: Once you can perform a single leg balance for at least 30 seconds without any issue, consider progressing to the following options whilst balancing:

• Close your eyes
• Turn your head from side-to-side
• Reach your arm out as far as possible
• Reach your leg towards the side
• Stand on your tippy-toes

STEP 8: Weight Bearing Exercises

The ideal alignment of the leg involves the hip, knee and foot being in line with one another.

This helps distribute load on the knee more evenly throughout all of the knee structures.

Try your best to maintain the ideal alignment of the leg whilst performing the following knee exercises.

a) Supported Forward Lunge

Instructions:

• Put a foot step in front of a wall.
• Place your foot on top of the step.
• Have both of your hands supported onto a wall.
• For the leg that is on the step, keep the knee in line with your feet throughout this exercise.
• Lean as much of your bodyweight as possible onto the leg that is on the step.
• Move your knee forwards as much as possible.
• Perform 20 repetitions.
• Progression:
  • Gradually reduce the amount of support being provided by your arms
  • Move your knees more forwards
  • Move slower/Use less momentum
  • Lean more body weight onto the leg

b) Lean Back Squats

Instructions:

• Hold onto a stationary object that is in front of you.
• Place your feet shoulder-width apart.
• Keep the knees in line with your feet throughout this exercise.
• Lean backwards so that your entire body weight is relying on your arms.
• Place most of your body weight onto your heels.
• Drive your hips backwards as you squat down as low as possible.
• Stand up to return to the starting position.
• Perform 20 repetitions.
• Progression:
  • Gradually reduce the amount of support being provided by your arms.
  • Squat deeper
  • Move slower/Use less momentum

c) Step Up

Instructions:

• Place your foot onto a step.
• Hold onto something for support.
• For the leg that is on the step, keep the knee in line with your feet throughout this exercise.
• As you step up onto the step, use as much support from the hand as required.
• Slowly lower yourself back to the starting position.
• Perform 20 repetitions.
• Progression:
  • Use less arm support
  • Use a higher step
  • Move slower/Use less momentum

d) Step Down

Instructions:

• Stand on top of a step.
• Hold onto a stationary object for support.
• For the leg that is on the step, keep the knee in line with your feet throughout this exercise.
• Slowly reach your other foot down to the floor.
• Return to starting position.
• Perform 20 repetitions.
• Progression:
  • Perform the exercise slower/Use less momentum
  • Use a higher step
  • Use less arm support

STEP 9: Strengthen In Vulnerable Position

Realistically – It is not possible to maintain the ideal alignment of the knee 100% of the time with every movement that you do.

To build up the resilience in your knee, you will also need to strengthen the knee when it is NOT in the ideal straight alignment.

Try the following exercises!

(Please be careful as these exercises have the potential to re-aggravate your symptoms. Be gentle.)

a) Side Lunge

Instructions:

• Stand upright.
• Take side lunges towards the opposite direction of the leg with the inner knee pain.
• Aim to push your big toe/foot (of the trailing leg) firmly into the ground as you take the side steps.
• Perform 30 repetitions.
• Progression:
  • Push the foot harder into the floor as you take a side step
  • Move quicker
  • Keep the knees in a more bent position

b) Pivoting

Instructions:

• Quickly walk forwards.
• Place the foot (that is on the side with the inside knee pain) down in front of you.
• Lean most of your body weight onto the foot at the front.
• Push your big toe and inner foot into the ground as you pivot your body away from this leg.
• Walk in the other direction.
• Perform 30 repetitions.
• Progression:
  • Walk and Pivot with a quicker speed

STEP 10: Increase Load On Knee

By this stage of your rehabilitation, your knee should be much stronger and the pain in the inside of the knee shouldn’t be as pronounced as it was.

If you would like progress your knee to more advanced movements, consider performing the following movements:

• Bouncing on the spot
• Hopping on the spot/forwards and backwards/side-to-side
• Jogging/Running in straight line
• Quick change in direction

STEP 11: Other Things To Consider

The following factors may predispose you to developing inside knee pain as they tend to cause the knee to collapse inwards. (… which can place more strain on the inside of the knee.)

Consider addressing these factors if they are appropriate in your situation.

a) Limited Ankle Dorsiflexion

Ankle Dorsiflexion is the movement of the ankle where it bends backwards.

This ankle movement is required during the “Push-off phase” of walking to maintain the ideal position of the knee.

If you have stiff ankles, consider performing the exercises on this blog post:

See Post: Ankle Dorsiflexion Exercises

b) Overpronated Foot

Overpronation of the foot refers to the foot excessively rolling inwards.

The knee position will tend collapse inwards as the ankle/foot rolls inwards.

If you have overpronated feet, consider performing the exercises on this blog post:

See Post: Exercises for Overpronated Feet

c) Weak Glute muscles

The glute muscles control the position of the knee.

Weakness in the Glute muscles can lead to the knee collapsing inwards.

If you have weak glute muscles, consider performing the exercises on this blog post:

See Post: Glute Strengthening Exercises

d) Limited Big Toe Extension

Limitations in big toe extension can lead to the knee collapsing inwards as you walk.

If you have a stiff big toe, consider performing this exercise:

Instructions:

• Place the undersurface of the big toe onto the corner of the wall.
• Aim to get the foot as close to the wall as possible.
• Lean your foot firmly into the wall.
• Aim to feel a stretch underneath the big toe.
• Hold for 30 seconds.
• Note: Do not force this stretch if you start to feel pain at the top of the big toe base.

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Conclusion

This blog post is a complete guide on how to fix the pain on the inside of the knee.

My recommendation is to try out all of the exercises in the initial stage of rehabilitation.

Over time – focus on the exercises that give you the best results.

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Disclaimer: The content presented on this blog post is not medical advice and should not be treated as such. It is not intended to be used as a substitute for professional advice, diagnosis or treatment. Use of the content provided on this blog post is at your sole risk. Seek guidance from a healthcare professional before attempting any exercise. For more information: Medical Disclaimer.