23 September 2022

Knee pain on the inside – causes, symptoms, treatment

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Persistent knee pain on the inside prevents you from functioning normally? Does it increase when you bend or walk? Don’t underestimate him!

The knee joint is the largest and at the same time the most vulnerable to injuries in the human body. Well-groomed, well-functioning knees allow for free movement of the legs, and also determine the correct load on the pelvis and the lumbar spine. So when we suffer from pain in the knees , it is the lower part of the spine – especially when walking – that first takes over their function and thus becomes exposed to further, usually very painful injuries. But don’t worry – although the recovery and rehabilitation process is usually quite slow, you can win with joint pain. And the faster and more accurate the diagnosis, the easier it is to get rid of this nagging problem. Side knee pain on the inside can have several causes. The most common ones are presented below.


1. Muscle contracture around the knee joint

taping on the knee

The knee joint is surrounded by the thigh and calf muscles that contribute to the extension and flexion movements of the legs. This first movement involves the quadriceps muscle, located on the front of the leg above the knee (consisting of the rectus muscle, the large intermediate, the large lateral and the large medial). In the second one: the back muscles of the thighs (including the biceps muscle of the thigh, the semitendosus and the semipembranous muscles), as well as the tailor’s, slender and gastrocnemius muscles.

Muscle strain and , as a result, their contracture occurs as a result of overload, e.g. many hours of physical activity (such as cycling or walking on uneven terrain, e.g. in the mountains). The culprits may also be a lack of proper warm-up and overly intense training, such as doing squats. Contracture occurs more easily the less flexible the tendons that hold the knee in motion.

Symptoms:

‘Pulling’, intense pain on the inside or back of the knee , mainly occurring when you bend or straighten the leg (depending on the group of strained muscles).  

Treatment:

Use an anti-inflammatory and analgesic ointment or gel to relax your aching muscles . However, the basis for returning to full fitness should be daily, regular stretching and relaxing exercises. It’s important to keep a balance between the front and back exercises.

Note: If the muscle contracture has not appeared as a result of exercise, has been persistent for a long time, and is accompanied by pain elsewhere in the knee joint, it may indicate other, more serious problems. In this case, it is necessary to consult an orthopedist who will diagnose the problem and implement appropriate treatment or refer you to rehabilitation.

 2. Injury of the meniscus

knee rehabilitation

The meniscus are the flexible cartilage parts of the knee joint, located between the femur and tibia. They affect their mutual “fit”, stabilize the joint and absorb the loads that are transferred to the tibia during movement. There are two menisci in our joints: medial and lateral. The former is less mobile, so it is easier to damage. Injuries of the meniscus are often accompanied by damage to the anterior cruciate and tibial collateral ligaments. This “set” of ailments is called the “O’Donoghue triad”.

Symptoms:

Sharp stabbing pain (especially when loading), swelling, pain on the inside of the knee when bending and straightening the joint, painful “twitching”, pain when the knee is touched at the site of the meniscus. Symptoms appear immediately after the meniscus is injured and intensify within a dozen or so days. After this time, there is pain in the joint capsule , a feeling of “blocked” joint, fluid accumulation inside the joint (so-called “water in the knee”), and weakness in the front muscles of the thigh. Neglecting the injury may lead to further changes, and, consequently, even to a rupture of the meniscus during squats or turns, e.g. in dancing.

Treatment:

The regeneration of damaged menisci depends on the circulation of lymph and blood at the site of the injury. Therefore, treatment is not easy, because these places have very little blood supply. In lighter cases, physical therapy treatments such as ultrasound, magnetotherapy, electrotherapy, and laser therapy are recommended. A set of exercises appropriately selected by a physiotherapist, which will relieve the painful knee, will certainly help to alleviate the symptoms. Some surgeons also recommend partial removal of the menisci, but such surgery significantly accelerates the appearance of degenerative changes in the joints at a later age.

3. Inflammation of the goose foot

masseur - knee

This ailment is manifested by inflammation of the attachment of three muscles: semi-tendon, slender and tailor’s, located at the bottom of the knee on the inside, about 5 cm below the medial part of the joint. The name of the trailer (“goose foot”) comes from the fact that it resembles the membrane between the fingers of a goose. The muscles converging at this point are responsible for knee bending, internal rotation (rotational movement) of the lower leg and dynamic stabilization of the medial compartment of the knee joint.

Goose foot inflammation most often occurs as a result of training mistakes, such as inappropriate shoes , lack of warm -up , too heavy a load or poor exercise technique . The probability of an injury increases as a result of untreated injuries and defects of the osteoarticular system. It can also occur in obese people and people with diabetes or rheumatoid arthritis.

Symptoms:

Moderate pain from the inside below the knee. Symptoms often worsen during the night, causing morning discomfort and stiffness in the legs. Pain also occurs when walking up stairs, getting out of the car, sitting on and getting up in a chair, or during physical activity such as jogging. The muscles in these areas become more tense and local swelling may appear.

Treatment:

An ultrasound scan will help diagnose the problem. The mainstay of treatment is rehabilitation and physical therapy (ultrasound or laser treatment). Sometimes it is necessary to administer drugs with analgesic and anti-inflammatory properties. At home, it is good to cool the damaged area with an ice pack, and at night to relieve the leg with a pillow. It is also worth relieving the knee with a special elastic band or bandage. In order to relax the muscles, manual therapy and stretching exercises are used, but it may take about 4-6 weeks to regain full fitness. If there is no improvement after this time, your doctor may recommend steroid injections.

 4. Injury of the tibial collateral ligament

knee examination

Also known as the medial collateral ligament or MCL (short for Medial Collateral Ligament ). This ligament is located in the medial part of the knee joint, and its task is to protect the knee against valgus, i.e. excessive movement of the joint inwards.

This ligament is most often injured at the time of a sudden twist, e.g. when too much force is exerted on the side of the knee from the outside or the joint has made a sudden, sharp inward movement. These situations most often occur when practicing sports, such as skiing or football.

Symptoms:

In case of ligament damage: slight knee pain and swelling . In the event of a ligament tear or rupture: sharp pain, increasing inflammation and swelling of the knee, great instability of the joint, the feeling of “running away” of the knee.

Treatment:

Repairing a damaged MCL should begin with visiting a good physiotherapist, as well as performing an MRI or – at least – an ultrasound (which, however, may not show accompanying, but possible damage to the meniscus). As long as the ligament has not been ruptured, it can be cured during rehabilitation, because it is very well supplied with blood. The regeneration of the collateral ligament will be slowed down by full extension (e.g. while walking) or full bending of the knees, because this is when the structure works at its highest speed. These movements can therefore be limited by using a special orthosis worn on the leg. Such rehabilitation takes about 2 months. However, it should be supported by manual therapy and / or physical therapy, as well as exercises to strengthen the muscles of the legs.

In the event of complete damage to this structure, it must first be reconstructed surgically. However, it may take up to 4 months to regain full fitness after the procedure. Any return to sport should be supervised by a qualified medical trainer.

Good to remember:

The human body is one mechanism – failure of one element causes failure of others. It is no different with knee pain. If, after the visit to the orthopedist and the ultrasound examination, the doctor did not find any changes in the knee joint, the cause of the pain should be sought in another part of the body – it may be caused, for example, by a wrong position of the pelvis. In order to diagnose this problem (and possibly remove it), it is worth going to a good physical therapist. Many pain symptoms can be solved with the help of appropriate exercises, e.g. stretching. 

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