Orthopaedic Surgeon


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Inner side of knee

Pain On The Inner Side Of The Knee

The most common cause of medial knee pain or pain on the inside part of the knee is a medial meniscal tear. The tear can be acute or degenerative but either way can cause pain and limitation of activities. Occasionally a torn meniscus can flip in and out of the joint and cause pain as well as locking of the knee. The pain is typically worse with activity and fairly sharp in nature. Many patients complain that they cannot sleep with their knees together or find it uncomfortable to sit in a movie unless they can stretch their knee out in an aisle seat. The knee is often stiff after driving or sitting for long periods and particularly bad with twisting activities.

It is important to know whether the medial knee pain is dull or sharp, continuous or intermittent and it’s severity and location. Did it come on slowly over months or was it after and acute injury?

Medial compartment arthritis (usually osteoarthiritis) can cause pain on the inner side of the knee. This is usually more of an ache than a sharp catching pain and is present when you walk on the leg. As the arthritis worsens the pain can become continuous and interfere with sleep. Eventually even walking short distances becomes difficult.

Pain on the inside of the knee can be referred from the patellofemoral joint (kneecap) or even from the hip. A careful examination of the hip will reveal loss of motion and an xray will confirm the diagnosis. About twenty percent of people with no damage to the medial or inside part of their knee will feel pain there from damage to the patellofemoral joint. This is usually a chondral or joint lining cartilage injury.

After an acute knee injury such as a soccer knee clash or a fall while skiing you may experience pain on the inside of your knee. This may be a medial collateral ligament (MCL) injury. There will be tenderness along the line of the ligament which is worse than any joint line tenderness. Placing a valgus (foot pulled outwards away from the body) stress on the leg will stretch the MCL and create pain. If the MCL is completely torn you may feel that the knee is unstable rather than painful since a complete tear tends to tear the pain fibres as well.

Even significant tears rarely need a MCL repair and most can be adequately treated with crutches and a hinged knee brace.