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5 Causes of Inner Knee Pain - How to Effectively Find Knee Pain Relief

People of all ages and fitness levels can suffer from inner knee pain. This medial side of the knee is susceptible to various stressors and is impacted by what is happening in the joints and muscles above and below. Whether you’ve been cutting for those amazing drop shots on the tennis court, getting in all your lunges and squats at the gym, or jogging along the beautiful lakeshore in Manitowoc, you may have been inflicted with inside knee pain. Without the right diagnosis and treatment to eliminate the problem, many end up being frustrated and giving up the activities they love.

As you’ll read in this article, inner knee pain can have many causes that a busy, rushed clinician easily misses. When the underlying cause of this condition is not found, the knee suffers from chronic stress, further aggravating the joint itself, leading to greater pain and disability.

We’ve had patients arrive at our clinic having already suffered for years. They cannot exercise, run after their kids, or enjoy many fun outdoor activities in northeast Wisconsin. Many of them assume it is just “arthritis” or “old age” and feel very little hope for the pain ever to go away. This is a shame because it doesn’t have to be this way. It typically occurs because they received knee treatment directed at the symptoms rather than the underlying cause of the inner knee pain.

Unfortunately, a stubborn case of medial knee pain doesn’t typically go away on its own (especially if you want to stay active). It will usually worsen if you don’t get the right diagnosis and treatment or push through the pain. So if you’re having inner knee pain and reading this article, our goal is to give you the knowledge you need to make the right decisions about treatment and get you back to the active lifestyle you deserve.

More specifically, this article aims to

  1. Give you an understanding of why medial knee pain (often referred to as “patellofemoral syndrome”) is so difficult to resolve AND remain active.

  2. Arm you with five causes for inner knee pain that you may not have been told about or thought of so your knee pain doesn’t linger for years.

  3. Inspire you to take action and manage your knee pain before it gets worse

Why Standard Knee Pain Treatment Often Fails to Get Rid of Your Inner Knee Pain

I believe a big reason that pain along the inside of your knee becomes a chronic long-term issue for many people is that most knee pain treatment approaches do not fully address ALL the CAUSES of the problem. Most physicians and therapists are forced to rush from one patient to the next and don’t have the time to identify and treat all the potential causes of your pain.

Furthermore, depending on who you see for help, many treatment approaches are aimed at symptoms rather than causes. For example, many physicians will tell you to rest, avoid aggravating activity, take some anti-inflammatories, and offer a cortisone injection into your knee joint. Though people occasionally get some relief from this approach, I can promise you that your knee is not in pain because it is deficient in some man-made steroids like cortisone. Painful inflammation is a symptom caused by something else, and cortisone is aimed at decreasing inflammation rather than aimed at resolving the cause of the inflammation. Many people who get relief from this approach only find themselves dealing with the same inner knee pain less than a year later because the underlying causes of the problem were not addressed.

Another reason this injury is often unsuccessfully treated is that the potential causes of the problem are numerous and related to how we move as individuals. You can’t throw a canned set of exercises or a variety of gadgets like knee sleeves or patellar straps at it and expect a high level of success.

Every case is different. Our patients who have been diagnosed with patellofemoral syndrome or who describe being annoyed by their inner knee pain come in all shapes, sizes, and lifestyles. From avid pickleball players to occasional gym goers and sedentary desk workers, many people develop this debilitating knee pain and make their way to our clinic.

And when it strikes, it can completely disrupt your lifestyle. Suppose you are reading this and already experience pain along the inside of your knee. In that case, you probably know what I mean…pain with walking up and/or downstairs, inability to squat to pick something up off the ground, unable to go for a jog or complete a lunge. It’s no way to live! But please know that although it can be extremely annoying, you do not have to live with this or accept that you are simply getting “old.”

Five Causes for Inner Knee Pain

Like anything else in the human body, deducting the cause of inner knee pain down to five causes is oversimplified. As you can imagine, there are many more reasons why you have medial knee pain, but these five are the most common causes we see in our clinic. It is also important to note that many people have a combination of these causes that have led to their symptoms over time. I often tell people that when I treat them, I start with the most apparent cause and work my way through their body one layer or issue at a time. Kind of like peeling an onion or, better yet, licking a tootsie pop until you get to the core.

Tight Calf Muscles

When your calf muscles feel tight, they can have a combination of actual muscle stiffness and/or weakness. Either situation can create referred pain from the muscle to your inside knee or stress at the joint from the tension.

Tight Inner Thigh Muscles

Tightness within your inner thigh muscles can refer to the medial side of your knee. And one of the four inner thigh muscles connects near the inside portion of your knee joint, which can inflame a bursa located in this area.

Weak Outer Hip Muscles

If your outer hip muscles don’t have the strength or capacity to control your hip joint, your primary leg bone (femur) has difficulty maintaining its alignment. This often leads to a “knock-kneed” position which causes stress to the inside of your knee joint.

Foot Weakness

Your body compensates when your foot muscles do not provide adequate strength to stabilize your feet on the ground. Your foot often rolls inward (pronation), which causes your lower leg bone to rotate excessively. This rotation creates stress on your knee joint. Furthermore, when your foot and lower leg are no longer in an ideal position, your hips and the rest of your kinematic chain compensate. Unfortunately, your knees are like the middle child. They “live” between your feet and hips, receiving the greatest torsional stress.

Lack of Coordinated Movement

We all develop various patterns of movement based on our life experiences and genetics. Some of these patterns are very efficient, and others are layers of ineffective compensations. These patterns can lead to poor coordination, especially when we try something new or challenging. This lack of control can create poor joint positioning, building stress over time.

Client Inspiration

Words from a client with chronic knee pain who took action on what he thought was something he had to live with:

“I have been suffering with a knee injury for years (since reconstructive surgery in the military in the early 1980’s). During the past several years, that knee has become very unstable. Walking up stairs hurt and my knee would weaken and give out. Getting up from a chair would cause my knee to give out, buckling my leg and, at times, making me fall. Then I discovered Dr. Wergin (truth be told, my wife did 😊). I called and had the initial consultation. What was refreshing was that the consultation was with Dr. Wergin, not a paid screening service or intern. So, I decided to try 1 session. During that initial session, Dr. Wergin did a thorough intake on any history related to my injured knee. During the session, I was asked to perform several maneuvers of which one was a squat. I could NOT even get 25% down before my knee gave out. Fast forward after several sessions with Dr. Liz and being disciplined following her exercise regime and my knee has much more stability and is getting stronger! Just to see, a week ago I tried to do a squat. I was successful! Since then I have been doing more and more. Just the other day, after a long day sitting, I stood and cranked out 20 squats to get the blood flowing. I can’t tell you how thankful I am for making the decision to see Dr. Wergin and am so pleased with her treatment and progress. AWESOME!”

–Bill Deboer


If you suffer from inside knee pain and would like a comprehensive evaluation to determine the root cause of your symptoms, we'd love to help! We provide Diagnostic Physical Therapy Evaluations in Manitowoc, WI. Head to our website and book your appointment today! We also offer FREE phone consultations if you have questions before booking.

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