Inner (medial) knee pain
Your health expert: Mr Damian McClelland, Trauma and Orthopaedic Consultant, and Clinical Director for Musculoskeletal Services at Bupa
Content editor review by Pippa Coulter, June 2021
Next review due June 2024
Inner (or medial) knee pain means pain on the side of your knee nearest to the middle of your body (next to your other knee). Medial simply means middle. There is much you can do to manage inner knee pain, and treatments that can help too.
Causes of inner knee pain
There are several things that can cause inner knee pain. These include:
- injury such as a blow to the outside of your knee, which pushes your knee inwards
- activities that involve sudden twisting or pivoting of your knees – for example, skiing or playing rugby
- activities where you have to use your knee a lot – for example, cycling, gymnastics or swimming breaststroke
- getting older and your knee joint becoming worn down
Conditions associated with inner knee pain
There are several types of knee injury and other conditions that can cause inner knee pain.
Medial collateral ligament injury is a tear of the ligament that runs down the inner side of your knee. A ligament is a band of tissue that connects one bone to another. Your medial collateral ligament connects your thigh bone to your shin bone, helping to stabilise your knee. A tear can happen if you have a direct blow to your knee, if you twist your knee or if you overuse your knee.
Anterior cruciate ligament injury is a tear to one of the ligaments that runs across the inside your knee, connecting your thigh and shin bones. You might completely or partially tear your anterior cruciate ligament. It’s a sudden injury caused by twisting or overextending your knee. It can happen if you suddenly slow down, stop or change direction and is nearly always associated with sports.
Meniscal injury is a tear to one of the cartilage ‘shock-absorbers’ in your knee. These are known as the menisci (one on its own is called a meniscus). You could tear a meniscus if you twist your knee. This type of injury is common in sports where you have to change direction suddenly – for example, football or basketball. It can also happen if you work in a job that involves heavy lifting and twisting, such as construction or manual labour. You’re also more likely to tear your meniscus without any particular injury as you get older, through wear and tear.
Osteoarthritis of the knee is a condition that commonly causes inner knee pain. In osteoarthritis, there are structural changes to your joints: over time, your cartilage becomes damaged and painful. This condition mostly affects people over 45. The older you are, the more likely you are to get it.
Patellofemoral pain syndrome (PFPS) means pain at the joint between your kneecap (the patella) and thigh bone (the femur). It might happen if there’s repeated stress on your knee or if your kneecap moves out of alignment. PFPS usually causes pain at the front of your knee, but you can get pain on the inner side of your knee too.
Pes anserinus syndrome (or pes anserine bursitis) is when a small sac of fluid around your knee, known as a bursa, becomes inflamed. It’s common to have this condition alongside other knee problems. But anything that puts additional stress on your knees – for example, obesity and certain sports – may cause it too.
Medial plica syndrome is when a small fold of tissue (a plica) inside your knee becomes inflamed. It causes pain across the inside of your knee and tends to come on when you’ve suddenly become more active.
Inner knee pain symptoms
Pain on the inside of the knee can feel different for different people. You may feel it as a sharp pain, a burning pain or a mild ache. It can come and go, or you may get pain with particular movements such as squatting, going upstairs or straightening your leg. Other symptoms you may have depend on what’s causing your pain. You may have swelling or, with some types of injury, your knee may click or get stuck in one position (lock).
With a medial collateral ligament injury, you’ll have some pain and stiffness on the inside of your knee. These usually come on straight away. You may not always have swelling.
Pain from an anterior cruciate ligament injury may be sudden and you may hear a ‘pop’. Your knee is likely to swell up quite quickly and may feel as if it’s going to give way.
Symptoms of a meniscus tear generally come on over several hours following the initial injury. You may have pain and swelling and you may have difficulty fully straightening your leg. Your knee may also lock or feel unstable, as if it’s about to give way.
Osteoarthritis in your knee usually causes pain when you’re putting weight on your affected leg, and gets better when you rest your leg. You may have stiffness and loss of movement first thing in the morning or after sitting for a while. You may also have some swelling around your knee.
Patellofemoral pain syndrome causes an ache inside your knee. It’s usually at the front of your kneecap, but might be to the left or right of it too. It’s made worse by running, climbing stairs, squatting or after sitting for a long time.
Pes anserine bursitis can cause pain when you’re going up and down stairs or when you stand up. You may also have pain at night or some slight swelling.
Medial plica syndrome typically causes pain when you go up or down stairs or if you’ve been active for a long time. It can also hurt when you get up from sitting down for a long time. Your knee may also catch or click when you bend or straighten your leg.
When to seek medical help
If your injury is mild, you may be able to manage your symptoms yourself, without seeking medical advice. But you should see a doctor or physiotherapist, if:
- you can’t put weight on the affected leg
- you have severe pain, even when you’re not putting weight on it
- your knee gives way, clicks, or locks (gets stuck)
- you can’t move your knee
- your knee is hot, red or very swollen or you have a fever
Diagnosis of inner knee pain
If you see your doctor with knee pain, they’ll examine your knee and are likely to ask:
- when your pain started and if there’s anything that makes it worse
- if there’s any activity, accident or injury that could have caused it
- if you have any other symptoms such as your knee giving way or clicking, or pain in any other joints
They may suggest an X-ray or an MRI scan, but this is not always necessary. Your doctor may be able to make a diagnosis based on the examination and your symptoms.
If you have cartilage or ligament damage, your doctor may suggest a procedure to look inside your knee. This is called an arthroscopy (often known as ‘keyhole surgery’). It involves making a small cut in your knee and inserting a thin tube and a camera. As well as helping with diagnosis, damaged tissue can be repaired or removed during the procedure.
Self-help for inner knee pain
There’s a lot you can do to help yourself if you have a knee injury.
- Immediately after an injury, rest your leg and ideally elevate it too.
- Use ice packs and a tubular bandage (that fits over the knee) to help reduce swelling.
- Take painkillers such as ibuprofen to manage pain.
- If you can’t put weight on your leg, you may find crutches useful.
- Avoid causing further damage to your knee as much as you can.
Treatment of inner knee pain
Treatments for inner knee pain include physiotherapy, painkillers and surgery. Whether you need treatment and what treatment you have, will depend on exactly what’s wrong with your knee. For instance, you may be more likely to need surgery if you have cartilage damage (a meniscus tear) or osteoarthritis causing severe pain. If you have a ligament injury, physiotherapy may be enough.
For information on treatments, please see the relevant knee condition page.
- Medial collateral ligament injury
- Meniscus tear
- Anterior cruciate ligament injury
- Osteoarthritis of the knee
- Patellofemoral pain syndrome (PFPS)
Not quite what you're looking for? Browse all our knee condition pages to find the right treatment advice for your condition.
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There are lots of different conditions that can cause pain on the inner side of your knee. These include ligament injuries, cartilage damage and osteoarthritis. These conditions are most often caused by a sports injury, overuse of your knee or getting older. To find out more, see our sections on causes and conditions above.
The treatment you need for your inner knee pain will depend on exactly what’s causing it. There are many things you can do yourself, including resting your knee and applying an ice pack to it. But for some types of injury, you may need physiotherapy or surgery to repair any damage. For more information, see our sections on self-help and treatment above.
Your doctor will be able to assess how serious your knee pain is by asking you questions and examining your knee. If necessary, they’ll carry out some scans too. You should see a doctor if your symptoms are severe or don’t start to improve within a few weeks. For more information, see our section on managing inner knee pain above.
Medial collateral ligament (MCL) injury
The MCL is the most commonly injured knee ligament. It often gets injured during sports such as rugby.
Anterior cruciate ligament (ACL) injury
An ACL injury can be a partial or a complete tear, an overstretch, or a detachment of the ligament.
Meniscal tear
Tears of the menisci are a common injury. When people talk about a ‘torn cartilage’ in their knee they usually mean a meniscus injury.
Knee osteoarthritis
Osteoarthritis is a disease that causes pain and stiffness in your joints. Your knee is one of the joints that’s most commonly affected.
Patellofemoral pain syndrome
Patellofemoral pain syndrome is sometimes called ‘runner’s knee’ because it’s particularly common in people who run or do other sports.
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