Medial Knee Pain After Running
Understanding Pain on the Inner Side of Your Knee
Medically reviewed by Eva Umoh Asomugha, M.D.
Pain in the inner knee, also known as medial knee pain, can prevent you from walking and running normally. The condition is sometimes referred to as runner's knee, a generalized term for any knee pain that occurs with running.
The inner area of the knee is where some large muscle groups—including part of the hamstring muscles and the adductor muscles—come together. Inner knee pain can come on suddenly or gradually and may occur without any specific, known injury. It can even occur when you are not running.
Verywell / Theresa Chiechi
This article outlines the symptoms and causes of runner's knee as well as how the condition is diagnosed and treated. It also explains when more invasive treatments, including surgery, may be needed.
Symptoms of Medial Knee Pain
Symptoms of runner's knee can vary but often include:
Pain in the medial (inner) side of your knee joint
Pulsating or throbbing knee pain
Aching or dull pain radiating around the knee
Swelling in your knee
Sharp pains beneath your kneecap
Difficulty running, climbing stairs, or rising from a seated position
Inner knee pain is usually intermittent and occurs during running or immediately after running. It can also happen with any activity that puts stress on the knee joint.
The pain often occurs during weight-bearing activities such as stair-climbing. It can limit your ability to bend or straighten your knee.
What Causes Medial Knee Pain?
Runner's knee may be caused by different conditions and risk factors. Often more than one is involved. These include:
Trauma: Injury to the ligaments, tendons, cartilage, bones, and muscles can occur after trauma such as a fall, forceful twisting of the knee playing sports, or an automobile accident.
Overuse: Repetitive activities and exercise that exceeds the tolerance of the tissues around the knee can lead to pain and knee injury.
Misalignment of your kneecap on your femur (upper leg bone)
Weakness in muscles: Weak quadriceps, hamstring, and gluteal muscles that control your hip or thigh can lead to knee pain.
Muscle tightness: Tight quadriceps, hamstring, and gluteal muscles that control your hip or thigh can lead to knee pain.
Knee osteoarthritis: a degenerative process where the cartilage in the joint gradually wears away causing pain.
Medial meniscus tear: The pad of cartilage in the knee tears when a person twists or turns their upper leg while their foot is planted and their knee is bent.
Knee bursitis: With repetitive motion, the bursa—small fluid-filled sacs between bone and other moving parts, such as muscles, skin, or tendons—can become inflamed or irritated, causing knee pain.
Tendinitis: Inflammation of the tendons may result from overuse of a tendon in the knee during certain activities such as running, jumping, or cycling.
Plica syndrome: Plica is a thick band of tissue that can become inflamed due to injury or overuse. Symptoms may include pain, clicking, popping, swelling, and reduced range of motion.
Improper form while running can increase the risk of injury. Multiple studies that examined running styles found that a reduced length between each stride leads to less energy being absorbed by the hip, knee, and ankle joints. This could suggest that running using shorter strides is associated with a lower risk of injury. The study was performed on both outdoor surfaces and indoor equipment like treadmills.
When you are running or walking, the best position for your knee is directly over your foot. Sometimes, flat feet cause your lower leg to turn inward. This can place increased stress on the inner part of the knee joint, causing pain.
What Is Patellofemoral Pain Syndrome?
Patellofemoral pain syndrome is the same thing as runner's knee. It is considered a disorder of the patellofemoral joint. Besides running, other causes of the condition include walking up and down stairs, squatting, lunging, or standing up from sitting.
How Is Medial Knee Pain Diagnosed?
Diagnosing inner knee pain can be challenging because there may not be one clear cause. In many cases, multiple conditions contribute to your pain. Figuring out which are involved can take time.
During the physical examination for inner knee pain, your healthcare provider will assess various structures around your knee. This exam may include:
Palpation (gently touching and pressing the knee)
Knee range of motion measurements
Strength measurements of the hip, thigh, and leg muscles
Analysis of your gait (how you walk)
Imaging tests are often also part of the evaluation and may include:
X-ray, which can show damage to bones
Computerized tomography (CT) scan, in which multiple X-rays are combined to create three-dimensional "slices" of the knee joint
Magnetic resonance imaging (MRI), in which powerful radio and magnetic waves create highly detailed images of the knee, particularly of soft tissues
Treatment for Medial Knee Pain
There are various treatments for runner's knee. They range from simple home remedies to more invasive medical procedures. It's best to stop running until your pain is gone or you have a healthcare provider's clearance.
With the right treatment, you can expect your knee pain to go away in a few short weeks.
Home Remedies
Home remedies for inner knee pain can decrease your pain and improve your overall mobility. Home remedies may include:
RICE method: This acronym stands for rest, ice, compression (lightly wrapping the knee), and elevation (raising the knee above your heart to reduce swelling). Applying an ice pack to the knee can decrease pain and inflammation by reducing blood flow to injured tissues. Ice is most helpful soon after the pain starts or flares up. Ice your knee for 10 to 15 minutes several times a day.
Heat: Gentle heat applied to the knee can increase blood flow and improve tissue mobility. It can be applied after the pain has settled to help the knee move and feel better. Heat can also be used before stretching. It should be applied for 10 to 15 minutes.
Medication: Over-the-counter anti-inflammatory drugs like Advil (ibuprofen) or Aleve (naproxen) can decrease pain and swelling, while analgesics like Tylenol (acetaminophen) can help alleviate pain but not swelling. Be sure to contact your healthcare provider before taking any medication to ensure that it is safe for you.
Change of footwear: If flat feet are causing inward rotation of your knee joint, shoe inserts or fitted high-arch shoes can help support the arch of your foot.
Exercise: Exercise can strengthen muscles and improve knee mechanics involved with walking and running. Exercises should be slow and steady with controlled movements. These include stretches for the hamstrings, quadriceps, and hips as well as resistance exercises for the hamstrings, quadriceps, and buttocks.
When to See a Healthcare Provider
There are times when inner knee pain requires more than an ice pack and Advil. You should consider seeing a healthcare provider if:
Your inner knee pain is due to trauma.
The knee pain lasts more than a few weeks.
The pain is significantly limiting your ability to move.
The knee looks deformed or misshapen in any way.
There is increased redness, swelling, warmth, tenderness, or pain (suggesting an infection may be involved).
Medical Treatments
If pain persists despite these home treatments, call your healthcare provider. They may refer you to an orthopedic surgeon who specializes in bone and joint problems.
Medical treatments for runner's knee may involve:
Prescription anti-inflammatory drugs: Prescription nonsteroidal painkillers like Celebrex (celecoxib) or Voltaren (diclofenac) gel may be able to relieve knee pain better than over-the-counter medications.
Physical therapy: A physical therapist can prescribe exercises and movements that help strengthen muscles around the knee and improve the flexibility and range of motion of the knee joint itself.
Cortisone shots: Severe, persistent knee pain may require an injection of cortisone into the joint space. This steroid drug relieves pain by blunting the inflammatory processes within the knee.
Viscosupplementation: If osteoarthritis is causing your knee pain, it may be due to the lack of lubricating fluid within the joint. A synthetic lubricant can be injected into the joint space to help the joint surfaces slide past each other more easily, decreasing inner knee pain.
Knee surgery: If your knee pain persists despite conservative medical treatments, you may benefit from surgery to correct the problem. This may involve arthroscopic knee surgery, which uses specialized tools inserted through tiny keyhole incisions. People with severe knee arthritis may need a partial knee replacement or total knee joint replacement.
Surgery for medial knee pain is generally considered a last resort once all other treatments have failed.
Most people who have arthroscopic knee surgery return to pain-free walking within four to six weeks. More complex knee surgeries, like a total knee replacement, may require around six months of dedicated rehabilitation to get back to normal.
How to Prevent Medial Knee Pain
If you’re a runner, using the proper running form can help prevent runner's knee. For example, shorter running strides and making sure your knee is directly over your foot when running or walking.
Other strategies to prevent knee pain and injuries include:
Start running slowly, and keep steady progress
Don’t increase your mileage or intensity too quickly
Rest between runs
Incorporate other types of exercise into your routine to reduce strain on your knees
Wear properly fitting shoes and change them every 300 to 500 miles
Run on softer surfaces like a track or dirt path rather than pavement
Doing certain types of stretches can loosen tight leg muscles, as well as muscles on the side of the knee, that may be pulling the kneecap out of its groove as it moves.
Summary
Inner knee pain that occurs with walking, running, or weight-bearing activities is often referred to as runner's knee. Runner's knee can vary in its severity but typically causes pain and swelling in the medial (inner) part of the knee just under the kneecap.
Runner's knee may be caused by a traumatic knee injury, overuse, arthritis, or structural weaknesses in the joints and muscles that move the knee. The diagnosis of runner's knee involves a physical exam and possibly also an X-ray, CT scan, or MRI scan of the knee.
Depending on the severity, runner's knee may be treated with ice or heat application, over-the-counter painkillers, exercise, and a change of footwear. Severe cases may require prescription painkillers, physical therapy, cortisone knee injections, viscosupplementation, or surgery.
A Word From Verywell
Inner knee pain caused by running can be a challenging thing to treat. There can be many different causes for the pain and many different ways to treat it. Your doctor will usually take a stepped approach, starting with conservative treatments before moving on to more invasive procedures.
As much as you may want a "quick fix," a slow and steady approach often affords better results. With patience and a full understanding of the benefits and risks of the various treatment options, you'll be better equipped to make informed decisions.
Read the original article on Verywell Health.
