Updated: Jul 31, 2020
by Nora Gilman, MS, LAT, ATC
There are many structures on the inside of the knee which can cause pain in runners. Located medially of the patella (the knee cap) is the medial joint line, the MCL (medial collateral ligament), the medial meniscus, the medial patellofemoral ligament, and the attachment of adductor, hamstring, and quad muscles. Chronic onset of medial knee pain is likely due to overuse to any number of these structures.
Pain and inflammation on the inside of the knee with running, walking, or going upstairs.
My Clinical Experience:
(Note: this experience has not been clinically trialed and are theories only)
Knee pain is never because of a problem with the knee, rather, a problem with above or below the joint, such as the hip and foot. The knee is placed in between these two really important joints and can become injured without proper training. Runners perform their activity in a forward plane, therefore, runners commonly lack hip strength which is sustained with side-to-side movement. A lack of hip strength can cause stress on the inside of the knee. This problem is especially true in female athletes because their hips are typically wider than their knees.
What you can try:
Modify running: If you find running makes your symptoms worse, try to find an intensity or amount of running that you can sustain without making the condition worse.
Update equipment: Weak hips can cause pronation of the foot (arch falls ‘inward’) which causes stress on the inside of the knee. Make sure your running shoes are updated in order to provide enough support while the knee recovers.
Stability and Strengthening: Since the knee pain is likely caused by joints above and below the knee joint, starting a strengthening and stability regimen of the hip and foot can protect the knee while running.
Kinesio-Tape: Kinesio-tape applied to the medial knee during the day and during activity can act as a stand-in structure support to take the tension off the soft tissue. This added support can accelerate the healing time.
Cross Train: You can find other activities to engage in to keep your aerobic fitness while you turn down your running volume. Some alternatives are biking, swimming, or water jogging. These activities can strengthen other muscles that you may not be using in running. If any of these activities make your symptoms worse, try a different activity.
When to contact an athletic trainer:
If you need help and advice on properly modifying your activity, an AT can provide you with ongoing support.
If you need direction with the right stretching and strengthening protocol, an AT can get you started on effective exercise progression and regressions.
If you feel painful catching or clicking around the medial knee joint, an AT can advise you on the right steps to take next.