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 Rachael Mayfield-Blake, Freelance Health Editor, September 2023
Next review due September 2026

Inner (or medial) knee pain is exactly that – pain on the inside of your knee. ‘Medial’ means ‘middle’, and the inner side of your knee is the side nearest to the middle of your body. There’s a range of things you can do to manage inner knee pain, and treatments that can help too.

A diagram by Bupa of where inner knee pain is located

Causes of inner knee pain

Several things can cause inner knee pain. These include:

an 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 getting worn down

Conditions that cause 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, and helps 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 and connects your thigh and shin bones. You might completely or partially tear your anterior cruciate ligament. It’s a sudden injury and is caused by either twisting or overextending your knee suddenly. Or it can happen if you suddenly slow down, stop or change direction. It 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 – for example, 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 common cause of inner knee pain. In osteoarthritis, structural changes happen to your joints: over time, your cartilage becomes damaged and painful. This condition mostly affects people over 45 and 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 behind or 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 get active after sitting down for a while.

Inner knee pain symptoms

Pain on the inner side of the knee can feel different for different people. You may feel medial knee pain as a sharp pain or as 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 inside knee pain 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 symptoms usually happen straight away. You may have swelling, but not always.

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 develop over several hours following the initial injury. You may have pain and swelling and find it difficult to fully straighten 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 put weight on your affected leg, and gets better when you rest your leg. You may have stiffness and difficulty moving first thing in the morning or after you sit for a while. You may also have some swelling around your knee.

Patellofemoral pain syndrome causes either a sharp pain or an ache inside your knee, usually at the front of your kneecap, but might also be to the left or right of it. It will feel worse if you run, climb stairs, squat, or if you sit for a long time.

Pes anserine bursitis can cause pain when you go up and down stairs or when you stand up. You may also have pain at night or some slight swelling.

Medial plica syndrome usually 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 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 painfully, or locks (gets stuck)
you can’t move your knee
your knee is hot, red, or very swollen

Diagnosis of inner knee pain

If you see your GP with knee pain, they’ll examine your knee and will likely 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 – for example, your knee giving way or clicking, or pain in any other joints

They may suggest you have an X-ray or an MRI scan, but this isn’t always necessary. Your doctor may be able to make a diagnosis based on your examination and symptoms alone.

If you have cartilage or ligament damage, your doctor may suggest a keyhole surgery procedure to look inside your knee. This is called an arthroscopy and involves making a small cut in your knee and inserting a thin tube and a camera. As well as helping with your 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. It’s a good idea to follow the POLICE procedure after an inner knee injury. POLICE stands for the following.

Protect. Protect your injury from further damage. Rest immediately after the injury but not for long. Consider using some form of support or crutches.

Optimal Loading. Get active sooner rather than later. Start to put weight on your knee and build up your range of movement. Do this gradually – be guided by what feels right for you.

Ice. Place a cold compress such as a bag of ice or frozen peas wrapped in a towel onto your knee. Do this for around 20 minutes every couple of hours for the first two to three days.

Compression. Compress your knee using a bandage to help reduce swelling.

Elevation. Elevate your knee above the level of your heart to reduce swelling. Sit or lie on a chair and use a cushion to raise your leg.

Infographic: POLICE principles

Bupa's POLICE infographic (PDF, 0.5 MB), illustrates the ‘POLICE principles’ to reduce your pain and help you to recover. Click on the POLICE image below to download the PDF.

And there are certain things you should avoid in the first three days after your injury so you don’t damage your knee further. These can be remembered as HARM, which stands for the following.

H – Heat. Don’t have hot baths, showers or saunas, and avoid heat packs and rubs.

A – Alcohol. Drinking alcohol can slow down your recovery and mask your symptoms – increasing the risk that you’ll injure yourself again.

R – Running. Don’t run or do any other form of moderate exercise.

M – Massage. Massaging the affected areas can cause more swelling and damage, so avoid this for the first day or two.

You can use both POLICE and HARM to treat any type of soft tissue injury to your knee, including an inner knee injury.

Infographic: HARM principle

Bupa's HARM infographic (PDF, 0.6 MB), illustrates the ‘HARM principle' of things you should avoid doing in the first three days after your injury. Click on the HARM image below to download the PDF.

Treatment of inner knee pain

Inner knee pain treatment includes physiotherapy, painkillers and surgery. If 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 that causes severe pain. If you have a ligament injury, physiotherapy may be enough if your knee is stable when you move it.

For information on treatments, please see the relevant knee condition page.

Not quite what you're looking for? Browse all our knee pain 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.

For more information, see our sections on causes of inner knee pain and conditions that cause inner knee pain.

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 for inner knee pain and treatment for inner knee pain.

Your doctor will assess how serious your knee pain is by asking you questions and examining your knee. If necessary, they’ll arrange for you to have some scans too. Go to see a doctor if your symptoms are severe or don’t start to gradually improve within a few weeks.

For more information, see our section on when to seek medical help.

Bursitis is a condition where the area around a joint or bone is painful, red and swollen due to inflammation. A bursa is a protective thin pocket of jelly-like fluid that sits between your bones and tendons, and acts as a lubricant. Pes anserinus bursitis is one type of bursitis that can cause inner knee pain. Anything that puts additional stress on your knees, such as obesity and certain sports, may cause it.

For more information, see our section on conditions that cause inner knee pain.

More on this topic

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This information was published by Bupa's Health Content Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals and deemed accurate on the date of review. Photos are only for illustrative purposes and do not reflect every presentation of a condition.

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