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Physio Comes To You: Pain on Inside of Knee - Treatment in London

Associated Services

This information is not a definitive list but only a guide to possible causes of your pain which can be helped by your physiotherapist. There are a wide range of medical conditions that can cause your pain. An assessment by one of our physiotherapists will allow them to take a detailed history and perform a thorough examination to give a diagnosis. They can then treat you effectively or recommend a medical referral if it is required.

Patellofemoral syndrome

Often pain felt on the inside of the knee is connected to Anterior Knee Pain explained in more detail by clicking on 'Pain over front of knee'.

Medical meniscus pain

There are 2 meniscus. These are half moon shaped pieces of cartilage that sit between the tibia (shin bone) and femur (thigh bone) within the joint of the knee. The medial meniscus is the one on the inside of the knee joint. They help to lubricate the knee joint and provide shock absorption on impact. Sometimes if the knee is twisted then they can become inflamed or torn. There can be pain or clicking on certain activities ie getting out of the car or rolling over in bed. If the tear is significant then there can be significant pain and swelling.

Physiotherapy can help by performing tests to determine whether you have injured your meniscus. Treatments offered are advice on relieving any swelling and inflammation and progression through a number of exercises to regain movement of the knee and strength around the knee. If your physiotherapist feels you need a medical review we can recommend top London knee consultants.

Synovial plica

A capsule surrounds the knee. There can be 4 parts of this capsule called the medial plica, suprapatella plica, inferior plica and lateral plica. The medial plica is the most common and found in the inside of the knee. Sometimes these plica can rub on the bone. This can give rise to pain on the inside of the knee and clicking. There may be sharp pain felt when squatting.

Physiotherapy can help by performing certain tests to determine if this may be the cause of your symptoms and treat appropriately.

Pes anserinus tendinopathy or bursitis ('gooses foot')

Tendons of 3 muscles of the thigh called the Sartorius, gracilis and semitendinosis all combine together and insert into the same location on the inside of the lower leg near the knee. The pes anerinus is a small fluid filled sac called a bursa which lies between these tendons and the bone of the leg (tibia). Sometimes this bursa can become inflamed particularly in breaststroke swimmers, cyclists and runners. Symptoms include tenderness on the inside of the knee and swelling. Stretching and working of hamstrings can cause pain.

Physiotherapy can help by reducing the inflammation and taking you through specific exercise programme.

Medial collateral ligament injury

The medial collateral ligament runs down the inside of the knee and connects the femur (thigh bone) to the tibia (leg bone). This ligament can be sprained or torn. The sprain can be grade I where a few fibers of the ligament have been stretched. Grade II sprain means a large number of ligament fibers have be stretched and a grade III sprain is a complete tear of the ligament.

Physiotherapy can help by treating to stop any stiffness of the knee happening and encourage healing of the ligament. Exercises will be set to encourage strength and stability around the knee. If your physiotherapist feels the ligament sprain is severe enough to require a medical review we can recommend top London knee consultants who you can see. A brace may be required to fully protect the ligament and allow healing.

Osteoarthritis

This involves degeneration (wear and tear) of the joint surfaces of the inside of the knee. It is more common in later life and difficult to tell whether osteoarthritis or injury of the medial meniscus. Often an injury to the medial meniscus causes more stress on the inside of the knee and therefore makes the process of degeneration faster.

Physiotherapy can help with advice, setting exercises, pain relief. Being overweight contributes to the quickening the process of degeneration therefore weight loss is advised.

Slipped capital femoral epiphysis

This is a problem with the femur which can cause pain on the inside of the knee. IT tends to be more common in boys around the age of 12-15 and being overweight can contribute. The slip of the growth plate over the femur can happen suddenly or more gradually.

Perthes disease

This is a breakdown of bone over the femoral head (top of the thigh bone) which particularly affects males between the age of 4 and 10. Symptoms commonly include a limp and ache in the thigh, groin and knee. Some movement of the hip may be stiff and reduced.

Physiotherapy can help with providing appropriate exercises and advice.

Referral of pain

Pain felt on the inside of the knee may be coming from other parts of the body ie. trigger points in other muscles or from a problem in the pelvis, lower back or hip.

Rheumatoid Arthritis

Rheumatoid Arthritis is when the immune system goes haywire and attacks the body rather than defending it causing inflammation of the lining of the joints and tendons of the muscles. Affected joints in the body that have the arthritis become swollen, painful and stiff. Morning stiffness on waking is very common. Muscles around the joints often become weaker and doing certain activities of daily living can become more difficult.

We can provide experienced physiotherapists to see you at home and work with you to help manage your condition. The first time the physiotherapist visits they will carry out a thorough assessment which includes looking at your mobility and walking aids, muscle strength, joint movement, posture and function. Following the assessment the physiotherapist will discuss any treatments they can provide and set goals with you to improve your general function and mobility and achieve the maximum potential in your home, work and social life. These treatments can include advice on ice, exercise programmes, massage, taping, acupuncture and mobility programmes.

We can also provide occupational therapists to come to your home. They help people to regain the ability to carry out activities that have purpose and meaning to them and become or remain as independent as possible. Some of the services they can offer include:

  • Home assessments including modifications such as rearranging furniture, building ramps, widening doorways, grab bars, special toilet seats etc
  • Wheelchair assessments
  • splinting
Fibromyalgia

This condition does not involve inflammation but affects the fibrous tissues in many parts of the body ie. tendons, muscles, connective tissue etc. There can be a large number of tender points and a feel of generalized aching. One of the common tender points is on the inside of the knee. There a number of other symptoms including fatigue, sleep disturbances, sensitivity to temperature, morning stiffness, numbness and tingling, irritable bowel, depression and dry eyes and mouth.

Physiotherapy can help people with this condition. There are pain relieving techniques that can be used and they are experienced in pacing you back to being able to exercise again and return to activities whether sport, work or hobbies that you were able to do before the condition started. They also are able to provide advice on how to cope with your condition and manage flare ups of pain.

Chronic Pain

Acute pain is the pain we feel immediately after injuring ourselves and while the injury is healing. Chronic pain is pain that continues even though healing has occurred and it is not unusual to find no direct link between the pain and the original injury that may have healed a long time ago. Chemical changes happen in the brain and spinal cord to re-route signals to pain centres in the brain. Then any normal sensation such as a movement, touch, pressure, stretching etc can be felt as pain. In some instances the pain system can be activated without any physical stimulus ie changes in weather, mood, thoughts or no stimulus at all.

Physiotherapy for chronic pain has to involve many aspects and address other factors that come into play rather than just the pain itself. They will treat the pain and also use methods to help you manage your pain including advice on pacing and coping with flare ups and negative thoughts, graduated exercise programmes and goal setting. They will aim to return to you being able to participate again in activities you were involved in before developing chronic pain whether work, sport of hobby related.

Complex Regional Pain Syndrome

This condition as the name suggests is complex. The pain is often constant and of a burning type. The body part affected is often very sensitive to touch and just a stroke can cause pain. There can be changes in temperature and colour of the body part and on occasions growth of excess hair and swelling. The wrist can be affected by this syndrome and the pain can extend over the hand and up the arm. The exact cause of it is not clearly known and can happen with no cause but there can be an event before it occurs such as a fracture. 'The sympathetic nervous system' has been shown to be involved which controls blood flow and skin temperature.

Physiotherapy can help with this condition by keeping the part of the body affected moving and stop it stiffening up. They can help to use techniques to desensitise the area and acupuncture can help the pain in some cases. Your physiotherapist will also recommend a top London pain consultant to you who can use treatments to block the sympathetic nervous system from firing and provide appropriate medication to help with the pain.

Other possible causes

Your physiotherapist will take a detailed history of your symptoms and past medical history before performing a full physical examination. There are a number of other possible causes of your symptoms which are not appropriate for a physiotherapist to treat in any way or that need a medical opinion alongside physiotherapy treatment. In this case they will recommend you to your GP or an appropriate specialist doctor or specialist consultant. These possible causes include:

  • cardiovascular symptoms
  • respiratory (breathing) symptoms
  • gynaecological symptoms
  • urinary or genital symptoms
  • digestive symptoms
  • immune system symptoms
  • lymph system symptoms
  • hormonal symptoms
  • neurological symptoms
  • dermatological (skin) symptoms
  • medication side-effects
  • virus
  • infection
  • cancer
  • disease process
  • psychological problem ie. depression, anxiety
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