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.

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.

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

Symptoms of runner’s knee can vary but often include:

  • Pain in the medial (inner) side of your knee jointSwelling in your kneeSharp pains beneath your kneecapDifficulty 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.

Causes

Runner’s knee may be caused by different conditions and risk factors. Often more than one is involved. These include:

Recap

Runner’s knee typically causes pain in the inner part of the knee joint just under the kneecap. The pain can come and go but mainly occurs when weight is placed on the knee.

  • Trauma
  • Overuse
  • Misalignment of your kneecap on your femur (upper leg bone)
  • Weakness in muscles that control your hip or thigh
  • Muscle tightness around the hip or knee
  • Knee osteoarthritis
  • Medial meniscus tear
  • Knee bursitis or tendinitis
  • Plica syndrome, an inflammatory condition affecting the knee joint

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.

Diagnosis

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.

Runner’s knee is often caused by a traumatic knee injury but may also be due to overuse, arthritis, inflammatory conditions like Plica syndrome, or weaknesses of the muscles that move the knee.

During the physical examination for inner knee pain, your doctor 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)
  • Other specialized knee tests

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

There are various treatments for runner’s knee. They range from simple home remedies to more invasive medical procedures. With the right treatment, you can expect your knee pain to go away in a few short weeks.

Runner’s knee is diagnosed with a physical exam along with imaging tests like a CT or MRI scan to look for abnormalities in the structure of the knee joint.

Home Remedies

Home remedies for inner knee pain can decrease your pain and improve your overall mobility. Home remedies may include:

  • Ice: 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 doctor 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 Doctor

There are times when inner knee pain requires more than an ice pack and Advil. You should consider seeing a doctor 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 doctor. 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 their over-the-counter counterparts.
  • 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.

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 treated at home with ice or heat application, over-the-counter painkillers, exercise, and a change of footwear. If these fail to provide relief, prescription painkillers, physical therapy, cortisone knee injections, viscosupplementation, or surgery may be needed.

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.

Frequently Asked Questions

  • Is running bad for your knees?
  • No, running is not bad for your knees, but improper form while running can increase the risk of injury. Multiple studies that examined running styles found that a reduced length between each stride lead 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.
  • Does runner’s knee cause pulsating knee pain?
  • Yes, runner’s knee can cause pulsating or throbbing knee pain. It can also cause an aching or dull pain radiating around the knee and lead to swelling of the knee.
  • Is patellofemoral pain syndrome the same as runner’s knee?
  • Yes, patellofemoral pain syndrome and runner’s knee are the same. 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.

No, running is not bad for your knees, but improper form while running can increase the risk of injury. Multiple studies that examined running styles found that a reduced length between each stride lead 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.

Yes, runner’s knee can cause pulsating or throbbing knee pain. It can also cause an aching or dull pain radiating around the knee and lead to swelling of the knee.

Yes, patellofemoral pain syndrome and runner’s knee are the same. 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.