Clinical Picture –  How I Treat Inner Knee Pain

Clinical Picture – How I Treat Inner Knee Pain

Lately, I’ve had numerous clients report they’ve been struggling with inner knee pain. With gyms not easily accessible, they took up walking, hours of it! They reported the pain initially starting about 4-6 months ago, that it never really went away and that it progressively and slowly got worse. They reported that they never experienced pain throughout those months, only” irritation” (until recently of course, which is what forced them to come in). Mornings seem to be ok, a little stiffness which got better with some movement and a hot shower. Sitting didn’t hurt, walking usually aggravated it and walking downstairs seemed to be the most painful (walking upstairs was uncomfortable, but ok). They had full range of movement at the knee and only slightly tenderness. Certain key factors were observed in standing:

  1. Knocked knees with knee caps facing inwards
  2. High foot arches that collapsed inward

As the high arches collapsed, their shin bone rotated inward. To compensate for this, the hip has to rotate outwards to balance out. This created a rotational stress on the knee, possibly irritating the medial meniscus, which is a cushion in the knee joint that acts as a shock absorber. With more weight put on it, it seemed to hurt more. This presented as an issue as it prevented these clients from walking; however, treatment and especially education, seemed to prove pivotal. In under 10 days all of them were successful in controlling their pain and managing their knee symptoms 

I used 5 very straight forward methods, last one being the most effective:

  1. Manual therapy for the knee,  techniques that are targeted to the joint to increase movement, decrease irritation
  2. Soft tissue releases on the muscles surrounding the knee (hamstring, quadriceps, etc)
  3. specific strength Exercises for the muscles around the knee 
  4. GUNN IMS + Electrical modalities, (needling)
  5. Education!!! (most effective)
    1. intentionally keeping knee caps in line with second toe, as well as keeping the knees behind the toe line as one moves (while walking, running, squatting, doing a sit to stand and so on). This is to prevent that knocked knee collapse.
    2. Preventing flattening or collapse of the arch of the foot.. This means wearing shoes with appropriate arch support (either by tossing old ones out and replacing them with new ones that are properly fitted, or grabbing some quality insole). I recommend going to a shoe speciality store for this option as there are many shoes and many types of insoles. No single foot is the same, so an expert is highly recommended

If you suffer from medial knee pain, look at point #5 and see if there is an improvement. If the knee pain persists, then either hop on a virtual call with us on come in for a in-person assessment. We won’t disappoint! 

PS: if you chose to purchase insoles, make sure you take the ones in your shoes out before putting new ones in … common mistake, so don’t feel bad if you made it before ☺


Ranko Vukovic

Physiotherapist, CEO, Owner, Head Honcho