Home >Knee > Medial (Inside) Knee Pain
1. Medial ligament Disorders (MCL)
The medial ligament is regarded as a very serious injury involving the knee. The ligament’s purpose in the knee is to aid in sideways movement and balance.
The injury can either be a slight strain (2-3 weeks), a slight tear (4-6 weeks), or a complete rupture requiring surgery (approx. six months to full recovery).
The medial ligament when hurt will normally be associated with other surrounding injuries to that area. The medial meniscus, the cartilage and surrounding quadriceps muscles will usually be damaged or hurt also.
Damaging the medial ligament happens in a sudden jerky movement usually involving a twisting landing motion in which the knee will collapse inward, eg:falling from a great height and landing on a straight leg or landing in such a way your body weight is too large for the inner muscles and ligaments to bear.
The injured can sometimes feel the tear or hear an audible popping noise at time of damage.
Swelling quickly follows a sharp pain, which is usually followed by constant throbbing soreness and a need to limp.
2. Medial cartilage (meniscus) tear
There are two mensci in the knee; each rests between the thigh bone (femur) and shin bone (tibia) and act as ‘shock absorbers’ in the knee joint. The menisci are made of tough cartilage and conform to the surfaces of the bones upon which they rest. These menisci function to distribute your body weight across the knee joint. Without the meniscus present, the weight of your body would be unevenly applied to the bones in your legs (the femur and tibia). This uneven weight distribution would cause excessive forces in specific areas of bone leading to early damage of these areas. Therefore, the function of menisci is critical to the health of your knee.
How do the menisci work?
The joint is made up of three bones: the femur (thigh bone), the tibia (shin bone), and the patella (knee cap). The surfaces of these bones at the knee joint are covered with articular cartilage. This cartilege allows the bones to slide against each other without causing damage to the bone. The meniscus sits between the cartilaginous surfaces to distribute weight and to improve the stability of the joint.
The menisci are semilunar shaped and have a wedged profile. The wedged profile maintains the stability of the joint by keeping the rounded femur surface from sliding off the flat tibial surface. the blood supply to the menisci is provided by small blood vessels, but they also have a large area in the centre of the meniscus that has no direct blood supply (avascular). This presents a problem when there is an injury to the meniscus as the avascular areas tend not to heal. Without the essential nutrients supplied by blood vessels, healing cannot take place.
The two most common causes of meniscal tears are due to traumatic injury (often seen in athletes) and degenerative processes (seen in elderly patients who have degenerated cartilage). The most common mechanism of traumatic meniscal tears occurs when the knee joint is bent (flexed) and the knee is then twisted. It is not uncommon for this injury to occur along with tears of the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL); these three problems occurring together are known as the “unhappy triad”, which is seen in sports such as football when the player is hit on the outside of the knee. Individuals who experience a meniscal tear usually experience pain and swelling as their primary symptoms. Another common complaint is joint locking, or the inability to completely straighten the joint. This is due to a piece of the torn meniscus physically impinging the joint mechanism of the knee.
What treatments are available for a torn meniscus?
Any knee injury can be treated acutely with ice and immobilization. This will decrease swelling and pain in the joint. Your physician can use information about how the injury occurred and physical examination techniques to determine the likelihood of a meniscal tear. While x-rays are invariably normal with an isolated meniscus tear, the MRI evaluation will often reveal abnormalities of the meniscus. The next step is to determine whether or not surgery is necessary. If an individual is not a good surgical candidate or if their symptoms are not severe, surgery can often be delayed or avoided altogether.
A severe knee cartilage injury can radically change an active adult’s lifestyle. Symptoms such as locking, catching localized pain and swelling often affect your ability to work, play, even perform normal activities.
A cartilage lesion appears as a hole or divot in the cartilage surface. Since cartilage has minimal ability to repair itself, even what may seem like a small lesion (ranging from the size of a dime to a quarter), if left untreated, can hinder your ability to move free from pain, and cause deterioration to the joint surface.
Strengthening programs should only be commenced when:
Exercises should be 3 sets of 8-12 repetitions.
Early Injury Management
For approximately the first 72 hours following an injury, the RICE regime should be followed to ensure control of inflammation and pain relief.
R - Rest
I – Ice
C - Compression
E – Elevation
Rest from aggravating activity.
Ice should be applied in the first 72 hours or when inflammation persists. Ice should be applied for 15 to 20 minutes at a time. Ice should not be applied directly to the skin, but through a wet towel or cloth.
Compression can be achieved with an elastic bandage.
Elevation is used to help swelling to return to the heart through the blood stream.
The injured area should be elevated above the level of the heart.
The exercise bike provides for effective general knee strengthening, it is low/no impact and provides a consistent resistance for muscle strengthening.
The exercise bike can also be an effective exercise for conditions where joint stiffness is an issue.
The exercise bike is an effective warm-up prior to other strengthening exercises.
1. Quadricepts Stretch
2. Long Adductor Stretch
3. Hip Flexor Stretch