What is Medial Knee Pain?
Medial knee pain refers to discomfort experienced on the inner side of the knee joint. The term “medial” simply means closer to the midline of the body. This specific area includes several important structures that help stabilize and move the knee.
Two key structures often associated with medial knee pain are the medial collateral ligament (MCL) and the medial meniscus. The MCL is a strong band of tissue running along the inner side of the knee, connecting the thigh bone to the shin bone and providing stability against forces that push the knee inward. The medial meniscus is a C-shaped piece of cartilage that acts as a shock absorber and helps distribute weight evenly across the joint.
This inner region of the knee is particularly susceptible to pain during movements that place rotational or inward stress on the joint. Activities involving bending and loading the knee, such as squatting, can especially highlight issues within these structures.
Why Medial Knee Pain Occurs During Squats
Medial knee pain during squats stems from mechanical factors and tissue irritations. One common issue is improper squat form, known as valgus collapse. This occurs when the knees cave inward during the downward phase of the squat, placing excessive stress on the medial structures of the knee, including the MCL and medial meniscus. Incorrect form can also involve the knees tracking too far forward over the toes or a lack of engagement from the hip muscles, altering knee mechanics.
Muscle imbalances around the hip and thigh also contribute. Weakness in the hip abductors, such as the gluteus medius, can lead to the knees collapsing inward during the squat, as these muscles are responsible for keeping the knees aligned over the feet. Conversely, tightness in the adductor muscles, located on the inner thigh, can pull the knees inward, increasing strain on the medial knee. Addressing these imbalances helps manage and prevent pain.
Tissue injuries or irritations are frequent culprits. A mild strain of the medial collateral ligament (MCL) can cause pain, especially if the knee experiences sudden lateral stress. The medial meniscus can also become irritated or sustain minor tears, particularly with deep knee flexion under load, as the squat movement compresses and shears this cartilage. Meniscal issues might manifest as a dull ache or a sharper pain.
Another potential source of medial knee pain is Pes Anserine Bursitis or Tendinitis. The pes anserine bursa is a fluid-filled sac on the inner knee, cushioning the tendons of three hamstring muscles (sartorius, gracilis, and semitendinosus) where they attach to the shin bone. Inflammation of this bursa or irritation of these tendons can cause pain on the inner knee that is aggravated by squatting.
Identifying the Source of Your Pain
Understanding your medial knee pain’s characteristics provides initial clues about its source. Pay attention to the specific location of the pain: Is it directly on the inner joint line, slightly below it, or more diffused? Note the type of pain: sharp, stabbing, dull ache, or burning. Observe when the pain occurs, such as only during the deepest part of a squat or immediately upon loading.
Consider what other movements or activities, beyond squatting, aggravate your knee pain. Does it hurt when walking up or down stairs, when sitting with your knees bent for extended periods, or when twisting your knee? This broader context helps differentiate potential causes. Gentle palpation around the inner knee might reveal tenderness in specific spots, such as along the MCL or where the hamstring tendons attach.
These observations are helpful but not a substitute for professional medical advice. If you experience sudden, severe pain, significant swelling, a feeling of instability in your knee, or an inability to bear weight, seek immediate medical attention. Persistent pain that does not improve with rest and basic self-care within a few days also warrants a visit to a healthcare professional, such as a doctor or physical therapist, for accurate diagnosis and treatment.
Strategies for Relief and Recovery
Temporary activity modifications offer immediate relief for medial knee pain. Reducing the depth of your squats or decreasing the weight you lift lessens the load on your knee. Temporarily substituting squats with alternative exercises that do not aggravate the pain, such as leg presses or hamstring curls, allows injured tissues to rest and heal. Listen to your body and avoid movements that sharply increase pain.
The RICE protocol (Rest, Ice, Compression, and Elevation) helps manage acute pain and swelling. Resting the knee allows irritated tissues to calm. Apply ice for 15-20 minutes several times daily to reduce inflammation and numb the area. Gentle compression minimizes swelling, and elevating the leg above the heart reduces fluid accumulation.
Incorporate gentle movement and mobility exercises as pain subsides. Light stretching of muscles surrounding the knee, such as the hip flexors, quadriceps, and adductors, can improve flexibility and reduce tension contributing to poor mechanics. Foam rolling areas like the inner thigh, IT band, and glutes can release muscle tightness. These movements should be performed carefully, ensuring they do not increase pain.
Progressively introduce basic strengthening exercises for overall knee stability. Exercises like glute bridges and clam shells strengthen the gluteal muscles, crucial for proper knee alignment. These exercises should be low-impact and performed without pain. Consistently practicing proper squat form, even with bodyweight, retrains movement patterns and reduces medial knee stress.
Preventing Medial Knee Pain
Preventing medial knee pain recurrence, especially during squatting, requires consistent attention to preparation and body mechanics. Always warm up thoroughly before workouts to prepare muscles and joints. Include light cardio, dynamic stretches, and mobility drills for hips, knees, and ankles. A cool-down with static stretches helps maintain flexibility and aids recovery.
Progressive overload is fundamental for long-term knee health. Gradually increase workout intensity, volume, or weight over time, allowing your body to adapt and strengthen without overwhelm. Lifting too much weight or increasing repetitions too quickly can stress knee structures, leading to injury. A measured approach builds resilience safely.
Developing comprehensive strength and stability in surrounding knee muscles is crucial for prevention. Strengthening quadriceps, hamstrings, glutes, and core muscles provides robust knee joint support. Strong glutes control hip movement and prevent knees from caving inward during squats, mitigating medial knee stress. Incorporate exercises that challenge balance and proprioception to enhance knee stability.
Maintain good flexibility and mobility in hips, knees, and ankles for full range of motion during squats, reducing compensatory knee strain. Regular stretching and mobility work prevents stiffness and ensures the joint moves through its intended path. Pay attention to your body’s signals and avoid pushing through pain; pain often indicates a need for adjustment.