01 Jun Pain on Inside of Knee? The Problem No One is Talking About
Pain on the inside of the knee can be frustrating, especially when it isn’t going away with traditional advice from your friend (“Just ice it”) or your doctor (“Go to physical therapy”).
Fortunately, some problems can be easier for an Annoying Pain Specialist to diagnose.
If you’ve have had a trauma, you probably have meniscus or medial collateral ligament (MCL) damage.
Especially if the pain is behind your knee sometimes. It would feel like you put your wallet inside of a door hinge.
If you’re over 50, you probably have osteoarthritis.
These days, more and more people aren’t fully trusting their doctors’ opinions about the cause and solution to their inside the knee pain problems.
Rightfully so … there’s a very common cause of pain inside the knee that no one is talking about.
Before we get there, let’s rule out the more common problems.
How To Figure Out If You Have Meniscus, MCL, and Arthritis Damage
Certain problems are easily diagnosed by most doctors.
Trauma is a simple indicator that you need an MRI and have probably meniscus or medial collateral ligament (MCL) damage. Other data points that contribute to these diagnoses include:
- Pain going up or down stairs.
- Pinching inside of the knee or behind it with restricted flexibility when you bring your heel to your butt. It feels like someone put a wallet in the door-hinge of your knee.
During the heel-to-butt test, a healthy, pain-free knee would let your heel touch your butt the way it does for Amanda above.
If you’re over age 50, you could have meniscus or MCL damage. It’s more likely that you have arthritis. Arthritis is a garbage can term for bone growth or cartilage shrinking or tearing. Other data points that contribute to this diagnosis includes:
- Pain during inactivity that gets better with some activity (and worse with a lot of activity).
- The presence of pain/no pain or with/without restricted flexibility are not super relevant when you bring your heel to your butt.
The diagnosis of arthritis in the cartilage under the patella goes at the top of your diagnostic list when you feel pain under the patella at the bottom of a lunge forward with your other leg. If you’re not comfortable lunging, you can do the Lunge Stretch Test and have someone pick up your foot when your hip is at the end range of being pushed forward. If there’s no pain, you don’t likely have articular cartilage damage under the patella.
When your pain inside the knee doesn’t fit any of these diagnostic puzzles, there’s often another problem that is causing your pain. Unfortunately, almost no doctors are talking about this problem. Fortunately for you, this problem is very easily addressed by an expert.
The Problem No One is Talking About
When you’ve had your pain more than 2 months and you’ve seen 3-5 other doctors without more than 50% relief, you and I can probably both agree that there’s something else going on.
The pain on the inside of your knee can be caused by failed ankle or hip tests.
You would fail any of the following:
- Knee to Wall Test (Ankle Dorsiflexion) – with your toes 6″ away from the wall, can your knee touch it with your heel down?
- Thigh to Chest Test (Hip Flexion) – lying on your back, can your thigh touch your ribs?
- Lunge Stretch Test (Hip Extension)– kneeling, can the front of your hip move 12″ in front of your knee?
If you failed any of those tests, your knee would start as inflamed and get better with rest. As time went on and you didn’t fix the failed test, you’d be risking the meniscus, MCL, or arthritic damage you currently don’t have.
In order to get the failed test fixed and passing so that your knee operates at 100%, you need to find a adhesion specialist to find out if you have adhesion for any muscles that are responsible for stopping the joint in the correlated test.
If all of those tests are passing, the adhesion specialist would look at the knee joint itself.
Adhesion in the Knee Capsule is One of Most Common Causes of Pain On Inside of Knee
When it comes to pain on the inside of your knee, they’d look for adhesion inside of your knee capsule.
The knee capsule is a paper-like sheath that surrounds the whole knee joint (notice the green lines above and below the patella).
Adhesion acts like glue (red squiggles) in the knee capsule.
Normally, your heel should touch your butt like it did for Amanda above.
When you have adhesion in your knee joint capsule, you’d feel a slow-building tightness or mild pain in your knee joint with the Heel to Butt Test.
Your range would be restricted too. Amanda’s knee flexion range was 4 finger-breadths away (3″) from being full (see picture below).
Remember, a restricted Heel to Butt Test that is NOT caused by adhesion, but by meniscus damage, would have moderate or significant pain (that is often “pinching” in nature and felt behind the knee). When the restriction is arthritis, the pain would typically get better with exercise (not worse).
How to Fix the Pain Inside of Your Knee
When you get the adhesion removed from your knee, you can expect flexibility changes like this:
This gentleman’s heel-to-butt flexibility went from 3″ to 0.75″ in 5 minutes.
Treatment to get this type of quick and permanent change requires an expert who is able to feel exactly where the adhesion is:
The coolest thing about this type of treatment is that you’d notice relief immediately afterwards.
If You’re Going to Do Anything for Your Knee, Make Sure It Works
My heart breaks when people have been getting any pain treatment for 10, 20, or 30 visits without any significant relief.
This type of healthcare is not OK by me.
That’s why we have a 5 Visit Rule at Barefoot Rehab.
You should notice permanent relief in your pain in 5 visits or less. Often after one visit/treatment.
So if you’re going to get treatment for pain inside your knee, make sure it’s working. If it isn’t, find another doctor or healthcare provider.
Have you found a treatment that works for the pain on the inside of your knee? Tell us about it.
Lenore Hata WilliamsPosted at 17:31h, 22 June
Your website is amazing. Whether elbows or knees ( I have both problems) you addressed it in ways no other specialists have. While the best ‘ treatment’is to have you look at it ( and fix it, lol!) I can stop spending unnecessary time and $$ on things that haven’t worked.
What can you tell me about Plantar fasciitis on the same side as my knee problem?
Dr. ChrisPosted at 17:49h, 22 June
TY for kind words Lenore.
First, here: https://www.barefootrehab.com/the-truth-about-plantar-fasciitis-and-arch-pain/
Second, you need 6″ with Knee to Wall Test: https://www.barefootrehab.com/know-your-numbers-ankle-pain-foot-pain-and-ankle-dorsiflexion/
Third, it’s a combination of treating calf and foot and taking stress off foot to let it recover, assuming you don’t need surgery to repair a large tear.
Let me know if that’s helpful.
Boyd KirkPosted at 16:34h, 25 July
Hi. Can you refer a clinic in Sasktoon, Saskatchewan. I have knee flexion pain and its terrible. Ive been going to physio for over 3 months with minimal benefit. I still have shooting pain when I do the knee to butt test. Please reach out to me, your website is amazing. 306-270-8584 or email@example.com. Thanks, Boyd Kirk
Dr. ChrisPosted at 12:35h, 26 July
Responding over email.
Simon RamosPosted at 11:50h, 27 July
Hi. I recently received a blow to the inside of my knee a week back and the pain is progressively getting worse. The pain is amplified when I bend the knee and then extend it and the pain is usually a dull pain that radiates up my thigh. Although the pain is more in the lower area of the inside of the knee. I have physical therapy for underlying arthritis but it has not gotten any better with exercise. Keep in mind I am a 16 year old male with underlying chronic illness. My dad is going to find a orthopedic knee specialist and surgeon since he works at Texas Children’s Hospital. I was wondering if that is the correct move?
Dr. ChrisPosted at 21:26h, 28 July
Hi Simon, what’s the diagnosis your PT is working with? Is the pain bending and extending the knee in the middle of the range or the end of the range? What’s the exact tissue-specific diagnosis of the “arthritis”? Have you had an MRI? I would definitely see an adhesion removal specialist first, but you would probably have to travel out of state.
Chris MyrickPosted at 00:28h, 20 September
I am an avid hiker and had an undiagnosed knee injury that left me unable to walk down stairs. A few months later, after rest, stretching and stregthening, on the decent from a hike I started feeling pain in the same place, on the inside of the knee and numbness in the patellar tendon. I just found your article and fail all three tests for adhesion. What steps should i take?
Dr. ChrisPosted at 11:19h, 20 September
Hey Chris, if you fail, you’ll have to find an Integrative Diagnosis provider to get you the permanent relief you deserve. Check it out here: https://integrativediagnosis.com/find-an-id-provider/
Chris MyrickPosted at 16:06h, 21 September
Thank you for your prompt response I’ll be sure to look into this.
Dr. ChrisPosted at 12:38h, 23 September
Norman LancasterPosted at 06:18h, 10 November
my knee started it hurt one day after resting I got up and almost fell down . it’s more to the front of the inside of knee. after i walk a little the pain eases some. i didn’t hurt it that i know of
Dr. ChrisPosted at 00:52h, 28 January
How do you define “hurt”?
Pain, by definition, implies you DID INJURE it. Just because there was no trauma doesn’t mean you didn’t hurt it.
Mercedes Neves-HatchwellPosted at 04:41h, 17 May
I understand I have osteo arthritis in my knees;,I also torn my medial meniscus in November and Two months ago had arthroscopic medial Meniscus tear and bone spur shaving. Getting I assume, but can’t sleep due to sharp stabbing pain in the inner part of the injured knee; even the bed cover hurts…I think I have a adhesion? Please I need your help. My quality of life is no good
Dr. ChrisPosted at 12:45h, 30 May
Hi Mercedes! I’m sorry you’re dealing with this! Can I ask you where you live?
Nancy M.Posted at 13:16h, 25 February
Can you recommend a doctor in RI or MA that specializes in adhesions? I am a runner and have had a pinching pain behind my knee since July 2020. I have been to 2 different doctors several times and the pain is still there.
Dr. ChrisPosted at 17:12h, 26 February
Brady Back Institute – he created this technique and there’s no one better in the world.
andres lorenzoPosted at 06:07h, 06 March
hello I did a knee stretch where flexed to 160 like this image https://imgur.com/a/63C4bkx I did it 1 minute before going to sleep for several nights, it has already been 6 months and it still hurts, which could have been ?
Dr. ChrisPosted at 13:19h, 09 March
Adhesion is biggest possibility. Could also be meniscus or another joint pathology.
Nancy MPosted at 22:42h, 03 April
Thanks for the referral but Danvers is a little bit too far for me to travel I live close to Providence Any one in that area specialize in adhesions?
Dr. ChrisPosted at 12:11h, 05 April
There aren’t many of us. You can try a local myofascial therapist or rolfer and give them 5 treatments to get you some % of permanent relief. If none, you may need to travel. We often have people travel as far away as 2-3 hours.
TanyaPosted at 03:23h, 15 April
I have pain in my knee since 2018 and can’t squat, kneeling, heels to butt etc. I remember I had a good fall, skiing in 2017 and it felt like I strained something, but everything was fine 1 week after. 10/2019 I went to see a Dr.. we started with PT but nothing was helping and he did an MRI and diagnosed a Meniscus tear. I had surgery 7/2020 without any success and no relief in pain. I had a cortisone shot in 11/2020 which lasted maybe 2 month. Went to see another Dr. and he said it’s Mucoid degeneration of the ACL and he did surgery 3/15/2021 ( almost 4 weeks ago). Pt instructor said I’m flying through the ACL recovery, but I can tell that the surgery had nothing to do with the issue in my knee. I feel the same exact pain I felt since the beginning same area. I’ve told the Dr and his reply was there is nothing else what could be done, I keep telling them (Dr & PT) that if I lay on my back and try to do the foot to butt, that I feel like something is inside my knee what stops me from bending my knee. I’ve been researching the internet to figure out what else could be done and found your page, I was wondering if you could recommend anybody in Co who is specialized in adhesion. Please help, I’m so frustrated
Dr. ChrisPosted at 19:11h, 17 April
You’re in luck – about 60 adhesion docs in world and 3 are in CO. Type in your zip code here:
Zaina RomeroPosted at 22:34h, 05 March
Hi, I have pain on the inner side of my knee. All of a sudden one day my knee was hurting. I can’t recall anything happening that would result in this pain but obviously somethings wrong. It’s been about 3 weeks to a month now. I did the four test you showed..I believe properly..and the one I had trouble with was the heel to butt. There was some pain in the same spot and I feel a little something, not pain but something after doing that on the front bottom of my knee. I have stiffness and pain mostly when I wake up. But I do have to be careful during the day doing activities that make me move a lot. Like run or dance with my kids. Ive had knees that pop all of my adult life. Not sure what that means or if that’s normal, not normal. But I’d like to know what you think and if there’s anyone in Bakersfield Ca that you can recommend? Thankyou ❤️
Dr. ChrisPosted at 14:34h, 07 March
Hi Zaina, it sounds like you have some medial meniscus damage or adhesion in the capsule/meniscus. I believe we have one adhesion doc in CA. Check it out here. You may have to travel if you really want it better.