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Medial Knee Pain With Flexion

Thessaly And Ege Tests

Medial knee rotation and knee flexion muscle action with Muscle Premium

Two additional tests are the Thessaly test and the Ege test:

Advocates of the Thessaly test state it is a safe and reliable method to detect meniscal injuries. The Thessaly test is performed with the patient standing first on the good leg, and then on the symptomatic leg, with the knee in 5 degrees of flexion and again with the knee in 20 degrees of flexion. Next, the patient rotates the body internally and externally 3 times, and the test is considered positive if there is joint line discomfort and/or a sense of locking or catching.

To perform the Ege test, the patient assumes a squatting position with the lower extremities held in maximum external rotation and repeated in maximum internal rotation . Pain and/or an audible click during the maneuver are consistent with a positive test.

Medial Collateral Ligament Sprain

Injury to the medial collateral ligament is fairly common and is usually the result of acute trauma. The patient reports a misstep or collision that places valgus stress on the knee, followed by immediate onset of pain and swelling at the medial aspect of the knee.11

On physical examination, the patient with medial collateral ligament injury has point tenderness at the medial joint line. Valgus stress testing of the knee flexed to 30 degrees reproduces the pain . A clearly defined end point on valgus stress testing indicates a grade 1 or grade 2 sprain, whereas complete medial instability indicates full rupture of the ligament .

Other Fewer Causes Of Medial Knee Pain

Pain on the inside of the knee will occur from injuries or conditions, chiefly in the hip and lower back. The sciatic nerve gets squeezed or compressed radiating pain down the leg. Other sources of medial knee pain in young athletes include- tumors, slipped capital femoral epiphysis and Perthes disease within the hip.

Inner Knee Pain by Activity

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How Are Knee Problems Diagnosed

In addition to a complete medical history and physical exam, other tests for knee problems may include:

  • X-ray. This test uses invisible electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.

  • Magnetic resonance imaging . This test uses large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body can often determine damage or disease in a surrounding ligament or muscle.

  • Computed tomography scan . This test uses X-rays and computer technology to make horizontal, or axial, images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

  • Arthroscopy. A minimally-invasive diagnostic and treatment procedure used for conditions of a joint. This procedure uses a small, lighted, optic tube , which is inserted into the joint through a small incision in the joint. Images of the inside of the joint are projected onto a screen used to evaluate any degenerative or arthritic changes in the joint to detect bone diseases and tumors to determine the cause of bone pain and inflammation.

  • Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patientâs bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

Treatment Of Pain On The Inside Of The Knee

Flexion &  abduction &  lateral rotation of thigh at hip Flexion &  medial ...

Luckily, Pain on the Inside of the Knee can be treated and sure will disappear in no time. You can either treat it at home or go to see a physician who will attend to you and provide expert recommendation for you. However, most of the knee pain injuries or inflation can be resolved by using home treatment.

  • Rest your knee

One of the simple ways to solve Pain on the Inside of the Knee is to rest your knee. If you are sure that the injury occurred during activities such as sports or other physical events, avoid this activity until the knee has healed.

  • Use an Ice Pack

This is a common and simple step to ease yourself from knee pain. By Applying an Ice pack on the injured area of the knee for 30 minutes at least three to four times a day, can reduce the pain or inflammation, thereby relieving you of the pain. You can buy Ice packs from pharmacies and online, or you can make one in your home.

  • Anti-Inflammatories

You can also use anti-inflammatories as an Inner Knee Pain Treatment. You can use over-the-counter anti-inflammatory medications, such as aspirin or ibuprofen.

  • Exercises

Exercises such as quad stretch, hamstring stretch, and half squats can help to strengthen your knee and improve the healing process reducing and taking away the pain.

  • Consult a Physician

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The Terrible Triad: Part Ii

The degeneration of the meniscus root causes it to tear. When the tear occurs, the function of the meniscus is lost. That loss of cushioning function causes an increase in stress on the bone. The meniscus usually distributes the force of weight-bearing evenly across our knee joint surface. If the root tears and the function of the meniscus are lost, then the force of weight-bearing will concentrate is small areas on the joint surface. That will overstress the cartilage and lead to arthritis. In the terrible triad, many of you will also have at least mild osteoarthritis. Osteoarthritis of the knee implies that you have lost some of the articular cartilage which covers the ends of the bones in the knee. That cartilage also cushions the knee.

Causes Of Medial Knee Pain

There are many causes of inducing inner knee pain. Here we consider the most prevalent causes of inside knee pain. It can link to an injury. Some of the most prevalent incidents that lead to knee injury and pain, that combines a fall from high, sports injuries or enhanced activity.

Adults, particularly those over 60 years are most likely to experience knee pain. However, inner knee pain can also develop in kids and youngsters. The following are the most frequent possible causes of inner knee pain.

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Can Knee Injuries Be Prevented

To help prevent knee injuries:

  • Make sure your kids wear the recommended protective equipment for sports .
  • Make sure your kids wear supportive athletic shoes that are in good condition.
  • During workouts, kids should always warm up and cool down.
  • Encourage kids to do regular strength training to support muscles, and stretching or yoga to improve flexibility.
  • When jumping, kids should bend the knees while landing. This takes pressure off the ACL and prevents injury.
  • If kids cut laterally or pivot frequently , encourage them to crouch and bend at the knees and hips to reduce the chances of an ACL injury.
  • For kids who play just one sport, conditioning and training year-round even if it’s at a lower intensity than during the competitive season can help them stay in shape and make an injury less likely.

Treatment Of The Terrible Triad Of Medial Knee Pain

Valgus Stress Test | Medial Collateral Ligament (MCL) Knee

Most of you who have all three of the findings I mentioned above will usually have very severe pain. For some of you, your Doctor will focus only on the meniscus and recommend surgery to remove the torn meniscus.

That is not recommended as the best way to proceed if you have a degenerative root tear in the presence of osteoarthritis and bone marrow edema. If your doctor recommends surgery to clean out the knee, the research shows that the operation often fails to alleviate your pain, and increases your risk of needing a knee replacement.

Why does your knee hurt so much! It is often the bone marrow edema or inflammation in the bone from the stress reaction or insufficiency fracture which is causing your pain. Usually, time and limiting weight-bearing can improve that pain. It may take 1-3 months for the pain to subside. A subchondroplasty for bone marrow edema may help some people feel better. Determining who might benefit is often a challenge. And infections or complications from a subchondroplasty can be hard to manage.

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What Is Causing My Inner Knee Pain

Let’s have a look at the common symptoms associated with medial knee pain and what they typically indicate:

Pain On Inside Of Knee No Swelling: If there is no swelling with your medial knee pain, it is likely only a minor injury such as a small cartilage tear or a grade 1 sprain of the MCL.

Inner Knee Pain Running: Knee pain medial side during or after running is most typically caused by a cartilage tear or Runners Knee.

Inner Knee Pain When Straightening Leg:Pes Anserine Bursitis is the main culprit here as the bursa can easily get squashed when straightening the knee.

Medial Knee Pain With Flexion: Most medial knee pain gets worse with knee flexion, especially when weight bearing through the leg. If it’s worse when standing, it may indicate an MCL tear or meniscus tear. If it happens when you are sitting or bending the knee, it may be pes anserine bursitis or plica syndrome.

Anterior Medial Knee Pain: If your inner knee pain is coming round to the front of the knee, it may actually be a problem with the knee cap or Runners Knee rather than one of the structures on the inner knee.

Medial Knee Pain When Sitting Cross Legged: Pain in the inner side of knee when sitting cross legged is most likely due to a meniscus tear as this position places extra stress on the cartilage.

Medial Knee Injuries: The most common medial knee injuries are MCL tears and medial meniscus tears, which often both happen at the same time as a result of awkward twisting or sporting injuries.

What Are Knee Injury Symptoms And Signs

Acute knee injuries can cause pain and swell with difficulty bending the knee and weight-bearing. Acute knee injuries often may be considered as falling into two groups: those where there is almost immediate swelling in the joint associated with the inability to bend the knee and bear weight, and those in which there is discomfort and perhaps localized pain to one side of the knee, but with minimal swelling and minimal effects on walking.

If the swelling occurs immediately, it may suggest a ligament tear or fracture. If the swelling arises over a period of many hours, meniscal or cartilage injuries may be the cause. However, injuries to the knee may involve more than one structure and the symptoms may not present classically.

Longer-term symptoms that point to knee problems will include pain and swelling in addition to other complaints. Inflammation in the joint may be caused by even minor activity. Swelling may be intermittent, brought on by activity, and may gradually resolve as the inflammation decreases.

Pain, too, may come and go. It may not occur right away with activity but might be delayed as the inflammation develops. Pain can also be felt with specific activities. Pain while climbing stairs is a symptom of meniscus injury, where the cartilage is being pinched in the joint as the joint space narrows with knee bending. Pain with walking downstairs suggests patellar pain, where the kneecap is being forced onto the femur.

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Diagnosis Of Inner Knee Pain

If you see your doctor with knee pain, theyll examine your knee and are likely to ask:

  • when your pain started and if theres anything that makes it worse
  • if theres any activity, accident or injury that could have caused it
  • if you have any other symptoms such as your knee giving way or clicking, or pain in any other joints

They may suggest an X-ray or an MRI scan, but this is not always necessary. Your doctor may be able to make a diagnosis based on the examination and your symptoms.

If you have cartilage or ligament damage, your doctor may suggest a procedure to look inside your knee. This is called an arthroscopy . It involves making a small cut in your knee and inserting a thin tube and a camera. As well as helping with diagnosis, damaged tissue can be repaired or removed during the procedure.

Excessive External Tibial Rotation


Now, this one is a little more rare. A too outwardly rotated tibia will cause faulty tracking of the patella in the patellar groove, causing it to grind into the lateral aspect of the condyle. This condition is often referred to as chondromalacia patella.

Once again, as seen in the illustration below, we use the center of the patella and tibial tuberosity as landmarks for measurement. If the tibial tuberosity is vertically in line with the lateral edge of the patella, or further than that, this is a positive indication for excessive lateral tibial rotation.

Fig. 10

This condition is often caused by a combination of flat feet, and/or weakness of the hip flexors or gluteal complex, causing tibial external rotation or femoral internal rotation to excessive degree. To correct it, its a good and simple start to train the muscles that oppose the dysfunction:

Once again, measure the rehabs progress by using the landmarks of the knee. Youll want the tibial tuberosity in line with the 3:4th lateral aspect of the patella .

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Other Inner Knee Pain Treatments

If your inner knee pain worsens after several days, or if basic at-home remedies dont alleviate symptoms, you should go see your doctor.

Some treatment methods for more serious knee injuries include:

  • Steroid injection. This injection is used to treat pes anserine bursitis.
  • Physical therapy. Therapy often involves stretching, exercises, and ultrasound therapy.

Causes Of Anterior Knee Pain With Flexion

In Anterior Knee Pain with Flexion, the patient experiences stabbing pain in the front and the central part of the knee when flexing the knee. Below mentioned are some of the causes of Anterior Knee Pain with Flexion:

Chondromalacia Patella: This is a pathologic condition in which there is degeneration and softening of the cartilage on the underside of the kneecap. The kneecap which in medical terminology is termed as the patella is located over the knee joint.1 Frequent bending motion of the knee causes the back portion of the kneecap to slide over the bones of the knee. The thigh and the shin bone are connected to the kneecap with tendons and ligaments. With repeated motion and flexion of the knee, any of these components of the kneecap may start to malfunction resulting in pain and discomfort and cause Anterior Knee Pain with Flexion.

Runners Knee: Runners Knee is not a specific pathological condition but is an amalgamation of different disorders in the knee. As the name suggests, this condition is mostly found in runners or sprinters. It can be caused due to overuse of the knees which can irritate the patellofemoral joint, over-stretching of the tendons may also be a reason for Runners Knee because of which a person experiences Anterior Knee Pain with Flexion.

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Causes Of Inner Knee Pain

There are several things that can cause inner knee pain. These include:

  • injury such as a blow to the outside of your knee, which pushes your knee inwards
  • activities that involve sudden twisting or pivoting of your knees for example, skiing or playing rugby
  • activities where you have to use your knee a lot for example, cycling, gymnastics or swimming breaststroke
  • getting older and your knee joint becoming worn down

Osteoarthritis Of The Lateral Compartment Of The Knee

The Exam for Knee Pain – Stanford Medicine 25

Initial treatment of osteoarthritis includes symptomatic relief with painkilling and anti-inflammatory medication, exercise prescription and weight loss if indicated. Intra-articular hyaluronic acid injections have a similar effect to anti-inflammatories, but the patient does not have to take tablets daily.

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Surgery: Arthroscopy Vs Joint Replacement

An arthroscopic procedure preserves the natural structure of the knee joint. In contrast, a knee replacement procedure replaces it with an artificial one.

In addition, the size of the incisions in arthroscopic surgery and knee replacements is another crucial difference. Three small incisions are necessary for arthroscopic knee surgery, each about a centimeter in length . Knee replacement surgery, on the other hand, is an open procedure.

When determining the indication for a joint replacement on the hip or knee, the patient plays a decisive role. From a medical point of view, there is no must for an operation. Because it is not the x-ray findings of osteoarthritis or the degree of cartilage wear that are decisive for the surgical decision, but the patients level of suffering. For the latest technology, ask about robotic knee replacement surgery.

The most critical factor in the treatment algorithm is the patients level of pain. If your pain cannot be easily treated with nonoperative treatments, it is time to consider surgical intervention.

For personalized and innovative knee pain treatment in Hawaii, call Dr. Morton at +.

Things To Know About Knee Injury

The knee is a hinge joint that has a simple purpose. It needs to flex or extend to allow the body to perform many activities, like running, walking, kicking, and sitting. Imagine standing up from a chair if your knees couldn’t bend.

While four bones come together at the knee, only the femur and the tibia form the joint itself. The head of the fibula provides some stability, and the patella helps with joint and muscle function. Movement and weight-bearing occur where the ends of the femur called the femoral condyles match up with the top flat surfaces of the tibia .

Two major muscle groups are balanced and allow movement of the knee joint. When the quadriceps muscles on the front of the thigh contract, the knee extends or straightens.

  • The hamstring muscles on the back of the thigh flex or bend the knee when they contract.
  • The muscles cross the knee joint and are attached to the tibia by tendons.
  • The quadriceps tendon is special, in that it contains the patella within its fibers.
  • The patella allows the quadriceps muscle/tendon unit to work more efficiently.
  • The quadriceps tendon is renamed the patellar tendon from the kneecap to its attachment in the tibia.

The stability of the knee joint is maintained by four ligaments, and thick bands of tissue that stabilize the joint.

Inside the knee, there are two shock-absorbing pieces of cartilage called menisci that sit on the top surface of the tibia.

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