Medial knee pain, what could it be and how to prevent it?

Pain on the inside of your knee after twisting is one of the most common knee injuries we see at Alpine Physiotherapy.  Particularly if you are a skier, rugby fanatic or a budding Silver Fern! 

What could it be?

If you get the pain immediately after a twisting incident you have likely sprained your MCL (medial collateral ligament) or injured your meniscus.  Your MCL is the big ligament on the inside of your knee, it is one of the 4 ligaments that joins the femur to the tibia.  The meniscus are two C shaped shock absorbers in your knee which can develop tears if the twist is big enough.  If either of these two structures are damaged your knee pain is usually pretty local (ie doesn’t spread), you can bring it on by putting twisting or inward pressure on your knee, you may get knee pain when you bend your knee fully or when straightening it.  Unfortunately (or fortunately) you don’t get that much swelling with these injuries so it is easy to ignore until the next weekend when you are back on the field or skiing up Cardrona or TC.  There can still be a significant amount of damage with little swelling as these parts of the body have a very poor blood supply – which also means they can be notoriously slow when healing.

At Alpine Physiotherapy we use specific tests to see exactly how damaged your knee is.  An MCL strain or tear is graded from 1-3.  A grade 1 tear means that there has been some tissue damage but the ligament is mostly intact.  The tests may be sore but we can’t feel any more movement or laxity when comparing to the other side.  A grade 2 tear is when the inside knee ligament has torn but some of it still remains intact. A grade 3 is when the ligament is completely torn and there is excessive movement on testing without what we call an “end feel” of the ligament.  A grade 3 MCL tear will need to be fitted with the correct knee brace which is locked for a short amount of time to optimise healing. If needed we will refer you on to a specialist doctor who can organise an MRI. 

MCL and meniscus injuries often occur together as they MCL has small fibrous attachments to the outer part of the meniscus.  There are many different types of tears which are named after either the shape they take or the position/location they’re in.  If big enough they can cause your knee to lock and be very painful when weight bearing or walking. 

How long does a knee sprain take to heal?

That completely depends on how badly torn it is.  Minor ones can be back on the slopes in a matter of days or weeks with the help of specialised knee taping techniques or a knee brace. Large tears can take months to be back to 100% and can potentially be a season but not career ending injury. The sooner you see one of our physios and get onto the correct knee treatment plan for your injury the faster you will be back on your feet.

How can knee sprains be prevented?

A strength and plyometric training programme specific to you and your sport has been proven to reduce your injury risk by huge amounts.  Webster and Hewett 2018 did a study on knee injuries in soccer and showed that injury prevention programmes reduce non-contact lower limb injuries by 67%!  Skiing specific knee injury prevention exercises can be found by joining our free facebook group SKI FIT WANAKA. Netball NZ released their programme Netball Smart early 2021, FIFA 11+ has repeatedly proven to be effective at reducing knee injuries in Soccer and FIFA 11+ Kids is a perfect one to get the 8-11 year olds started.

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