Medial (Inner) Knee Pain Exercises

Strengthening and stretching exercises can help ease medial (inner) knee pain caused by chronic conditions such as osteoarthritis and knee tendon bursitis or acute injuries such as a sprained medial collateral ligament (MCL) and partially dislocated kneecap.

The exercise plan can differ by your condition and the severity of your symptoms. The plan should ideally be directed by your healthcare provider, a physical therapist, or a specialist in joint and bone disorders (orthopedist).

This article offers eight exercises that can ease inner knee pain by increasing flexibility and strengthening the knee and supporting structures. It also describes ways to ease knee pain and exercises and activities to avoid during recovery.

Straight Leg Raise

Straight leg raises (SLR) are a great initial way to target the quadriceps muscles in the front of the thigh. The technique activates this knee-supporting muscle without placing excessive pressure on the joint itself. It can be helpful for osteoarthritis, meniscal lesions, a subluxed kneecap, or an MCL sprain. In addition, performing this version of a leg raise can also improve friction-related issues like pes anserine bursitis. To do this technique appropriately:

1. Lie on your back and keep your uninvolved knee bent.
2. Tighten your thigh muscle on the involved side.
3. Keeping the muscle contracted, slowly lift the injured leg about 12 to 16 inches in the air. Do not allow your knee to bend as you do this.
4. Hold the leg at the top of the motion for one to two seconds before slowly lowering it down again.
5. Try three sets of 10 repetitions.

Single-Leg Balance

Proprioceptive exercises like the single-leg balance technique are a great way to target the stabilizing muscles in the leg. This technique helps build strength and balance in individuals and can be beneficial for people with medial osteoarthritis, a medial meniscal tear, a patellar subluxation, or an MCL sprain. Here’s how to complete it properly:

1. Stand on a level surface and straighten your injured knee by squeezing your thigh muscle.
2. Lift the other leg in the air and try to maintain your balance without leaning your body or using your arms if possible.
3. Hold this position up to 30 seconds if you can before returning the involved leg to the ground.
4. Repeat the pose five to 10 times.

If the exercise gets easy, it can be progressed by closing your eyes. You can also increase the challenge by standing on something wobbly like a sofa cushion or a thick bath towel. Be sure you have a nearby counter or chair to grab if you lose your balance.

Seated Knee Extension

Seated knee extension is another easy way to focus on the quadriceps muscle using only a resistance band or ankle weight. This exercise can help build strength and improve symptoms associated with medial OA, medial meniscal tears, MCL sprains, or pes anserine bursitis. To correctly complete this technique:

1. Sit on the edge of a higher chair with your legs dangling toward the ground.
2. Secure a resistance band around your ankle and tie it to the leg of the chair. A light cuff weight can also be fastened around your ankle instead.
3. Without lifting your thigh off the chair, slowly extend your injured knee against the resistance.
4. When your affected leg is completely straight, hold this position for one to two seconds before slowly bending it toward the ground again.
5. Complete three sets of 10 repetitions.

Resisted Side-Stepping

In addition to the quadriceps muscle, the gluteus medius plays an influential role in supporting the inner knee. Building strength in this fan-shaped muscle, which is located on the outside of your hip, may help improve the symptoms associated with medial knee osteoarthritis, medial meniscal degeneration, an MCL sprain, a patellar subluxation, or pes anserine bursitis. Resisted side steps are a good way to target this important area. Here’s how to do this exercise:

1. Stand with your feet shoulder-width apart and tie a resistance band around both ankles.
2. Bend your knees slightly. Without losing the squat, take a large step to the side with the injured leg.
3. Slowly bring your uninvolved leg back toward you until the legs are once again shoulder-width apart. Try not to let your trunk lean to the side as you make these movements.
4. After taking 10 side steps in one direction, reverse and go the other way 10 times. Try completing three sets to each side.

Step-Ups

Using the bottom step in your house, the step-up exercise activates the quadriceps muscles while mimicking a common daily activity. This simple technique is another way to reduce the pain associated with knee osteoarthritis, MCL sprains, meniscal lesions, and patellar subluxations. To do a proper step-up:

1. Begin facing the stairs with the foot of your involved side on the bottom step.
2. Slowly step up with your uninvolved leg while making sure that your injured knee does not buckle inward.
3. Once both feet are on the step, reverse the movement and gradually lower the uninvolved foot back toward the ground. Again, be sure to keep the knee aligned over your foot.
4. Complete this exercise 10 times and aim for three total sets.

If the step-ups are getting too easy, you can make them more difficult by increasing the height of the step or by holding a dumbbell in each hand as you do them.

You can also try completing side step ups in addition to forward step ups. Not only does this engage the glutes (buttocks muscle), but it can help with knee support and medial knee pain.

Wall Squat

Using only an empty wall, the wall squat technique will have you feeling the burn in your quadriceps muscle. This exercise can increase strength in this area and help improve the medial knee symptoms associated with OA, meniscal tearing, an MCL sprain, a patellar subluxation, or pes anserine bursitis. Give it a try like this:

1. Stand with your back to a smooth wall and your feet about 12 inches away from it.
2. Lean against the wall so that your buttocks and shoulders are touching it.
3. Bend your knees as you slide your body halfway down the wall.
4. Engage your core muscles to maintain good posture and keep your back on the wall.
5. Hold this position for five seconds before sliding back up again. Make sure not to let your knees go over your toes as you do this.
6. Complete two to three sets of 10 repetitions of the exercise.

If you have difficulty returning to the standing position after performing a wall squat, consider placing chairs next to you that you can grab for added support. This can help prevent overuse strains and muscle imbalance. Alternatively, you can start with sit to stand exercises and work your way up to wall squats.

To make this exercise more challenging, try increasing the amount of time you hold the squat or sliding further down the wall until your knees are bent to a 90-degree angle. You can also attempt the exercise while holding a dumbbell in each hand to increase the difficulty.

Because excessive pronation of the foot can cause the arch to cave inward and increased amounts of stress to be placed on the medial knee, it is a good idea to wear supportive footwear while you exercise.

Hamstring Stretch

If you have a medial knee injury, the lack of movement of the knee can quickly cause your hamstring to become tighter. When this happens, your ability to fully extend the knee decreases, exposing you to pain and instability as you walk or climb stairs.

It is important, therefore, to increase the flexibility and strength of your hamstrings by doing gently controlled stretches regularly. Here's how:

1. Lie on your back with your legs straight and your arms at your sides.
2. Grasp one leg with both hands behind your thigh.
3. Keeping your leg straight, lift it into the air as high as you can with your foot flexed. (To avoid possible back pain, the opposite leg may be bent for comfort.)
4. Hold the stretch for five to 15 seconds without locking the knee.
5. Release and repeat with the opposite leg.

As you get stronger, you can hold the stretch longer and/or add repetitions.

Alternatively, a hamstring stretch can be performed using a stair or chair.

Butterfly Stretch

The butterfly stretch is a yoga pose traditionally used to stretch the inner groin muscles.

To do the butterfly stretch:

• Sit on the floor with your legs stretched in front of you. 
• Bring your knees to your chest with your feet together and your heels pulled close to your hips.
• Let your knees open and slowly drop to the ground.
• Holding your feet for balance, let gravity slowly pull your knees down.
• Flex and relax your muscles to encourage your knees downward but do not bounce.
• Hold the position for as long as comfortable and then release.

Safe Activities for Knee Pain

If you have medial knee pain, you may need some time to rest until the acute pain and swelling have passed. You should then start moving again, albeit at a reasonable pace.

Some injuries, such as an MCL tear, can take a full six to eight weeks before you can return to sports or normal activity. During that time, you may need a knee splint, brace, or compression bandage to support the knee. A mobility device like a walker, a pair of crutches, or a cane may also be needed.

As you start to regain mobility, there are certain low-impact activities that you can do on a regular basis to recover. These include:

• Treadmill walking
• Swimming (only flutter strokes initially)
• Stationary cycling
• Deep-water walking

The recovery plan should be guided by several principles:

• Always warm up before starting any physical activity.
• Be consistent, engaging in physical activity two to three times weekly.
  
• Build up the duration and intensity gradually. Do not rush.
• Slow, controlled movements are more effective and safe than fast, abrupt movements.
  
• Cool down after any exercise or physical activity.
• Use support if needed and ease back if there is any discomfort.

Exercises to Avoid

Rehabilitation for a medial knee injury can be tricky because you can easily re-injure yourself by overdoing it. Even if you are pain-free, you may not necessarily be in your pre-injury condition. If you are older or experienced a severe injury, you may not always be able to do the activities you used to. Speak with your provider about appropriate exercise.

The knee is ultimately a complex but delicate structure, and you should avoid certain exercises and activities that can set your recovery back, including:

• Lunges and squats
• Running or jumping
• Hiking or walking on uneven surfaces
• Cycling rapidly, on uneven surfaces, or up steep hills
• Lifting heavy objects without a knee brace or support
• Any activities that require a quick change of direction, including dancing

If you experience pain, stop immediately. It means you are overdoing it.

Other Ways to Relieve Inner Knee Pain

Acute knee pain is characterized by inflammation, redness, and swelling. This can only happen not only with acute injuries but also when you overdo it with arthritis or bursitis.

To relieve acute inner knee pain:

• Rest your knee as much as possible, elevating your leg to decrease blood circulation and ease throbbing pain.
• Ice the knee for 10 to 15 minutes several times a day. Place a cloth barrier between your skin and the ice pack to prevent frostbite.
• Use a compression bandage to reduce swelling and inflammation.
• Take an over-the-counter pain reliever like Tylenol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) like Advil (ibuprofen) or Aleve (naproxen).

See a healthcare provider if the pain and swelling don't go down (or get worse) after a few days.

Summary

Stretching exercises can help ease medial knee pain, while strengthening exercises can help provide knee support and stability. Depending on the severity of your symptoms, you may need to meet with a healthcare provider or physical therapist to design a safe, effective, and appropriate rehabilitation plan.

The aim of any program is to take it slow and steady, increasing the intensity and duration of activities gradually. Avoid weight-bearing exercises, running, jumping, or any activity that requires a quick change of direction until you are amply healed and your provider gives you the OK.