Knee pain on the inner side of the joint is a common issue that can make everyday movements like walking, squatting, or even sitting uncomfortable. Whether it’s a sharp twinge or a lingering knee soreness on inside, this kind of discomfort is often linked to problems like meniscus injuries, MCL sprains, osteoarthritis, or inflammation in the soft tissues around the joint. You might notice it more when crossing your legs or feeling pressure on the inside top of your knee. This post explores the most common causes of inside knee pain and offers guidance on typical management strategies that reduce strain and enhance mobility.

Over 25% of adults will experience persistent knee pain in their lifetimes.¹ The inside (medial aspect) of the knee is a common area of discomfort. If you are experiencing pain in this area here are five common injuries that may be the culprit.

Knee Pain on Inside: 5 Common Causes of Knee Soreness on Inside of the Joint

Meniscus Irritation or Injury

The medial meniscus helps absorb weight as you move, particularly during high impact activities like running and jumping. It is often injured while playing sports. Unexpected collisions, stopping and starting at high speeds and twisting movements are the events that typically result in meniscal injury. Afterward, you may notice pain and swelling throughout the knee especially on the inside of the joint. You will also experience a loss in range of motion, and may feel like your knee is unstable while walking. If you have suffered a traumatic injury to your meniscus you should seek medical attention immediately. Depending on the nature of the tear, surgery may be warranted.

While traumatic meniscus injuries are common, it is also possible to irritate the meniscus through repetitive movements. Frequent squatting and bending while working, can over time, cause small fissures to develop in the meniscus resulting in nagging pain and instability. In these situations, an offloader knee brace can be a great treatment option. Because the brace actively reduces pressure on the joint, it will help keep you on your feet and working while letting your meniscus heal.

Pes Anserine Bursitis (PAB)

Bursae are small fluid-filled sacs that sit between bones, muscles, and tendons. They allow for proper joint function by reducing friction during movement. The Pes Anserine Bursa is located on the inside of the upper tibia (shin bone), just below the knee joint. Strain caused by over-exercising or poor biomechanics can cause it to become inflamed.² Symptoms include tenderness, swelling, and pain on the inside of the knee. Typically PAB resolves with rest, physiotherapy, icing, and anti-inflammatory drugs.³

Synovial Plica Syndrome (SPS)

Plica are extremely thin sheets of viscous tissue that surround the knee joint. Sometimes this tissue can get in the way of normal joint movement causing impingement, which can be painful and reduce the range of motion of the joint. The plica on the inside of the knee is most commonly affected.⁴ Typically pain presents itself on the upper/inside area of the knee at 70-100 degrees of knee bend.⁴ Symptoms often begin without an obvious cause, although those with weak quadriceps muscles appear to be at higher risk.⁵ Episodes of pain are generally worsened by heavy physical activity or prolonged knee flexion such as when the leg is bent during sleep.⁵ Catching, popping, grinding, cracking, and instability are also commonly reported, making it tough to differentiate from other types of knee pain.⁶

Rest and activity modifications are commonly recommended for SPS. Temporarily avoiding lunging, squatting and high impact activity is also recommended. A tailored exercise regime prescribed by a physical therapist can help return the knee joint to normal function. In cases where exercise, rest and other conservative treatments have failed, surgery may be considered.⁵

Medial Collateral Ligament (MCL) Sprain/Strain

The MCL is an integral part of your knee joint – attaching the inside edge of the thigh bone to that of the shin bone. As inward stress is applied to the knee joint, the MCL helps resist strain and keep the joint stable. Sometimes the strain surpasses the strength of ligament causing it to partially tear or in more serious cases completely rupture. This injury is common in sports that involve tackling, and high impact athletic feats. In professional soccer, 70% of MCL injuries are due to contact with another player.⁷ Given the strength of the MCL, injuring it comes with immediate symptoms such as pain, swelling, inability to bear weight and instability.

• Grade I: The MCL has been overstretched, while there is no major damage, it’s function will be compromised until it has healed.
• Grade II: The MCL has been partially torn and may require surgery to repair depending on the extent of the damage.
• Grade III: A complete tear of the MCL requiring surgery to reconstruct the ligament.

Medial Knee Osteroarthritis (OA)

Arthritis is the most common cause of knee pain for those over the age of 50.¹ Over 35% of knee arthritis diagnoses include degeneration in the medial compartment of the knee.⁷ As you age, the cartilage protecting your joint slowly erodes away. In arthritic knees this degeneration is advanced, exposing bone surfaces onto each other. This creates excessive friction during movement. Symptoms include grinding sensations, stiffness, and pain. There are four grades of osteoarthritis (I-IV) which can be diagnosed using x-ray imaging.

In medial knee OA, the arthritis is confined to the inside of your knee only. This means that the lateral and patellofemoral compartments on the outside of your knee and the kneecap may still be quite healthy. There are many treatment options at your disposal. Painkilling drugs, exercise, diet, knee braces, injections, and surgery are all viable options. If you are suffering from medial OA, surgery is considered a last resort – most doctors recommended exhausting your conservative treatment options first.⁹

Tip from our bracing specialists

If you’re noticing knee soreness on the inside of the joint, or a persistent ache from knee pain on the inner side, it’s often a sign that the structures on the medial side of your knee are under strain. This can happen from repetitive movements, poor alignment, or even everyday activities that put pressure on that area. Focusing on gentle strengthening and mobility work can help relieve tension, while a Spring Loaded brace may offer extra support by reducing stress through the inner part of the joint – making it easier to move without worsening the discomfort.

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Resources

Hopefully, this information has provided you with some insight as to what could be causing the pain on the inside of your knee. For more information on knee pain treatments visit our Complete Guide to Knee Pain

If knee arthritis is the underlying cause of your knee pain check out:

• • • Learn more about Osteoarthritis
    • Learn more about Osteoarthritis Treatment Option

Frequently Asked Questions (FAQ)

1. What causes knee soreness on inside of the joint?
Knee soreness on inside of the joint is often related to overuse injuries, such as medial meniscus tears, inflammation of soft tissues like bursae, or ligament strain. These issues commonly develop from repetitive movements or poor alignment during physical activity.

2.Is knee pain on the inner side a sign of something serious?
Knee pain on the inner side can sometimes point to underlying issues like medial collateral ligament (MCL) sprains or early arthritis. While it’s not always serious, recurring or worsening symptoms may suggest a need for targeted support and movement adjustments.

3.Why does the inside of my knee hurt when I cross my legs?
Pain on the inside of the knee when crossing your legs could be caused by irritation of the pes anserine area, soft tissue inflammation, or pressure on the medial structures of the joint, especially if you sit in that position for long periods.

4.What are some common triggers for inside top of knee pain?
Inside top of knee pain is often aggravated by squatting, climbing stairs, or twisting motions. It may be due to overuse, muscle imbalances, or inflammation near tendon insertions like the pes anserine.