The knee is a supporting structure of the human body, in fact it is a joint that has the task of supporting most of the body weight and, at the same time, plays a fundamental role in the execution of all those movements that allow us to walk , jumping, running, bending and squatting: then to carry out all the daily activities.
We have already told you about knee pain in a specific article that you can read here . Today, however, we have decided to dedicate the subject of our discussion to internal knee pain which has causes and characteristics that are slightly different from normal knee pain.

Characteristics of pain
The joint in question is a structure subject to continuous stress and stress, and this suggests the reason why internal knee pain (also called knee pain ) is such a widespread symptom, especially in the elderly, in subjects who practice sports very often and in overweight people.
In the elderly it is a para-physiological phenomenon linked to the normal phenomena of wear and tear due to age. In athletes, pain can easily be the consequence of excessive fatigue or trauma, while for overweight subjects, knee pain is due to the constant and excessive weight load that goes to burden the soft tissues of the knee.
In other cases, however, knee pain occurs in relation to a pathological state. However, if the pain persists, and with this also motor difficulties occur, you are strongly advised not to minimize the symptoms and to promptly contact your doctor.
In light of what we have seen so far, pain in the internal lateral knee in any case can constitute a serious limitation to the performance of daily activities, work tasks and especially sports activity, therefore, every pain must be considered in its global consequences. and subjected to careful checks if it is acute, disabling or occurs frequently.
On the other hand, when the pain is mild, perhaps resulting from a small trauma, such as a bump or a fall, or resulting from an intense training session or physical effort, such as lifting weights, it is generally sufficient to apply ice packs on the site of pain, an action that allows to reduce swelling due to vasoconstriction, and to leave the leg at rest for a few days, avoiding further overloading the knee .
In addition to referred pain in the kneeother types of manifestations and symptoms can also be added, such as a sense of weakness in the joint and sagging when putting on weight, inability to move the leg due to pain and functional impedance, difficulty in extending or flexing the leg, skin redness, skin injured and subcutaneous hematomas, swelling due to an internal effusion of fluid, bone deformities, fever and still the presence of noises when the joint is moved, similar to creaking or the sound of stepped stones.
It is important to add that all these symptoms can manifest themselves in only one knee ( right or left indifferently) or in both knees andthe pain can be localized only to the inner part of the knee or involve it in all its extension, and that the pain can occur even without swelling .
At this point we just have to analyze in depth what can be all the possible causes that at the origin of this widespread pain.

Internal knee pain: the most common causes

Ligament pathologies
The ligament most responsible for internal knee pain is the so-called medial collateral ligament (MCL) which has the function of preventing, or in any case limiting, all those movements that could lead to a dislocation towards the inside of the knee. There are mainly 3 types of ligament injuries:

  • mild stretching;
  • partial tearing of ligament fibers;
  • complete tearing of the fibers.

The extent and degree of the injury are assessed by performing a diagnostic test, or rather a simple maneuver performed by the orthopedic specialist. This maneuver, called valgus stress, is performed both with the leg extended and with the leg flexed (bent), evaluating the functionality of the ligament in its entirety.

Lesions of the menisci
The menisci of the knee act as a real “seal” and are placed between the femur (above) and the tibia (below). They have the task of absorbing mechanical stresses and stabilizing the entire joint by distributing the loads.
The two menisci of the knee have particular and singular shapes: the internal one is more involved in internal knee painassumes the appearance of a “C”, the other (the external one) the appearance of an “O”.
Each meniscus is then divided into an anterior part (anterior horn), an intermediate part (intermediate horn) and a posterior part (posterior horn). It can be said that mainly the injuries to the menisci are consequent to flexion movements of the knee, typical of squatting, an event in which the femur can trap and “pinch” the medial meniscus, injuring its back while, as regards the lateral meniscus this is less subject to the problem as it is more mobile and thicker than the medial one.
Sometimes, however, the injury can also be due to direct trauma, frequent during sports activities that involve physical confrontation such as football, or team sports in general.
In the light of what we have seen, therefore, it is easy to understand how much a meniscus injury affects the knee joint of excessive stress that causes the cartilage to wear out, thus establishing a process of arthrosis .
We must also keep in mind that the menisci, as well as any other tissue of the body subjected to continuous mechanical stress, with age are subject to natural degeneration and wear processes called meniscosis, which cause chronic pain and fatigue.

Body weight
as seen previously, overweight subjects exert excessive pressure that burdens the knee cartilage and soft tissues, causing wear and consequent pain. To learn more about this widespread cause, I recommend reading this resource which well explains the relationship between internal knee pain and the importance of losing weight. To read it click on this link .

Fatigue
It is certainly the most trivial but also the most common cause that lies behind this type of joint pain. Inner knee pain is mainly caused by numerous pushups while lifting weights. This occurrence is unfortunately very frequent in people who have to move and lift weights for work.
For this reason it is always advisable to wear a brace that keeps the joint in place and avoids traumatic movements that can cause trauma or even worse an injury to the ligaments .

Trauma
This is the most common occurrence of those who practice team sports that involve physical contact and clashes, football is an example. Depending on the trauma, simple bruises can occur that cause blood vessels to rupture, then swollen knees , bruises, red skin, skin lesions and limitations in movement.
If the trauma, on the other hand, is very intense, it can lead to injury to the menisci and rupture of the anterior cruciate ligament, unfortunately a very common phenomenon in footballers.

Arthrosis
Osteoarthritis is a process of degeneration of the anatomical structures of the knee (especially cartilage and ligaments) which can be a consequence of both age-related wear and joint overload, and also pathological phenomena.

Rheumatoid arthritis
It is an autoimmune disease in which there are phenomena of inflammation in the joints of the body, causing severe pain, bone deformities and motor difficulties.
The identification of the triggering cause of this disorder is the responsibility of the orthopedic specialist who represents the reference figure to be consulted in the very first instance when this problem arises.
Below, I want to explain what happens during the visit and which diagnostic tests you will most likely have to undergo.

Diagnosis: which factors are taken into consideration
As previously mentioned, knee pain should not be underestimated, especially if it causes severe persistent pain and if it causes significant limitations of movement. When it manifests itself and results in relevant symptoms, it is always good to talk to your doctor, who, having assessed the situation, can direct you to a specialist visit in orthopedics.
The orthopedic examination takes place in two stages, a first phase of information collection, and a phase of actual knee examination, that is what is called an objective examination.
During the anamnesis, the orthopedist is informed about all the symptoms reported by the patient and the modalities of onset and manifestation of the disorders, while during the physical examination the doctor first evaluates the healthy knee. Why
The answer is very simple: this way of proceeding allows you to compare the painful knee in an appropriate manner.
In fact, it is always necessary to take into account the anatomical characteristics of each one without falling into the wrong assessment that a curved knee or moved backwards is an indication of pathology when it is naturally so.
During the knee inspection, the presence of swelling is also evaluated , a probable indication of the presence of fluid. In this case we proceed with the articular emptying of the liquid through an arthrocentesis, carried out only and only by the doctor specialized in orthopedics by means of syringes in a sterile environment.
The liquid withdrawn will then be analyzed to study its components and evaluate the cause of the pain with greater clarity, for example the presence of blood is typical of a direct trauma that causes a lesion of the menisci, which can be associated with the rupture of the anterior cruciate ligament which and strongly vascularized.
If the effusion appears as serous it can indicate the lesion of the meniscus only, and if the effusion is repeated several times then it is an indication of arthrosis, or of an inflammatory process. An adipose effusion, on the other hand, tends towards a real knee fracture, which will be confirmed by means of CT and MRI to assess the state of the knee ligaments .
The instrumental diagnostic investigations (radiography, magnetic resonance, CT scan, scintigraphy) allow to view the bone and soft structures of the entire joint, verifying wear and injury processes, while through a blood test the index factors of a rheumatic disease.
Generally it is not necessary to undergo all these analyzes, only a few and targeted ones are enough to quickly reach a diagnosis and undertake the most effective therapy.

Therapies and treatments for gonalgia
On the internet there are dozens of advice on the usefulness of natural and non-natural remedies, which would guarantee to solve the problem in a short time and in a complete way, obviously these are indications that have no scientific validity and on the contrary, if implemented they would risk negatively compromising, sometimes even irreversibly, the healing of the knee.
In case of knee painthe only professional figure to possess the appropriate and competent knowledge in order to diagnose the problem, and prescribe a therapy, is the orthopedic specialist. It goes without saying that if the symptoms are mild and do not require urgency, it is advisable to first ask your doctor for an opinion.
It is very complex to try to identify a single effective therapy for solving the problem: the entire pathological picture must always be related to the triggering cause.
In many cases, especially immediately after an injury, it will be sufficient to apply cold compresses on the internal (or medial) site of the knee and leave the limb at rest.
In other cases, however, it is necessary to administer a drug therapy with the aim of calming the symptoms, therefore by means of anti-inflammatory and painkillers, and if the disorders are of greater clinical interest, it is necessary to undergo surgery.
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