Ask the Experts - Injury

Answers from Sean Fyfe:

Q. Dear Sir,
I am suffering from a painful knee injury on the medial side of the knee. It’s especially bad when I run and I actually cannot run as a result of the pain. I weigh 90kg, do you have any advice?
Regards,
Hasan

Click here to - View all questions for Sean Fyfe

Medial knee pain, or pain on the inside of the knee joint while running can be the result of a number of pathology’s. These are as follows – patello- femoral joint pain (or pain in the knee cap joint), medial retinaculum pain (pain in the fibres that attach to the inside of the knee cap), injury to the medial meniscus or cartilage (shock absorbers and connective tissue inside the knee joint) or injury to the pes anserinus (the common insertion point of three muscles at the front inside portion of the lower knee).

The first step is to localise the area of pain and determine where tenderness is felt. This will significantly help the diagnosis. Gaining an accurate diagnosis is the key to fixing any condition. Without it the correct rehabilitation plan can not be established. My advice then is to see a Sports Physiotherapist to get a diagnosis.

However, a lot of medial knee pain injury’s are related to poor stabilisation of the knee and hip. Exercises such as strengthening the lateral hip stabilisers, the vastus medialis (inside quad muscle) and glutes will help you maintain a better knee position while running and thus decrease the load on the medial knee structures. Improving the strength and endurance will allow you to hold the better position for a longer running time. Poor biomechanics can also be a cause of the knee assuming a less than ideal position while running which can overload the medial knee structures and orthotics may be required to help this.

So, you need to start by getting an accurate diagnosis which will most probably be one of the above, and then start a rehabilitation plan that includes a strengthening program followed by a gradual return to running.

Good luck!