Why does the inside of my knee hurt when I run?

Pinpoint the spot

Runners with front-of-knee pain are common; inner-knee pain is less so, and the exact location helps. A tender spot a few centimetres below the joint on the inner shin suggests the pes anserine. A tender, sometimes cord-like band on the inner side of the kneecap suggests a plica. Pain directly on the joint line, with swelling or catching, suggests the meniscus.

Pain on the inner shin that you can press on along the bone, and that is present on walking or at night, raises the possibility of a stress fracture of the upper tibia.

Typical training triggers

• Rapid increases in weekly distance while preparing for a race
• Lots of downhill running or running on one side of a cambered road
• Feet that roll in markedly, or knees that drift inward with each stride
• Weak hip muscles allowing the knee to collapse inward
• Returning to outdoor running in October or November after a summer of little training

Adjusting your running

Cut weekly distance by around half for two weeks and drop speed sessions and hills. Run on flat, even surfaces such as a track or a treadmill. Cross-training on a bike or in the pool maintains fitness.

Strengthen the hip abductors, glutes, hamstrings and calves two or three times a week. A physiotherapist can look at your running form; small changes such as a slightly higher cadence often reduce load on the inner knee. Return to normal distance gradually, increasing by about ten percent a week once you are comfortable. In Qatar's warm months, keep runs early or late and stay hydrated.

When to see a specialist in Doha

Stop running and get assessed if you have pain at rest or at night, pain on walking, a tender spot on the shin bone, or a limp. These suggest a stress injury that needs imaging. Swelling, catching or locking suggest a meniscus problem.

Book an appointment if inner-knee pain persists for more than four to six weeks despite reduced training. At Aman Hospital, Dr. Gelber examines the knee, hip and alignment and arranges an MRI when bone stress or a meniscus tear is suspected.