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

Why the inner side takes the strain

When you walk, more of your body weight passes through the inner half of the knee than the outer half. People who are slightly bow-legged load it even more. That is why wear of the cartilage and meniscus, and the pain that comes with it, so often starts on the inner side.

Where the pain sits is the first clue. Pain right on the joint line, the crease you can feel between the thigh bone and shin, points to the joint or meniscus. Pain a few centimetres lower, on the inner shin, points to the pes anserine bursa or tendons.

Likely causes

• Early medial knee osteoarthritis: a dull ache with walking and standing, stiffness after rest, sometimes mild swelling
• Degenerative medial meniscus tear: joint-line pain, sometimes catching, often with no clear injury in people over 40
• Pes anserine bursitis: tenderness below the joint on the inner shin, common in people with knee arthritis, diabetes or extra weight
• Old MCL sprain or ligament strain: inner pain linked to a previous twist
• A stress reaction or bone marrow oedema in the inner tibia or femur, which can follow a sudden rise in walking

What you can do at home

Break long walks into shorter ones on flat ground, and choose cushioned, supportive shoes. Walking in air-conditioned malls or on a treadmill in summer avoids heat and uneven pavements. Cycling and swimming keep you fit with less load.

Strengthening the quadriceps, hamstrings and hip muscles reduces inner-knee pain in many people. If you carry extra weight, even a modest loss reduces the force through the inner knee at every step. A cold pack after walking and simple pain relief, if safe for you, can help flare-ups.

When to see a knee surgeon in Doha

Book an assessment if walking pain lasts more than six weeks, if the knee swells, locks or gives way, or if you are reducing your daily activity because of it. Sudden severe inner pain without injury in an older adult, or pain at rest and at night, should be seen sooner.

At Aman Hospital, Dr. Gelber examines the joint line, ligaments and alignment, and usually starts with standing X-rays. An MRI is added when a meniscus or bone problem would change treatment. Most patients start with exercise-based care.