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October, 2002, Vol. 02, Issue 10

Medial Knee Pain

By Ben Benjamin, PhD

Question: Pain on the medial side of the knee when applying a valgus stress indicates what structure is most likely injured?

Answer: The medial collateral ligament.

Illustration of medial collateral ligament. - Copyright – Stock Photo / Register Mark The medial collateral ligament. The valgus stress motion applies a stretching tension to the medial aspect of the knee joint, and primarily stresses the medial collateral ligament. The medial collateral ligament is the major structure that holds the medial side of the knee joint together. It limits side-to-side motion and prevents the knee from buckling inward, while helping to maintain the hinge motion of the knee.

Pressure is applied unnaturally to this ligament when a person walks with his or her feet turned outward. This poor alignment causes injury to the medial collateral ligament while doing everyday movements such as walking or climbing stairs. This injury often is caused by a fall or a tackle that buckles the knee suddenly inward, especially in sporting events such as football, soccer or basketball.

When the medial collateral ligament is injured, the knee is usually swollen and hot or warm, depending upon how recently the injury was sustained and how severe it is at the moment. Usually, the client cannot fully bend or straighten the knee without pain. Swelling may not occur if the strain is fairly minor.

To test for this injury, valgus stress is applied with the client lying supine. Place one hand on the medial ankle and the other at the lateral aspect of the knee. Apply a shearing stress, pushing each hand in the opposite direction - the hand on the ankle laterally, and the hand on the knee medially. In general, pain is felt at the medial side of the knee where the injury is. This injury is easy to identify because there is usually no referred pain in the knee itself.

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