Knee Pain: How to Diagnose the Cause at Home and the Best Exercises to Treat It

Introduction

This video is all about knee pain. I’ll share tests you can do at home to help determine the cause, the best therapy you can do at home, and exercises to help rehabilitate your knee. The knee is a complicated joint, so I’ve narrowed it to the most common causes, subdivided into pain on the inside of the knee, the outside, and the knee generally. The timestamps in the description let you jump to the relevant section.

Inside of the Knee — MCL Anatomy

The first structure is the medial collateral ligament. Every ligament is like a piece of rope, keeping the joint tucked together and limiting excess movement. The MCL sits on the inside of the knee, connecting the thigh bone to the shin bone, protecting against too much inward movement. It’s commonly injured by a blow to the outside of the knee (football, rugby, American football) or by twisting and turning, as in skiing.

MCL Self-Test

Lie on your back, place your foot on the outside of the bed, turn the foot outwards and keep it fixed, then push your knee in. If this recreates the pain or you feel a clicking, it’s a positive test for MCL irritation or sprain.

HARM Protocol (first 3–5 days)

For an acute injury, two protocols apply for the first three to five days. HARM means avoid Heat, Alcohol (it slows healing), Running, and Massage.

POLICE Protocol

POLICE: Protect (relative rest, don’t bang it), Optimum Loading (walk as normally as possible, even with crutches — loading helps tissue heal quicker), Ice (a cold pack wrapped in a towel, never directly on skin, ~20 minutes, five times a day), Compression (an elastic support to reduce swelling and stiffness, which speeds rehab), and Elevation (to reduce swelling). Use HARM and POLICE for the first 3–5 days, then continue with POLICE.

Home Therapy — Cross-Friction

After 3–5 days, continue with cross-friction, which maintains mobility and prevents scar-tissue formation. Rest the knee on a towel, find the tender point along the ligament, and go across it (90 degrees to the way the ligament runs) using your fingers or the back of a knife (to save your fingers) for one to three minutes, once a day. It’ll be a bit sore with some swelling — that’s fine — then ice for about 20 minutes. A little olive oil reduces skin friction.

MCL Rehab Exercises

Start exercising as soon as possible to prevent stiffness and loss of range. Expect some discomfort; do them little and often, as much as pain allows. First: in a half-sit, loop a towel around the foot and pull it towards you, holding where you feel discomfort for about 10 seconds, then straighten — five reps, three sets. Second: lying on your back, straighten the affected knee and lift the leg above the horizontal, hold five seconds, lower — five reps, three sets. Third: a wall squat, feet 20 cm from the wall, down to 90 degrees at hips and knees, keeping the knees tracking straight over the feet (not caving in), hold 5–10 seconds, up — five reps, three sets.

Outside of the Knee — LCL

The lateral collateral ligament sits on the outside, connecting thigh to shin, injured by a blow to the inside of the knee or by twisting. Use the same HARM and POLICE mnemonics. Test: lie on your back, heel on the outside of the bed, turn the foot inwards and push the knee outwards; pain or clicking on the outside is a positive test. Therapy is cross-friction (top to bottom along the ligament, with olive oil, one to three minutes daily, then ice) and the same mobility exercises.

ITB Band — Renne’s Test

The ITB band runs from the hip to the outside of the knee and is often an overuse injury in cyclists and runners. To distinguish it from the LCL, use Renne’s test: with a chair for balance, press your thumb firmly into the ITB band, bend to about 45 degrees, then push all the way up; if this reproduces the pain, it’s a positive Renne’s test for ITB irritation. Treat with cross-friction along the band (often tender lower down, one to three minutes daily, then ice) plus foam rolling: foot in front, pelvis tilted, roll the outer thigh from hip to knee for three to five minutes a day.

Meniscus — Symptoms and Tests

The meniscus is a half-moon-shaped cushion inside the knee that absorbs shock. Five symptoms of a tear: joint stiffness, pain and tenderness along the joint line, a popping sound, difficulty straightening the knee, and locking. Two tests: the Thessaly test — stand on the affected leg, knee bent about five degrees, foot fixed, and turn your body in and out (then repeat at 20 degrees); pain or popping is positive. Ege’s test — turn the feet outwards and squat to 90 degrees to test the inner meniscus, then feet inwards to test the outer; pain or popping along the joint line is positive.

For a meniscus tear, in my experience as a physio and chiropractor, exercises rarely give a strong result. Thankfully the meniscus often heals on its own — it can take about nine months — or keyhole surgery is simple, quick to recover from, and effective. My recommendation: see your specialist and get it sorted. I hope you found value in this video. Take care of yourself, take care of someone else if you can, and bye for now.