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What is internal knee derangement?

Internal derangement of the knee (IDK) is a chronic condition that interferes with normal knee joint function. Several things can cause it, such as injured ligaments, loose pieces of bone or cartilage in the knee joint, or a torn meniscus.

Over time, it can cause pain, instability, and limited knee flexibility. Keep reading to learn more about the symptoms of IDK and how to treat it.

In addition to pain and discomfort, knee locking is one of the more common symptoms of IDK. Your quadriceps and hamstrings, two muscles above your knee joint, may freeze in position. They might also give out at the same time, causing your knee to buckle.

Additional symptoms depend on the underlying cause of IDK:

  • Meniscus tear. After some initial pain and swelling, you may start to feel pain when flexing or turning your knee. The pain may go away when you bend your knee. You might also find it hard to fully extend your knee.
  • Ligament tear. Depending on the ligaments involved, you’ll feel pain in your inner or outer knee. You may also notice some swelling around the affected ligament. Until the ligament is repaired, you’ll likely have some knee instability as well.
  • Loose bodies. Knee injuries and normal wear and tear can cause bits of cartilage or bone to break loose within your knee joint. As they move around in the joint, you might feel pain in different parts of your knee.

Sudden injuries — such as a blow to your knee or twisting your knee — and gradual damage from repeated stress on your knee can both cause IDK. Examples of repeated stress include:

  • climbing stairs
  • crouching or squatting
  • heavy lifting
  • carrying too much weight

Your meniscus can also tear slowly over time. During the process, small pieces of cartilage can break off from your meniscus, leaving a frayed end and loose bodies floating around in your knee joint.

It’s important to see your doctor if you notice knee pain or stiffness that doesn’t go away after a day or two. To figure out what’s causing the pain, they’ll start by asking you about any recent injuries or other symptoms you’ve been having. They’ll likely move your knee into several positions while asking if you feel any pain.

Depending on the results of your exam, you may also need an MRI scan to give your doctor a view of the soft tissue inside your knee. This will help them see any signs of a torn meniscus. They may also use a knee X-ray to check for bone damage.

There are several treatment options for IDK, depending on the underlying cause and your overall health. Treatment also depends on your daily activity level. For example, if you’re an athlete, you may want to opt for more invasive surgery that will help your knee endure ongoing stress.


IDK doesn’t always require surgery. For minor tears, try following the RICE protocol, which stands for:

  • Rest.Give your knee a day or two of rest. During this time, try to avoid putting pressure on it as much as possible.
  • Ice.Apply an ice pack to your knee for 20 minutes at a time. Do this up to four times a day. Consider investing in a reusable ice pack, which you can find on Amazon. Look for a flexible one that you can wrap around your entire knee for maximum benefit.
  • Compression.Wrap your knee with an elastic bandage to reduce swelling. Just make sure you don’t wrap it too tightly, which could interfere with your circulation.
  • Elevation.Try to prop your knee up on some pillows as much as possible for a few days.

Your doctor might also suggest wearing a knee brace, which you can find on Amazon, to help support and stabilize the joint as you heal. Look for one that’s labelled as “level 2” to make sure it provides enough support. Physical therapy can also help to strengthen the muscles around your knee to improve flexibility and range of motion.


If you do need surgery, you might be able to opt for minimally invasive arthroscopic surgery. This involves making a few small incisions and inserting small tools through them to repair damage to your meniscus or to remove loose bodies. This is usually an outpatient procedure involving six to eight weeks of recovery time.

If you’re injury is more severe or you regularly put a lot of stress on your knee, you may need a more invasive procedure to repair a torn ligament. This usually involves taking a tendon from your hamstrings or other area and sewing it to the torn ligament to help restore its function. Following a procedure like this, you may need to use crutches for a week or two to keep pressure off your knee. It may take up to a year to fully recover.

Following any type of knee procedure, your doctor will likely recommend you follow up with a physical therapy program to rebuild muscle and improve strength.

IDK can be a painful condition that limits your ability to get around and perform simple, everyday tasks, such as shopping, gardening, housework, and even walking or climbing stairs. Several things can cause IDK, so it’s best to follow up with your doctor about any ongoing knee problems. If you address it early, you may be able to avoid any type of surgical treatment.