Tendons are fibrous tissues that connect muscles to bones, enabling muscles to move bones by contracting. When tendons are damaged or overworked, it can cause pain in the back of the knee, which can be very uncomfortable and debilitating.
Knee pain caused by tendon issues is one of the most common types of knee pain. Although treatment is available, it’s important to understand that many potential causes exist for tendon pain behind the knee. Proper diagnosis is essential for effective treatment and management of this condition.
Posterior Knee Anatomy
The posterior knee refers to the area located behind the knee joint. It encompasses the attachment points for the tendons of the hamstring, rectus femoris, and gastrosoleus muscles. This region comprises various structures, including the following:
Medial Collateral Ligament (MCL)
The MCL is a band of connective tissue that connects the thighbone to the shinbone on the inner side of the knee. It helps stabilize the knee joint by preventing excessive stretching or tearing in any direction, ensuring the femur does not slide side to side.
Lateral Collateral Ligament (LCL)
The LCL is located on the outside of the knee and performs a similar function to the MCL. It stabilizes the knee joint by preventing excessive stretching or tearing in any direction.
Anterior Cruciate Ligament (ACL)
The ACL is a band of connective tissue connecting the thighbone to the shinbone at the front of the knee. It helps stabilize the knee joint by preventing excessive rotation or overextension, thereby keeping the shinbone from sliding forward.
Posterior Cruciate Ligament (PCL)
The PCL is found at the back of the knee and functions similarly to the ACL. It stabilizes the knee joint by preventing excessive rotation or overextension. While the ACL prevents the tibia from sliding forward, the PCL prevents it from sliding backward.
Hamstring Muscles
The hamstring muscles consist of three muscles located on the back of the thigh. They assist in bending and straightening the knee and rotating the lower leg inward or outward.
Popliteus Muscle
The popliteus muscle is a small muscle situated at the back of the knee. It aids in bending, rotating, and stabilizing the knee joint. This muscle is critical to the process of walking.
Extensor Muscles
Extensor muscles are responsible for straightening a limb and are present in every joint in the body. The primary extensor muscles at the knee are the quadriceps and calf muscles. Unlike most extensor muscles, those in the knee are directed forward instead of backward.
What Does It Feel Like To Have Tendonitis Behind The Knee?
Tendonitis is the inflammation of a tendon due to overuse or injury. It can occur anywhere in the body where a tendon is present, including behind the knee. Pain associated with tendonitis behind the knee usually happens when you move or press on the affected area.
Several types of tendonitis behind the knee include patellar tendonitis, gastrocnemius tendonitis, and popliteus tendonitis. Each type of tendonitis can cause different types of pain.
Here are some general symptoms of tendonitis behind the knee:
- Swelling
- Pain with jumping, running, or walking
- Pain when bending or straightening the leg
- Tenderness behind the lower kneecap
It is important to consult a healthcare professional if you experience any of these symptoms. Due to the frequent use of the knee in daily activities, proper diagnosis and treatment are essential to avoid further injury or long-term damage.
Possible Causes Of Pain In The Back Of The Knee
Various causes can lead to tendon pain behind the knee, including the following:
Trauma
Traumatic injuries to the knee, such as a fall or direct blow, can cause inflammation and swelling of the tendons. The release of inflammatory proteins during such injuries aims to speed up healing. Still, it can also irritate and damage surrounding tissue, resulting in pain in the back of the knee and reduced mobility.
Misalignment
Misalignment of the knee joint can cause extra strain on certain tendons due to an imbalance in muscle tension. This strain can lead to inflammation and pain in the back of the knee, particularly during activities that involve a lot of movement or weight-bearing. Knee joint misalignment can occur due to injury, aging, or chronic conditions.
Strains Or Sprains
Strains and sprains happen when muscles or ligaments are stretched, twisted, or torn. These injuries can cause inflammation and pain in the back of the knee and can also reduce your range of motion. Strains and sprains often result from overuse or sudden movements, such as those experienced during sports activities.
Overuse
Overtraining or repetitive movements can lead to inflammation and pain in the back of the knee due to tendon strain from frequent use. This pain may intensify during activities like running or jumping but can also occur at rest.
Tendon-Related Conditions Leading To Knee Pain
Many different medical conditions can cause pain in the tendon behind the knee. The following are some of the most common of these conditions:
Baker’s Cyst
A Baker’s cyst is a fluid-filled sac that forms in the back of the knee when a joint becomes inflamed. This swelling and pain can lead to discomfort and a sensation of tightness behind the knee. These cysts develop due to a buildup of lubricating fluid, often resulting from arthritis or torn cartilage.
Patellar Tendonitis
The patellar tendon connects the kneecap to the shinbone, and patellar tendonitis is an injury to this tendon. It causes pain and tenderness behind the kneecap, as well as swelling and difficulty with straight leg raises. Often caused by overuse or repetitive strain, it is common among athletes involved in jumping activities like basketball or volleyball.
Calf Tear
A calf tear occurs when the muscle fibers in the calf are torn, usually from overstretching. This injury can cause pain and swelling behind the knee, and it can make moving or putting weight on the leg challenging.
Knee Arthritis
Knee arthritis affects the joint tissue, leading to pain and stiffness. Commonly caused by wear and tear over time and age-related degeneration of cartilage, symptoms include swelling, tenderness, and difficulty with movement.
Hyperextended Knee
A hyperextended knee occurs when the joint is bent beyond its usual range of motion. This can cause pain in the back of the knee, often resulting from a fall, sports-related activity, or overstretching. Symptoms include swelling, tenderness, and difficulty with movement.
Chondromalacia
Chondromalacia occurs when the cartilage around the kneecap is damaged, causing pain and inflammation. It is often due to overuse, repetitive strain, or misalignment of the knee joint. Symptoms include tenderness behind the kneecap, swelling, and difficulty with movement.
Meniscal Tear
A meniscal tear involves a tear in the cartilage of the knee joint. It can cause pain, swelling, and tenderness behind the kneecap. This injury often occurs due to contact sports, excessive twisting or hyperextension of the knee, or age-related wear and tear. Symptoms include discomfort when bearing weight and difficulty with movement.
Hamstring Injuries
Hamstring injuries involve the strain or tear of muscles or tendons in the hamstring, causing pain in the back of the knee, swelling, and tenderness. Commonly caused by overstretching or repetitive strain during activities like running, symptoms include tenderness behind the knee and difficulty with movement.
Bursitis
Bursitis is the inflammation of the bursae, fluid-filled sacs that cushion and protect the knee joint. This condition can cause swelling, tenderness, and pain behind the knee, often due to overuse, repetitive strain, or direct trauma. Symptoms include swollen bursae, tenderness, and difficulty with movement.
Deep Vein Thrombosis
Deep vein thrombosis (DVT) occurs when a blood clot forms in the deep veins of the body, such as in the legs. It can cause pain behind the knee, swelling, and tenderness. Often resulting from prolonged immobility or injury, symptoms include swollen veins, tenderness, and difficulty with movement.
At-Home Remedies
At-home remedies such as rest, ice, elevation, and ibuprofen can be beneficial for pain in the back of your knee. Resting the affected area is vital to avoid further injury or aggravation. Applying an ice pack to the back of the knee can help reduce inflammation and relieve pain. Elevating your leg above heart level may also help to reduce swelling. Ibuprofen or other over-the-counter pain medications can be taken to minimize discomfort. If your pain persists, it is essential to seek medical attention.
When To Seek Medical Attention
If you’re experiencing persistent pain or discomfort in your knee area, it’s crucial to seek professional medical assistance. Pain in the back of the knee may signal a more serious issue, making it advisable to consult a doctor if the pain persists or worsens.
Neglecting pain in this area can result in additional injury or the development of chronic conditions. Therefore, it’s essential to seek medical attention promptly if needed.
How To Diagnose Tendon Pain
Given the numerous potential causes of tendon pain behind the knee, an accurate diagnosis by your doctor is crucial for proper treatment. The following are some methods your doctor may use to diagnose the condition:
Physical Exam
Your doctor will likely conduct a physical exam to assess tenderness and swelling in the back of your knee. They may also palpate for any bumps or lumps and test your range of motion. This examination helps identify specific symptoms, providing a better understanding of the potential underlying condition.
Imaging Tests
Imaging tests such as MRIs, X-rays, and ultrasounds can provide your doctor with detailed views of the area to detect any underlying issues. These tests help identify damage or inflammation in the tendon.
Blood Tests
Your doctor may order blood tests to check for signs of infection or inflammation. These tests help pinpoint the specific cause of the tendon pain and rule out other potential conditions.
Common Treatment Options For Posterior Knee Issues
There are several conventional treatments that doctors may prescribe to treat knee pain. Most doctors recommend rest to reduce inflammation and allow the body to heal. Depending on the diagnosis and the severity of your condition, additional treatments may include:
Prescribed Medications
In some cases, your doctor may prescribe medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. These medications help treat the symptoms and can be effective in managing pain and inflammation.
Injections
For severe pain, your doctor may recommend injections. These can include corticosteroid or hyaluronic acid injections, which help reduce inflammation and relieve pain in the knee joint. Corticosteroid injections help reduce inflammation by delivering a potent anti-inflammatory directly to the area, which can be especially beneficial during flare-ups. Hyaluronic acid injections, on the other hand, work as a lubricant, mimicking the natural fluid in the joint to ease movement and reduce discomfort. Both types of injections are designed to relieve pain and improve mobility, though the choice of injection depends on individual needs, pain severity, and your doctor’s recommendation.
Surgery
In severe cases, surgery may be recommended. Depending on the diagnosis, this could include meniscus repair, ligament reconstruction, or removal of a loose body. Surgery is reserved for advanced cases and provides an opportunity for targeted recovery and improvement.
Physical Therapy
Physical therapy is another effective treatment option for knee pain. A physical therapist can help you strengthen the muscles and ligaments around the knee joint and provide exercises to reduce inflammation. They can also teach you proper stretching and exercise techniques to prevent future pain or injury.
How NextPain Care Manages Tendon Pain Behind The Knee
At NextPain Care, we recognize the significant impact that knee tendon pain can have on your daily life. Our primary goal is to help you regain your mobility through effective pain management. We start with true conservative care, focusing on non-invasive treatments such as behavioral health, physical therapy, meditation, diet and exercise, bracing, and supplements, and about 50% of our patients find relief at this level.
If conservative treatments do not achieve the desired results, we move to the next level of care, which includes the use of low-risk medications such as NSAIDs, neuropathics, and muscle relaxants, alongside interventional pain management techniques. For the remaining patients who need further intervention, we offer advanced procedures such as joint injections, nerve blocks, peripheral nerve stimulation, and more.
Address tendon pain with focused care.
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