Chiropractor Chandler AZ

Causes of Pain in the Back of the Knee

Like most knee pain, back of the knee, or posterior, knee pain can develop gradually over time. This gradual increase in pain can mean there are underlying knee conditions that need to be addressed. Sometimes pain in the back of the knee can come on suddenly, resulting from an injury. It is common for back of the knee pain to manifest in swelling of the back of the knee which can be accompanied by sharp pain during movement. There are multiple injuries which can cause back of the knee pain, but some are more common than others.

Most Common Possible Injuries
knee model posterior labeled

Bakers cyst is a common injury to affect the back of the knee. This condition is the inflammation of the popliteal bursa, which causes the back of the knee to swell. The popliteal bursa is a fluid-filled sac which sits between the hamstring muscle tendons and the patella to reduce friction of the bone during movement. When there is swelling in the knee joint, excess synovial fluid seeps out of the joint into the popliteal bursa, which in turn forms the cyst. Bakers cyst is most common among people who have osteoarthritis, but a hard blow to the back of the knee or a cartilage tear can also create the cyst.

Hamstring tendonitis is the inflammation of or damage to the hamstring tendon which connects the hamstring muscle to the outer knee. Damage or inflammation can be caused by excessive strain or force on the tendon. The hamstring muscle is made up of three muscles: biceps femoris, semitendinosus, and semimembranosus. All theses muscles work together to bend the knee and extend the hip backward. Inflammation of any of these three where they insert into the bone can cause back of the knee pain. Hamstring tendonitis is a common overuse injury, especially in athletes. Sports that consist of running, jumping, and rapid speed changes are likely to cause hamstring tendonitis.

The popliteus muscle runs in the back part of the knee, a lot smaller than the hamstring muscle. This muscle is responsible for the internal rotation of the shin bone. It is also responsible for unlocking the knee joint when bending the knee. A popliteus muscle sprain can cause back of the knee pain. It commonly happens as an overuse injury, but can also happen suddenly. Popliteus muscle sprains are very common among runners who overuse the muscle to bend the knee while running. Sudden injury to the muscle is due to a sudden force on which can occur during a car accident when the knee is overextended.

The last most common injury to cause pain to the back of the knee is gastrocnemius tendinosis. The gastrocnemius is a muscle located on the back of the calf. The upper end of the muscle attaches to the back of the knee. It is responsible for maintaining proper mechanics at the knee for weight bearing. If the muscle becomes strained or overused, pain can occur in the back of the knee. This injury is an overuse injury. Activities such as walking, running, and climbing stairs can cause strain to the gastrocnemius muscle.

Less Common Possible Injuries
knee model lateral view labeled

The less common injuries to cause back of the knee pain include posterior cruciate ligament strains, meniscus injuries, and deep vein thrombosis. The posterior cruciate ligament is one of the many ligaments attaching the femur to the tibia. It keeps the tibia from moving too far back. A strain to the ligament can be caused by a bent knee hitting a dashboard during a car accident or an athlete falling on a bended knee. Meniscus injuries to the knee commonly result in meniscus tears and occur in athletes who play contact sports such as football and basketball. Deep vein thrombosis is a blood clot that can form behind the knee causing swelling and pain. A clot can form if the veins in the knee are damaged.

Back of the knee pain should be conservatively treated before surgery is suggested. Most conservative treatments will relieve the pain and fix the problem, negating the need for surgery.

Home Treatments

At home the first step is always PRICE: protect, rest, ice, compress, and elevate. Reduce the stress and strain to the knee. Over the counter nonsteroidal anti inflammatory drugs (NSAIDs) as recommended by your doctor can help reduce pain and inflammation. Ice helps block the knee pain and reduce inflammation.

Medical Treatments

NSAIDs are often prescribed for the initial acute injury stages. In severe cases that involve multiple joint regions, muscle relaxers or oral steroids can be given. Trigger point injections, botox, or steroid injections can be treatment options, as well. Pain management is not usually required unless stronger medications or joint injections are involved in treatment.

MRI and X-rays will not usually be ordered to evaluate mild to moderate muscle, tendon, and ligament injuries. Severe cases may utilize advanced imaging to rule out bone fractures, edema, nerve entrapments, tendon or muscle ruptures. Nerve conduction velocity (NCV) testing may be utilized in cases that also involve muscle, sensory or reflex loss.

Conservative Treatments
GT therapy

Therapeutic treatments for addressing soft tissue injuries involve massage therapy, manual therapy, trigger point therapy, Graston Technique, or Active Release Technique. These treatments increase blood flow, decrease muscle spasms, enhance flexibility, speed healing, and promote proper tissue repair.

Iliotibial band Syndrome is common in runners who develop the injury because of weakness and poor stabilization of the leg and hip muscles. Specific knee exercises are given to increase strength and endurance. Proprioception exercises help teach the muscles how to work together again to stabilize the knee during walking or running.

When these treatments are incorporated into a treatment plan, patients heal faster and are less likely to have long-term pain, soft tissue fibrosis, or scar tissue in the injured muscle. These soft tissue treatments are incorporated with therapeutic exercise and flexibility programs.

Improve Movements to Eliminate Hip Pain

The back, hip, and lower extremity work as a comprehensive unit allowing for many of the repetitive tasks you complete at home, work, and during recreational activities. Injuries to one area of the musculature often indicates that additional damage has been incurred by adjacent muscles.

Many therapeutic exercises can help restore proper strength and endurance to the leg muscles. Isometric exercises are often the initial treatment exercises, followed by single plane rubber band exercises for the hip, knee, and ankle: flexion, extension, adduction, abduction, circumduction, inversion, and eversion. Dynamic exercises involving stability foam, rubber discs, exercise ball, and BOSU balls can be performed on the floor. The more unstable the surface, the more effort and stabilization is required of all the lower extremity muscles.

treatments for knee pain

Vibration plates enhance neuromuscular learning throughout the ankle, knee, foot, hip, and back muscles. Additional strength exercises can be found on the hip, knee, and foot strengthening pages. More information for injuries and treatments for knee pain and foot pain.

Our Chandler Chiropractic & Physical Therapy clinic treats patients with a variety of muscle, tendon, joint, and ligament injuries. The clinic provides treatment for runners, tri-athletes, and weekend warriors in addition to common headache, neck, and back patients traditionally seen in Chiropractic, Physical Therapy, Massage Therapy clinics. We work with all ages and abilities of the residents in Phoenix, Tempe, Gilbert, Mesa, and Chandler AZ.