Pain behind the knee: causes and treatments Knee Health

Posterior knee pain, ie pain behind the knee, can greatly limit your mobility due to the pain and swelling it causes. In this article we look at the most common causes — and treatments –for knee pain – so if you suffer pain at the back of your knee then hopefully we can help you identify the problem, and thereby set you on the road to recovery!

Causes of pain at the back of the knee:

Bakers Cyst

This is where the bursa – a fluid-filled sac – at the back of your knee gets inflamed, resulting in swelling, pain, and tightness behind the knee. It can result from a sudden blow to the posterior of your knee, but most of the time it develops gradually – usually it is caused by knee conditions like arthritis.

Treatment: Ice, proper exercise, sometimes surgery. A Baker’s Cyst can take a few months to heal, if not treated correctly they can also recur.

Posterior Cartilage Tear

This is where the cartilage lining your knee joint gets torn at the back. The major symptoms include pain at the back of your knee, swelling, a locking sensation of feeling of general instability, problems straightening out your knee. Again, this injury can occur suddenly as a result of twisting forces being applied to the knee, OR it can occur gradually through general wear and tear.

Treatments: rest, ice, compression, elevation (RICE); proper exercises; knee braces, sometimes surgery. Recovery can take months – especially as the cartilage here is poorly supplied by blood, which retards the healing process.

Calf Strain or Tear

A calf strain or tear occurs when you overstretch or tear your calf muscle. One of the possible symptoms is pain at the back of the knee – in addition to at the back of the calf – along with swelling, bruising etc.It can occur suddenly when you violently change direction or speed and twist your knee, or it can develop gradually from repeated jumping or running.

Treatments: proper rest, RICE, massages, appropriate exercise. Recovery usually occurs in 6-12 weeks.


Wear and tear and years of repetitive movements cause the cartilage lining your joints to wear away and the structure of the underlying bones to alter (they become more brittle). This chronic condition is called osteoarthritis, and is most common in people over 50. Symptoms include dull, aching pain, swelling, and stiffness, or a clicking or grinding noise. These symptoms come on gradually; they tend to get worse after prolonged rest, activity or cold weather.

Treatment: proper exercise, ice, walking aids, medication, knee braces, losing weight. Osteoarthritis is a chronic condition and the changes in bone structure can’t be undone, however with proper treatment you can minimize the pain, improve functioning and prevent further deterioration.

Hamstring injuries

When you tear one of the muscles at the back of your thigh – the hamstring muscles – one of the symptoms is pain at the back of your knee where the hamstring tendon connects to the bones. A torn hamstring usually occurs suddenly due to some injury and is not an injury of wear and tear.

Treatments: RICE, appropriate exercises, and rehabilitation, massages. Recovery usually occurs within 6-12 weeks.

Knee Sprain

A knee sprain occurs when you overstretch or tear one of the ligaments attaching to your knee. Symptoms can include pain at the back of the knee, decreased mobility, swelling and bruising. This is not an injury of wear and tear, instead, it results from a sudden twisting motion or force being applied to the knee.

Treatment: RICE, exercises, knee brace. Recovery can take 2 to 3 months, depending on how severe the injury is.

Deep Vein Thrombosis

This is where you get a blood clot in one of the deep veins in the leg. One of the symptoms can be – you guessed it! – pain at the back of the knee (or calf), as well as redness, swelling, etc. It can either occur suddenly or develop gradually, as a result of periods of inactivity, a particular medical condition, pregnancy, genetics – another potential cause is obesity.

Treatment: blood-thinning medications (ie anticoagulants), compression stockings, certain exercises. Long-term treatment may be required to fully recover from this condition. Left UNtreated it can be life-threatening.

Treatments: Exercise

We have mentioned some of the treatments for posterior knee pain in passing, such as the R.I.C.E, here we will look at a few of these in more detail – specifically, the exercises you can do to reduce pain at the back of your knee and increase strength and flexibility in this region. By exercising the muscles surrounding the knee in appropriate manners you can reduce pain, swelling, and stiffness in the knee, as well as strengthening the muscles that support it, thus enhancing stability and making your knee less prone to future injury. Here are some of the easy exercises you can do to treat pain at the back of your knee.

  • Quad clenches: strengthening your quadricep muscles (the muscles at the front of your thigh) will greatly enhance the stability of your knees. It’s one of the best exercises to do following a knee injury. Lie flat on your back, or alternatively sit up straight. Keep your legs and knees straight. Then slowly tighten the muscles at the front of the thigh by pushing your knee down. Feel the thigh muscles clench; hold for 3-5 seconds before releasing. Repeat 10 times.
  • Short Arcs: the aim of this exercise is again to strengthen the quads, which will, in turn, stabilize the knee joints. To do this exercise, lie down flat on your back or sit up straight with your leg placed horizontally on a flat surface. Place a rolled-up towel under the knee. Pull all your toes towards you, clenching the thigh muscles. Very slowly, raise your foot up from the bed until the knee is straight. Hold for about 5 seconds before slowly lowering. Repeat 10-20 times.
  • Straight Leg Raise: this exercise will also strengthen your quad muscles. Lie flat on your back, keeping your leg and knee completely straight. Pull all your toes toward you then clench the muscles at the front of your thighs, locking the knee. Raise your foot about 6 inches from the bed. Hold for about 5 seconds, then slowly lower. Make sure your knee remains straight the entire time. Repeat 10 times.
  • Long Arcs: this exercise also strengthens the quads. To do it, sit on a firm chair keeping your knee bent with your foot flat on the floor. Raise up your foot, straightening the knee as much as possible. Hold for about 5 seconds then slowly lower it. Now bend back your knee as far as it will go. Repeat 5-20 times.
  • Knee Marching: this is another fine exercise for knee pain that will strengthen your quads without putting excessive weight through your knee joints. Sit in a chair, your feet positioned flat on the floor. March up and down on the spot, lifting and lowering your legs (and knees). Continue for about a minute.
  • Kick Backs: this exercise strengthens your hamstrings and thereby your knees. Stand straight and hold onto a table or chair. Lift up your foot towards your bottom as far as you can, making sure to bend your knee. Hold for about 5 seconds. Repeat 10 times.
  • Heel Raises: this exercise strengthens the calf muscles, leading to more support for the knees, and improved coordination between the ankle and knee. Stand straight with your feet a little bit apart, and hold onto something for balance, eg a wall. Rise onto your toes lifting up the heels as much as you can. Hold for 5 seconds before slowly lowering yourself. Repeat 10 times.
  • Sit to Stand: this exercise will strengthen your quads and glutes, and improve your overall knee mobility. Sit in a chair with your feet flat on the floor. Leaning forwards, raise your bottom, and stand yourself up straight before sitting back down. Repeat 10-20 times.

Mathew Foster

I am Mathew Foster – an enthusiast of sports who not only regularly practices different sports, but also has a deep interest in it.

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