Back of Knee Pain

Back of knee pain can sometimes be very uncomfortable, especially if it persists for an extended period of time.
The Back of knee pain is a complex anatomical region because it contains a variety of tendons, vessels, nerves and muscles. Depending on the situation in which the Back of knee pain, the causes, and corresponding therapies may differ. In principle, however, regardless of age and trigger, all of the diseases discussed below may always be responsible for the withdrawal.

Back of knee pain causes

There are several causes of pulling and Back of knee pain. The location and duration of the pain play a role as well as the athletic background and the behavior before the onset of the pain. Various acute and chronic conditions that may be considered are:

Back of Knee Pain

  • Lack of stretching of the muscles
  • Tendon irritation of the tendons of the calf muscles
  • Bruises and strains of the knee joint
  • knee osteoarthritis
  • Crack of the collateral or lateral ligament
  • meniscus tear
  • Baker cyst
  • swollen legs (leg edema)
  • Vein thrombosis

Back of knee pain when walking / running / exercising

Pulling on movement generally indicates mechanical damage to the musculoskeletal system. While pains that are also at rest tend to suggest a more dangerous event, with pain on movement, one can be relatively sure that the movement is the trigger for the pain or the pulling. It is also important, if the pain only occurs while running, or already while walking.

Although we use the same muscles and joints in both processes, walking is a much greater burden on the musculoskeletal system than walking. Pulling while walking thus tends to indicate heavier injury than pulling while walking.
It is also helpful if the Back of knee pain can be located more accurately.

Back of knee pain, ie in the direction of the calf, is more likely to suggest tendinitis or tendon strain of the triceps surae muscle. The triceps surae has three (“tri-“) muscle heads, all of which originate in the region of Back of knee pain. The triceps surae is commonly known as the “calf muscle”.

Where a muscle is attached to a bone, there are tendons that fix the muscle body to the bone. These tendons can be irritated, for example by intensive running training, and cause a pulling. This is rather harmless and should disappear again through protection or not occur at gentle training.

In the worst case, pulling is more of a pain than pulling, depending on how much the tendons have been overstretched. Incidentally, this kind of pain or Back of knee pain is very easily reproduced by stretching our knees and trying to touch the ground with the tips of our hands. However, this should not be done if the Back of knee pain already hurts, as it would reinforce the pain and pulling relatively safely.

A  pull in the hollow of the knee after exercise and especially after running can be a sign of lack of stretching before the sport at best. It is not without reason that stretching and loosening are part of every recommended warm-up program. Pulling that only results from a lack of stretching is not dangerous and usually disappears after a few days. Care should be taken to stretch enough after exercise.

If this is not the case, then more serious causes must be considered. Especially a pulling while walking also speaks for a damage that is already triggered by very low load. Depending on the age, wear processes in the knee joint itself are also to be considered, ie osteoarthritis. Permanent, high stress on the knee joint can lead to abrasion of the cartilage surfaces and wear of the joint surfaces. This particularly affects athletes, such as marathon runners, or football players, but also very overweight people who bring a lot of weight to the joints.

With age but also amateur athletes can be affected. Back of knee pain while walking can be heralds for this. Especially in sports that “go to the joints”, such as tennis, squash, Jogging, and playing soccer, can cause these symptoms to prematurely. Whether it is actually osteoarthritis, can be easily clarified by an x-ray, CT or MRI from the knee. CT plays a subordinate role in daily practice.

An experienced doctor can determine the arthrosis stage in the x-ray of the knee well. The only way to accurately depict cartilage damage is MRI of the knee.

In this case, more lenient sports such as swimming, cycling, or yoga should be preferred. While Back of knee pain after exercise, as already mentioned, may be the first signs of impending deterioration, pain when walking is already considered an advanced stage. If the pain, or the pulling has been around for some time, and latent “crept”, so it is to think of a chronic process, such as a progressive osteoarthritis.

If the pulling while walking have made quite suddenly noticeable – so there are no signs of a chronic event – so it may be a strain, or bruise. Although bruises are more likely to be in the area of ​​the kneecap, they can sometimes reach the Back of knee pain.

Especially after sports sports injuries must be taken into account, which were perhaps not noticed in the heat of the moment. Only when you arrive at home, it begins to draw and hurt. In this case, however, it is usually possible to obtain freedom from symptoms within a few days through sparing and cooling.

If the Back of knee pain is clearly due to an acute cause, painkillers such as ibuprofen or, in the case of a sensitive stomach, better paracetamol can be used to support a short period (a few days) . If the drag lasts longer than three days and does not noticeably improve during this time, you should go to the family doctor or orthopedist.

The same applies to complaints that have existed for some time – ie months – and have now deteriorated. Imaging techniques are available to the physician to assess the “inner life” of the knee, which is absolutely necessary in chronic conditions.

Often a pull in the hollow of the knee disappears relatively quickly on its own again and can be estimated as harmless. However, if it lasts longer or develops creeping, then the causes should be researched to make sure that a more dangerous event is concluded.

Back of knee pain to the calf – thrombosis?

Back of knee pain, which reaches into the calf, speaks for a muscular cause. The calf muscles – more precisely, the trcieps surae – consist of two large muscles: On the one hand, the gastrocnemius muscle, which forms the outer, externally visible part of the calf muscles with its thick muscle belly. His two muscle heads have their origin on the femur and thus run from the Back of knee pain to the Achilles heel.

Under the musculus gastrocnemius lies the soleus muscle. It also has its origin in the region of the Back of knee pain, more specifically on the back of the tibia and fibula. Together, both muscles form the muscle triceps surae.

On the one hand we need this muscle if we want to bend our knee, on the other hand, if we want to stand on our toes. This muscle is almost always exposed to a lot of stress during sports. Back of knee pain to the calf usually affects this muscle, especially after exercise. As already mentioned, the pulling may be caused by a ligamentous stretch, or ligament tear in the region of the Back of knee pain.

A pull to the calf would not be typical for this. In addition to the tendon may also be overstretched muscle, individual muscle fibers may even be torn. Pulling into the calf would be conceivable in such a scenario. After a few days of protection, the pulling and the pain usually go by itself – provided the muscle is sufficiently spared during this time.

However, if there is no reason for muscle overstretching, a more serious cause must be considered as well. For example, if you feel a pain and a pull in the calf after long periods of sitting, long bus rides, or long flights, this can be a sign of a thrombosisbe.

This can also occur in younger patients, for example, when taking the “pill” (see: risk of thrombosis of the pill ), or in overweight nutritional status. In such cases, a doctor should be consulted as soon as possible, as the thrombosis can resolve, and as embolus can enter the lungs or the brain. There he can cause a pulmonary embolism , or a stroke . By a simple ultrasound examination of the calf the suspicion of a thrombosis can be excluded or confirmed.

A thrombosis is a blood clot within a vessel. This can either close the vessel directly in place, or dislodge and get into other parts of the body. There, the blood clot can continue to grow, and so move larger – and more important – vessels, such as the cerebral veins. The legs are predestined for thrombosis. This is also known as leg vein thrombosis or calf vein thrombosis. Thrombosis usually manifests itself as painful congestion, overheating and swelling of the leg in the area behind the thrombosis.

But even a Back of knee pain can be characteristic of this, at least in the early stages. Risk factors for a leg vein thrombosis are in addition to the “pill” and obesity also smoking, little exercise, and lack of fluids. Therefore, especially on flights should be drunk always enough and continuously. On long-haul flights, it is also advisable to step on and off the plane: during movement, the contracting leg muscles massage the vessels, thus promoting blood flow within the veins.

But also thrombosis stockings can help: These are particularly tight, thereby compressing the superficial veins, which increases the flow velocity of the blood. The lower arteries, however, are not affected by the increased pressure conditions.

Pull on the outside of the knee

Back of knee pain may indicate a rupture of a lateral ligament (also collateral ligament). These bridge the knee joint and form a connection between lower leg and thigh. Your task is to stabilize the knee to the side.
A lateral kick against the knee joint may cause the collateral ligament to rupture, usually on the side opposite the tread. An external kick against the outside of the left knee would thus result in a rupture of the inner sideband of the left knee.

A rupture of a collateral ligament is less severe than a cruciate ligament rupture because it usually does not require surgery. However, it also requires a several weeks immobilization and healing phase, which can be up to 20 weeks.
Furthermore, a meniscal tear must also be considered. The menisci lie – in pairs – right and left in the knee joint in the joint space. They “buffer” the pressure exerted by the part of the body above the calf.

A meniscal tear can cause pain and unpleasant Back of knee pain. The pulling is to be heard especially in the outer area of ​​the knee joint, and may occur increasingly when walking / under load. A meniscal tear can also be treated conservatively.

Whether an operation actually brings benefits is currently controversial. With surgery, there is always a risk of introducing germs into the sterile joint capsule – the knee is particularly vulnerable to this. Whether an operation must be carried out depends on many factors such as general condition, physical activity, and age. Incidentally, the inner meniscus is statistically twice as likely to be affected as the outer meniscus.

Drawing in the hollow of the knee when stretching / when bending

A pulling in the popliteal space occurs in particular during movements that stress the knee in its full range of motion. These include complete stretching, and complete ankle bending. When the knee is stretched, the two muscle heads of the calf muscle “gastrocnemius muscle” are stretched to their full length because the muscle is attached to the thigh and the heel.

If the muscles or the tendons on the heel and thighs are already irritated, this can cause additional pain. In the Back of knee pain and Achilles tendon then occurs an unpleasant pulling on.

Stretching during warm-up is perfectly normal and to some extent so intentional. Finally, the muscles should be stretched yes. However, the stretching should not take longer than seven seconds at a time, and only to a tolerable level of pain. If pulling is already at rest, it should under no circumstances be stretched and the leg rested. Sport should then generally be waived until the pulling no longer occurs.

However, as the leg flexes, the structures in the Back of knee pain are compressed and pressurized. If the space available in the Back of knee pain already narrowed anyway, this can cause pain. A prominent representative of space occupations in the popliteal fossa is the so-called Baker’s cyst, It is a protuberance of the joint capsule of the knee joint in the dorsal direction (ie “behind”), into the popliteal fossa.

As a result, there is a constriction of the local musculature, as well as a compression of the nerves and vessels of the popliteal fossa, which in turn causes pain. Especially when bending the leg then the already cramped conditions in the popliteal are further deteriorated, as the relaxed calf muscles pushes up, and skin and fat tissue in the popliteal fossa. A Bakerzyste can be easily felt from the outside as a small protrusion in the popliteal fossa become.

However, the diagnosis is made by MRI of the knee joint or ultrasound. The Baker’s cyst is just one reason why pain and pulling can occur when the knee is bent in the popliteal fossa. Also malformations of the vessels, swelling due to bruising and excessive fatty tissue can compress nerves in the popliteal fossa and thus cause pain.

After sitting / getting up

One of the most dangerous complications underlying pain and pulling in the popliteal fossa is the leg vein thrombosis . It occurs especially after long sitting on flights, or bus trips. When you get up, you often notice a downright bump in your legs and a tingling sensation over your calves, all the way down to your knees. The legs are heavy and swollen.

This is normal after long periods of sitting, as water and blood – following gravity – accumulate in the legs. While walking, the muscles massaging the vessels and pumping the blood back from the legs to the heart – this is the reason why we do not have fat legs after long marches.

On the plane, however, we are restricted in our freedom of movement, which is why our legs get fat. In the worst case, small blood clots form in the deep veins of the leg due to the slowed blood flow, and over time clog our veins. Pain after sitting for long periods – ie 3-4 hours in a row – may suggest a thrombosis, depending on the circumstances.

Even when getting out of bed we can sometimes observe this phenomenon. When the legs are thick and swollen up into the popliteal fossa this is often a sign of limited cardiac output. The famous “water in the legs” is a sign that the heart at rest – during sleep – is no longer able to carry the entire blood volume. At the latest then a visit to the family doctor or cardiologist should be made.

Back of Knee Pain
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