Back of knee pain cause and treatment | Massage and 4 Exercises

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Pain in the back of your knee is a common, but easy to treat condition. It’s one of the less serious knee pain problems you can have.

Nevertheless, it can be very annoying.

But with our treatment plan, you can cure the pain in the back of your knee by yourself.

In my experience as a physical therapist, massage combined with specific exercises helps best when you want to relieve the pain in the back of your knee.

This is what the treatment plan looks like:

  • Massage the back of your knee
  • Increase the strength and stability of your leg and knee
  • Wear a knee brace to reduce the load on your knee for pain relief

I’ll explain the treatment plan in detail in this post together with several other topics:

knee brace

Anatomy of the back of the knee

Your femur and your chin bone form your knee. Your joint capsule covers the bones to give it more stability and keep everything together.

The back of your knee is also referred to as the popliteal fossa or knee pit.

The name comes from the fact that your popliteus muscle, the popliteal vein, and the popliteal artery all run through the cavity.

Furthermore, several muscles also run along the back of your knee.

These are your three hamstring muscles:

  1. semimembranosus
  2. semitendinosus
  3. biceps femoris
back of knee anatomy

These muscles run from your but to your calf region just below your knee. These muscles help to flex your knee and rotate your lower leg.

Your calf muscles are the other muscles that run over the back of your knee. They are called the gastrocnemius muscles. They also help you to flex the knee, as well as help you to stand on your toes and push off during walking.

The last structures that run at the back of your knee are the nerves that control the nerves and sensation of your lower leg.

What causes pain in the back of the leg behind the knee?

Every structure mentioned above can cause pain in the back of your knee. There are several possible causes for these structures to start to hurt. I’ll discuss every possible cause here below.

 

Overuse

The most common cause for pain at the back of your knee is an overuse of your knee. When there is an imbalance between the load and loadability of your knee, the back of your knee can start to hurt.

The reason for this is that the muscles in the back of your knee tighten to compensate for the increased load. They try to take over the load, which leads to the overuse of these muscles.

 

Osteoarthritis

One of the reasons for an imbalance in your knee is the development of osteoarthritis. Osteoarthritis is the loss of cartilage in your knee.

To compensate for the loss of cartilage, you have to increase the strength of your leg muscles. When your leg muscles aren’t strong enough, the muscles in the back of your knee will compensate, which causes tightness and, thus, pain at the back of your knee.

 

Overweight

Another overuse issue can be overweight. Your knees have to support all the weight of your body. So the more you weigh, the more you load your knees. It can cause overuse of your knees, which can results in pain at the back of your knee.

Therefore, losing weight can be a big relief for your knees and really helps in reducing knee pain in general.

 

Baker’s cyst

Another possible cause for knee pain at the back of your knee is the development of a baker’s cyst. A baker’s cyst is a fluid collection in the back of your knee. It’s often a result of osteoarthritis. With osteoarthritis, your knee produces more synovial fluid, which gets encapsulated, forming a baker’s cyst.

A baker’s cyst can be surgically removed, but it often comes back pretty fast again, so there is usually no point in removing it. There is also nothing else you can do about it.

 

Calf or hamstring tightness

The 4th possible cause can be calf or hamstring tightness. As mentioned before, your calf and hamstring muscles run over the back of your knee. When these muscles tighten up, they will cause pain.

You can feel this pain at the back of your knee or in the hamstring or calf itself.

 

Thrombosis

A more uncommon cause is the forming of thrombosis. Thrombosis happens when a blood clot blocks one of your arteries. It most often occurs in your lower leg.

The blocking of the artery causes blood to get trapped in your lower leg. It causes pain, swelling, and also redness in your leg. The pain can also be felt in the back of your knee, but most often concentrates in your calf region.

Risk factors for thrombosis are a sedentary lifestyle combined with overweight, diabetes, and smoking.

When you suspect to have thrombosis, you should see a doctor as soon as possible.

Regular exercise, healthy eating, and living a stress-free life all help reduce the risk of thrombosis.

Pain in the back of your knee treatment with massage and exercises

To treat the pain at the back of your knee sufficiently, there are three things you have to do.

The first thing is reducing the load on your knee. It eliminates the cause for your knee pain and makes the overall treatment more effective.

You can reduce the load on your knee by losing weight and wearing a knee brace. Due to the weight reduction, your muscles have to work less to resist the load reducing the tension.

Another very effective way is to massage the back of your knee, hamstring, and calf muscle. It reduces the tightness in your muscles and, therefore, the pain. You can also use a foam roller to reduce the tension in your leg muscles.

These two treatment options relieve your pain immediately.

Furthermore, you’ll have to do the following exercises to improve the strength of your leg to support your knee.

I’ll discuss the exercises here below.

knee brace

Knee pain exercise 1: Increase the strength of your thigh muscles

The first exercise you’ll have to perform increases the strength of your thigh muscles. These muscles move and support your knee.

They’re responsible for reducing the load on your knee and also to support the muscles in the back of your knee.

Perform the exercise like this:

  • Lay down at your back
  • Lift the leg of your painful knee
  • Repeat this ten times
  • Do this three times

You can see how to perform the exercise in the video below.

Perform the exercise twice a day. You can build up the number of repetitions up to 3×20. As these muscles become stronger, you will notice that your knee pain reduces. The exercise works for every form of knee pain.

When the exercise gets easier, you can also start performing squats and lunges to increase the strength of your legs.

Knee pain exercise 2: Increase the stability of your knee

The second exercise you can do to reduce the load on your knee is improving the stability. When your knee is more stable, the muscles supporting your knee react faster to loading or sudden movements.

That way, your muscles can absorb the forces applied to the knee. It results in a reduction of pain.

The most straightforward way to improve the stability of your knee is by standing on one leg. The balance disturbance trains your muscles to react faster.

You can see how it works in the video below:

Perform the exercise as often as possible. You can do it when you brush your teeth, when you’re cooking dinner or when you watch tv.

When the exercise becomes easier, you can also close your eyes to make the exercise more challenging.

Your eyes give feedback to your organ of balance, which helps to maintain your balance and stability. When you eliminate this feedback, your muscles have to rely on the feedback they get themselves to maintain the stability. It gives your stability an extra boost.

The final way to make the exercise even more difficult is by standing on a balance cushion.

ankle stability

Knee pain exercise 3: Stretch your hamstring muscle

As mentioned before, the pain in the back of your knee can also be a result of a tight hamstring.

To reduce the tension in your hamstring muscles, you can stretch them along with a massage or foam rolling.

Perform the exercise like this:

  • Place your injured leg on a chair
  • Reach forward with your hand toward your toes
  • At the same time, pull your toes towards you
  • Hold this position for 20 seconds
  • Repeat it several times

You can see how to perform the exercise in the video below

Repeat the exercise several times a day. When you keep your leg slightly bend, you’ll focus primarily on stretching the hamstring. When your knee is extended, you’ll also stretch the nerves in your leg. This can give a burning sensation in your calf muscle.

Knee pain exercise 4: Stretch your calf muscle

The fourth and final exercise focuses on stretching your calf muscle. Tightness in your calfCalf muscle pain treatment with 3 exercises for fast recovery muscle can also be a cause for pain at the back of your knee.

You’ll feel this pain primarily when you walk and push off your steps.

By stretching the calf muscle, you’ll reduce the tension and, therefore, the pain in the muscle.

You can perform the exercise like this:

  • Place your injured feel behind you and keep the knee extended
  • Move the weight of your body forward until you feel a stretch in your calf muscle
  • Hold this position for 20 seconds
  • Repeat this three times a day

You can see how to perform the exercise in the video below.

Perform the exercise 2-3 times a day. You’ll feel that the tension reduces as well as the pain. Make sure to keep massaging the muscle as well.

Conclusion

As you can see, there is a lot you can do to solve the pain in the back of your knee. When you still have questions after reading this article, feel free to ask them by sending me an e-mail to [email protected].

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