Posterior (back) Knee Pain in Runners

Posterior knee pain in runners is a condition marked by discomfort at the back of the knee joint during or after running. This pain can stem from various causes, including muscle strains, tendonitis, or underlying structural issues. Runners experiencing posterior knee pain may notice stiffness, swelling, or aching sensations. Diagnosis often involves a comprehensive examination, possibly including imaging studies, to identify the specific source of the pain.  Some of the most common causes of gradual onset chronic pain at the back of the knee include:


Biceps femoris tendinopathy

Biceps femoris tendinopathy is a condition characterized by pain and dysfunction in the biceps femoris tendon, one of the hamstring tendons situated at the back of the thigh. This overuse injury is common among athletes engaging in activities involving repetitive hamstring use, such as running and jumping. Symptoms include localized pain, tenderness, and stiffness in the back of the knee. Management typically involves rest, ice, anti-inflammatory measures, and targeted exercises to strengthen and rehabilitate the affected tendon. Addressing contributing factors, such as biomechanical issues and training adjustments, is crucial for both treatment and prevention.


Baker’s cyst

Baker’s cyst, or popliteal cyst, is a condition that can affect runners, characterized by the accumulation of synovial fluid behind the knee. This cyst typically develops as a result of underlying knee joint issues, such as osteoarthritis or meniscus tears, leading to an overproduction of synovial fluid. Runners with Baker’s cyst may experience a visible swelling behind the knee, accompanied by tightness and discomfort. While the cyst itself is usually benign, it can cause pain and limit mobility. Treatment often involves addressing the underlying knee condition, along with measures to alleviate symptoms, such as rest, ice, compression, and elevation.


Popliteus injury

Popliteus injury in runners is a condition involving damage to the popliteus muscle or tendon, situated behind the knee joint. This injury can result from overuse, sudden twists, or biomechanical imbalances, causing symptoms such as pain, swelling, and discomfort during running. Runners may experience difficulty bending or extending the knee and notice weakness in the affected leg. Management typically includes rest, ice, anti-inflammatory measures, and targeted exercises to strengthen and rehabilitate the popliteus muscle. Addressing contributing factors like improper running techniques or footwear is crucial for both treatment and prevention.


Hamstring tendon strain

Hamstring tendon strain in runners is a common injury involving damage to the tendons of the hamstring muscles, typically caused by overuse, sudden acceleration, or inadequate warm-up. Runners with this condition may experience symptoms such as pain, tenderness, and tightness in the back of the thigh. Severe strains can lead to difficulty in walking and hamstring weakness. Treatment often includes the R.I.C.E. protocol (rest, ice, compression, and elevation), along with targeted exercises to rehabilitate the affected tendons. Runners are advised to gradually resume activities, address contributing factors like biomechanical issues, and consider proper warm-up routines to prevent recurrence. . More information on Hamstring Tendon Strain.