Posterior knee pain, or pain behind the knee, is a common presenting symptom. It can affect younger athletes as well as the middle aged population. If you have experienced this before, you will probably agree that is can be very frustrating. While there are many potential causes of pain behind the knee, Dr. Smith will take a look at some of the more common conditions and how you can treat them.
Pain behind the knee – Bakers Cyst
A bakers cyst is a fluid filled cyst that may develop behind the knee. Patients often experience a feeling of tightness in this region and the pain can be worsened by bending and extending your knee. The fluid that forms the baker’s cyst comes from the synovial fluid within the knee joint. When there is pathology within the knee joint such as arthritis or a meniscus tear, there is usually increased amounts of this synovial fluid within the knee joint. Usually a Baker’s cyst maintains its connection with the knee joint, although sometimes this connection can be closed over, and the cyst itself can also rupture resulting in acute significant pain behind the knee. This discomfort can last several months and early treatment includes a compression bandage, ice, and pain relief.
While Baker’s cysts themselves may be painful, they are a benign condition that rarely requires any direct treatment. We don’t routinely drain the cyst, as it is likely to quickly return if we don’t address the underlying condition within the knee joint. If you have been diagnosed with a Bakers cyst on ultrasound and have ongoing symptoms, it is worth visiting a knee specialist to determine why you have developed the cyst and whether you would benefit from treatment targeted at the likely arthritis or meniscus tear within the knee joint.
Pain behind the knee – Meniscus tear
A sudden twisting injury to your knee can certainly result in a meniscal tear. Depending on the location of the tear, you may experience pain behind the knee. The meniscus is a ‘C’ shaped piece of cartilage that acts as a shock absorber during normal activities. When you sustain an acute meniscus tear, you often lose this function of the meniscus and pain develops. The meniscus is attached to the tibia via its two ‘horns’ One at the front (anterior) and one at the back (posterior). In select cases, a twisting injury may cause an ‘avulsion’ of the posterior horn of the meniscus. This can be extremely painful and cause pain behind the knee. Treatment of these tears require special attention by an orthopaedic surgeon as they can be difficult to manage.
Pain behind the knee – Hamstring tendonitis
Stiffness and pain behind the knee at the start of a run may be attributable to hamstring tendonitis. The hamstring muscles are unique in that they pass across two joints, the hip and the knee. The hamstring tendons are responsible for straightening the hip and bending the knee during running exercises. Repetitive running or jumping exercises can exacerbate this condition, and is often the result of a combination of loss of technique with fatigue, and overuse. Assessment by a physiotherapist or sports doctor will help determine the likely cause and a management plan can be initiated.
Pain behind the knee – Gastrocnemius tendonitis
The gastrocnemius muscle is medical term for the calf muscle. Its primary function is to allow your ankle to push off during running and jumping exercises. This muscle takes origin from just above the knee joint and runs down the back of the leg to become the achilles tendon. Tendonitis may occur with repetitive knee extension, ankle dorsiflexion (toes pointing upward) activities. Simple advice such as rest, intermittent ice, and a compression calf sleeve may be beneficial.
If you are experiencing pain behind the knee and would like an assessment by Dr. Mike Smith, orthopaedic surgeon, then please contact his rooms to book an appointment.