Painful hollow of the knee – that can be behind it

Painful hollow of the knee - that can be behind it

Pain in the hollow of the knee can indicate various injuries or diseases of the knee joint: After a fall or an accident, pain in the hollow of the knee can indicate damage to the knee ligaments or a meniscus, for example. However, if the hollow of the knee hurts, especially after sport, the cause is often excessive or incorrect strain.

Pain in the hollow of the knee: an overview of the causes

Rarely, thrombosis of the leg veins can also cause pain in the back of the knee. On the other hand, palpable pain and swelling in the back of the knee are often signs of a so-called Baker’s cyst: This is a primarily harmless bulging of the joint capsule filled with synovial fluid.

We have compiled an overview of the possible causes behind pain in the hollow of the knee.


Injuries to the knee joint as the cause

A fall, an accident, or twisting of the knee joint can damage a meniscus or the knee ligaments, resulting in a cruciate ligament rupture. Depending on the exact location of the injury, the pain can also be localized in the back of the knee or radiate there.

In the case of pain after a fall, the LUCKY rule generally applies first:

  • Rest (avoid strain on the affected leg)
  • ice (cooling)
  • Compression (light pressure to reduce swelling and bruising, e.g. by taping with an elastic bandage)
  • Elevate _

If the pain does not improve after a few days, you should consult a doctor – an MRI can usually confirm the diagnosis.

Pain in the back of the knee after exercising

The hollow of the knee hurts, especially during exertion or after sport. In that case, the cause may be an overload of the hollow of the knee muscle (musculus popliteus) or the rear thigh muscles (ischiocrural muscles). These muscles are located at the back of the thigh and run past the back of the knee to the calf.

Exercising too intensively or incorrectly – for example, when jogging or cycling – can lead to irritation or inflammation of the tendons in these muscles. This manifests itself in pain on the inside or outside of the hollow of the knee, primarily when the knee bends or when there is pressure on the tendon. Under certain circumstances, the affected tendon can also be thickened or overheated.

It is then advisable to take a break from sports for a few days. If  the muscles are overloaded,  heat – for example in the form of red light or warm compresses – is good. In the case of inflammation, however, cooling makes more sense: the affected back of the knee is then usually overheated and swollen. However, the preventative effect of stretching before or after exercise is controversial: However, light stretching does not seem to do any harm.


Baker’s cyst: swelling in the back of the knee

A Baker’s cyst is a bulge in the knee joint capsule that occurs when increased synovial fluid is formed due to increased pressure in the joint. The cause is usually irritation of the knee joint – for example in the case of  osteoarthritis , meniscus damage or  joint inflammation . A Baker’s cyst occurs less frequently after knee injuries.

A Baker’s cyst appears as a palpable swelling or  bump in the back of the knee  . When you stretch or bend your knee sharply, you may also experience pain or a pulling sensation in the back of the knee. Rarely, the cyst can   rupture – this causes sudden, severe pain as well as redness and overheating of the back of the knee. Find out  what you can do if you have a Baker’s cyst here.

Thrombosis as a rare cause

In rare cases, pain in the back of the knee can be a sign of a thrombosis in a leg vein. In order to estimate the likelihood of thrombosis, it is important to know your risk factors:

Immobilization of the legs, such as when confined to bed or after operations or injuries where relief with crutches is necessary

  • Sitting for long periods of time, for example on long-haul flights or long journeys by train or car
  • Overweight
  • Age over 60 years
  • Cancer diseases
  • Thrombosis in the past
  • Diseases with a tendency to clot (thrombophilia)
  • Pregnancy and postpartum period (up to six weeks after birth)
  • Smoke
  • Taking the  contraceptive pill  or hormone treatment with estrogen

In the event of a thrombosis, additional symptoms may include swelling of the back of the knee or calf as well as a bluish discoloration or clearly visible veins (as in  varicose veins ). In addition, pain when squeezing the calf or putting pressure on the sole of the foot can increase the suspicion of a thrombosis.

If you suspect that you may have a thrombosis, you should see a doctor as quickly as possible, as in the worst case scenario, a life-threatening  pulmonary embolism  can result. Read  all the details about thrombosis here.

Nerve irritation: pain when stretching

The tibial nerve runs through the back of the knee and, among other things, allows the foot to be extended. Rapid muscle growth during intensive strength training, a knee joint effusion or a Baker’s cyst can constrict the nerve and cause pain in the back of the knee.

The pain usually occurs when straightening the knee or  after long periods of walking or running  . In addition, irritation of the tibial nerve can cause a burning or tingling sensation in the calf.


Pain in the back of the knee in children

In children, pain in the hollow of the knee or calf that occurs without a previous fall is often due to growth. Such growing pains usually occur in kindergarten and primary school and disappear independently after a while. However, if the pain persists for a long time or is unusually severe, it should be checked out by a doctor – this is especially true if the child has fallen or been in an accident.

In rare cases, a detachment of the growth plate (epiphyseolysis) can be behind a painful back of the knee in children. This condition can occur for no apparent reason or due to an injury. Rapid treatment is then essential, as otherwise growth disorders can occur.

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