Pain in the tendons behind the knee, physical therapy: Focus Fizikal✓

Pain in the tendons at the back of the knee represents a common functional problem that directly affects the stability of the leg and the mechanics of walking. The back of the knee, known as the popliteal fossa, is where the strong tendons of the hamstring muscles and calf muscles attach. These tendons play a crucial role in controlling knee flexion and preventing excessive knee extension, which is why they are under constant dynamic load during daily and sports activities.

The anatomy of the tendons behind the knee includes the medial tendons (semitendinosus and semimembranosus) on the inner side and the lateral tendon (biceps femoris) on the outer side. Deep in the popliteal fossa, there is the tendon of the popliteal muscle, which is responsible for the initial phase of leg flexion. When chronic overuse or sudden movements occur, microtraumas can develop in these tendons, which the body fails to heal in time, leading to degenerative changes and thickening of the tendon tissue. Understanding the connection between thigh muscle tension and the load on the tendons behind the knee is crucial for determining the exact source of the pain. Timely physiotherapeutic diagnostics and targeted procedures prevent the development of permanent shortening and rupture of tendon fibers.

The symptoms of tendon pain behind the knee vary from a feeling of tightness and stiffness during the first steps in the morning to sharp stabbing pain when attempting to run or squat. Patients often report that the discomfort worsens with activities that require strong pushing off the foot from the ground or sudden braking movements. The clinical presentation is specific, as the pain is usually localized to the tendons themselves, which can be palpated as firm, painful bands behind the knee.

The most common symptoms associated with pain in the tendons behind the knee include:

• Sharp pain on the inner or outer back side of the knee that occurs during strong knee flexion against resistance.
• A feeling of tightness and "shortening" of the tendons, preventing the knee from fully straightening without discomfort.
• Localized tenderness when direct pressure is applied with a finger on the tendon attachments just above or below the joint line.
• Pain that arises after sitting for long periods with the knee bent, followed by a sensation of stiffness when attempting to stand.
• Popping or a feeling of friction in the tendons during movements of bending and straightening the leg under physical effort.

These signs are clear indicators that the tendon structures at the back of the knee are under excessive load, which requires professional evaluation. Recognizing these symptoms early allows a physiotherapist to prevent the development of chronic tendinopathy, which significantly prolongs the recovery process.

• Tendonitis
• Bursitis
• Osteoarthritis
• Joint injuries