Back of Knee Pain: Causes, Exercises, and Relief

Pain at the back of the knee (posterior knee pain) can range from a minor annoyance to a significant problem that affects walking and daily activities. The good news: many causes respond well to the right exercises and self-care.

This guide helps you understand what might be causing your posterior knee pain and what you can do about it.

Common Causes of Back of Knee Pain

1. Hamstring Tendinopathy

What it is: Irritation or degeneration of the hamstring tendons where they attach behind the knee.

How it feels:

• Aching pain at the back of the knee
• Worse with bending the knee against resistance
• Stiffness after sitting
• Tender to touch at the tendon

Common causes:

• Overuse (running, cycling, sports)
• Sudden increase in activity
• Tight or weak hamstrings

2. Baker's Cyst (Popliteal Cyst)

What it is: A fluid-filled sac that forms behind the knee, usually related to other knee problems like arthritis or meniscus tears.

How it feels:

• Visible or palpable swelling behind the knee
• Tightness, especially when bending the knee fully
• Aching that worsens with activity
• May feel like a "water balloon" behind the knee

Important: Baker's cysts are usually symptoms of another knee problem. Treating the underlying issue often resolves the cyst.

3. Calf Muscle Strain (Gastrocnemius)

What it is: Strain or tear in the upper calf muscle, which crosses behind the knee.

How it feels:

• Sharp pain during push-off or jumping
• Pain when pointing toes or going up on tiptoes
• Possible bruising or swelling in upper calf
• Tender to touch in the muscle belly

Common causes:

• Sudden acceleration (sports, running)
• Jumping
• Calf fatigue

4. Meniscus Tear (Posterior Horn)

What it is: Tear in the back portion of the meniscus (cartilage cushion in the knee).

How it feels:

• Pain at the back of the knee, often on one side
• Clicking, catching, or locking
• Swelling in the knee
• Pain with twisting or squatting
• Difficulty fully bending or straightening the knee

Common causes:

• Twisting injury
• Degenerative changes (wear over time)
• Squatting with rotation

5. Popliteus Muscle Strain

What it is: Strain of the small muscle at the back of the knee that helps unlock the knee from a straight position.

How it feels:

• Pain at the back of the knee, often toward the outer side
• Worse when walking downhill or down stairs
• Pain when bending the knee from a fully straight position
• May feel unstable on uneven ground

6. Arthritis

What it is: Osteoarthritis or inflammatory arthritis affecting the knee joint.

How it feels:

• Deep, aching pain that may be felt throughout the knee
• Stiffness, especially in the morning or after sitting
• Gradual onset over months or years
• May have swelling
• Often worse with activity, better with rest

7. Deep Vein Thrombosis (DVT) — Requires Medical Attention

What it is: Blood clot in a deep vein, usually in the calf.

Warning signs:

• Swelling in one leg (not both)
• Warmth and redness
• Pain that feels deep, not muscular
• Recent immobility (long flight, bed rest, surgery)

⚠️ If you suspect DVT, seek medical care immediately. This is a medical emergency, not something to treat with exercises.

When to See a Doctor

Seek medical evaluation if you have:

• Significant swelling that came on suddenly
• Inability to bear weight
• Knee that gives way or locks
• Fever with knee pain
• Pain after a significant injury
• Symptoms of DVT (swelling, warmth, redness in one leg)
• Pain that doesn't improve after 2-3 weeks of self-care
• Pain that's getting progressively worse

Exercises for Back of Knee Pain

Important: These exercises are for common musculoskeletal causes. If you have a specific diagnosis, follow your healthcare provider's guidance.

Phase 1: Gentle Mobility and Pain Relief

Start here if pain is significant. Goal: reduce stiffness without aggravating.

1. Gentle Knee Bends (Pain-Free Range)

• Sit or lie down
• Slowly bend and straighten the knee
• Stay within pain-free range
• 15-20 reps, 2-3x daily

2. Heel Slides

• Lie on your back
• Slide heel toward buttocks, bending knee
• Slide back to straight
• Keep it gentle and controlled
• 15 reps, 2-3x daily

3. Calf Pumps

• Sit with leg extended
• Pump ankle up and down (point and flex)
• Promotes blood flow and gentle movement
• 20 reps, several times daily

4. Prone Knee Bend (Gentle Hamstring)

• Lie face down
• Slowly bend knee, bringing heel toward buttocks
• Only go as far as comfortable
• 10-15 reps, hold 2 seconds at end range

Phase 2: Stretching

Progress here when acute pain has decreased.

1. Standing Calf Stretch

• Face a wall, hands on wall
• Step one foot back, keeping heel down
• Lean forward until you feel stretch in calf
• Hold 30 seconds, repeat 2-3x each side
• Keep back knee straight for gastrocnemius; bend it for soleus

2. Seated Hamstring Stretch

• Sit on edge of chair
• Extend one leg, heel on floor, toes up
• Hinge forward at hips with flat back
• Feel stretch behind thigh and knee
• Hold 30 seconds, repeat 2-3x each side

3. Lying Hamstring Stretch

• Lie on back
• Lift one leg, hold behind thigh
• Gently straighten knee until stretch is felt
• Hold 30 seconds
• Use a strap if needed

4. Gastrocnemius Stretch on Step

• Stand on a step, heels hanging off
• Lower one heel below step level
• Feel stretch in upper calf
• Hold 30 seconds each side

Phase 3: Strengthening

Progress here when stretching is comfortable.

1. Hamstring Curls (Prone)

• Lie face down, legs straight
• Bend one knee, bringing heel toward buttocks
• Lower slowly (3 seconds down)
• Start with bodyweight, progress to ankle weights
• 3×12 reps

2. Heel Raises

• Stand holding something for balance
• Rise up on toes
• Lower slowly (3 seconds)
• Progress to single leg when ready
• 3×15 reps

3. Nordic Hamstring Curl (Advanced)

• Kneel with feet anchored
• Slowly lower body forward, controlling with hamstrings
• Catch yourself with hands
• Push back up and repeat
• 3×5-8 reps (challenging!)

4. Bridge with Heel Dig

• Lie on back, knees bent
• Press heels into floor, lift hips
• Hold 5 seconds, emphasizing hamstrings
• Lower slowly
• 3×12 reps

5. Single-Leg Romanian Deadlift

• Stand on one leg
• Hinge forward, extending other leg behind
• Keep slight knee bend in standing leg
• Return to standing
• 3×10 each leg

Phase 4: Functional Exercises

Progress here when basic strengthening is comfortable.

1. Step-Downs (Backward)

• Stand on a low step
• Slowly lower one foot behind you to the ground
• Return to standing
• Control the descent with the front leg
• 3×10 each leg

2. Lateral Walks with Band

• Place band around legs above knees
• Squat slightly
• Step sideways, maintaining tension
• 10 steps each direction, 3 sets

3. Walking Lunges

• Take a step forward into lunge
• Push through front foot to step forward
• Alternate legs
• 3×10 each leg

Sample Rehab Program

Week 1-2 (Acute Phase)

• Phase 1 exercises: 2-3x daily
• Ice for 15-20 minutes after activities if swollen
• Avoid aggravating activities
• Gentle walking as tolerated

Week 3-4

• Phase 1 + Phase 2 stretches
• Once daily or after activity
• Begin light activity if tolerated

Week 5-6

• Phase 2 stretches + Phase 3 strengthening
• Strength exercises 3x per week
• Stretches daily

Week 7-8+

• Phase 3 + Phase 4 exercises
• Gradual return to full activity
• Continue maintenance exercises

Tips for Managing Back of Knee Pain

Activity Modification

• Reduce activities that aggravate (but don't stop moving entirely)
• Avoid deep squatting temporarily
• Reduce running/jumping until pain improves
• Consider cycling or swimming as alternatives

Self-Care

• Ice for 15-20 minutes if swollen or after activity
• Foam roll or massage the calf and hamstring (not directly on the painful spot)
• Compression sleeve may help with swelling
• Elevate when resting if swollen

What to Avoid

• Pushing through significant pain
• Overstretching (forcing range of motion)
• Complete rest (some movement aids healing)
• Ignoring symptoms that are getting worse

Preventing Recurrence

Once pain resolves:

1. Continue hamstring and calf strengthening 2x per week
2. Stretch regularly, especially after activity
3. Progress training gradually (10% rule for increasing activity)
4. Address flexibility deficits before they become problems
5. Warm up properly before sports and exercise

The Bottom Line

Back of knee pain usually responds well to appropriate exercise and self-care. The key is:

1. Identify the likely cause (helps choose the right approach)
2. Start gently and progress gradually
3. Address both flexibility and strength
4. Be patient — soft tissue healing takes weeks
5. Seek help if symptoms don't improve or worsen

Most posterior knee pain improves significantly within 4-8 weeks of consistent, appropriate exercise. If yours doesn't, or if you have any red-flag symptoms, see a healthcare provider for proper evaluation.

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Related Articles:

• Exercises for Knee Pain
• Hamstring Strain Exercises
• Calf Pain Exercises
• Knee Pain Going Down Stairs