Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will learn everything you need to know about back of knee tendon pain and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Back of knee tendon pain is a common complaint among athletes, active adults, and anyone who spends time on their feet. Pain in the back of the knee can involve not only tendons but also the joints, bones, and surrounding structures of the knees and legs. This pain can limit your ability to walk, run, or even sit comfortably. Understanding the causes, getting an accurate diagnosis, and following an evidence-based treatment plan are essential for lasting relief. This guide covers the most common causes of back of knee tendon pain, expert treatment options, and how Prolotherapy at ProHealth Clinic can help you return to your active lifestyle.
What Causes Back of Knee Tendon Pain?
Pain at the back of the knee is often related to tendon or soft tissue problems. The most common causes include:
- Hamstring Tendinopathy: Overuse or strain of the hamstring tendons where they attach behind the knee, common in runners and athletes.
- Popliteus Tendonitis: Inflammation of the popliteus tendon, a small muscle at the back of the knee that helps unlock the joint during walking.
- Baker’s Cyst: A fluid-filled swelling that can cause pressure and pain behind the knee, often associated with underlying tendon or joint issues. Multiple baker’s cysts can occur, and they may be associated with rheumatoid arthritis or osteoarthritis.
- Gastrocnemius Tendinopathy: Strain or inflammation of the gastrocnemius muscle tendon where it crosses the back of the knee. The gastrocnemius muscle is a major calf muscle in the lower leg that plays a key role in knee and leg movement.
- Other causes: Meniscus tear, posterior cruciate ligament injury, anterior cruciate ligament (ACL) injury, hamstring injury, ligament injuries, or referred pain from hip or lower back problems.
- A direct blow to the knee, such as from a car accident or while playing sport, can cause injuries to the posterior cruciate ligament and other structures, leading to sharp pain or posterior pain.
Pain may also be referred from the lower leg or present as posterior pain (pain at the back of the knee).
Risk factors include sudden increases in activity, poor flexibility, muscle imbalances, previous injuries, and certain sports (e.g., running, football, tennis). Tiny tears in tendons can result from overuse, and being injured during sports or other activities increases risk (NHS, 2023).
Symptoms of Back of Knee Tendon Pain
- Aching, sharp, or throbbing pain at the back of the knee (pain in the back), which may radiate down the leg or be felt as leg pain during certain activities
- Pain that worsens with activity, especially running, squatting, or climbing stairs; some people may feel pain specifically when moving or bearing weight
- Stiffness or tightness, especially after sitting or sleeping
- Swelling or a palpable lump (in the case of a Baker’s cyst); the knee may become swollen, making it difficult to move
- Occasional clicking, popping, or a feeling of instability
- Difficulty fully straightening or bending the knee; difficulty moving the knee or leg is a common symptom, especially after injury
If you experience severe pain, sudden swelling, inability to bear weight, or signs of infection (redness, warmth, fever), seek medical attention promptly.
Health Conditions That Can Contribute to Back of Knee Tendon Pain
Back of knee tendon pain, also called posterior knee pain, can often be traced to underlying health conditions that affect the knee joint and surrounding tissues. These conditions may lead to severe pain, swelling, difficulty bending, or even problems bearing weight on the affected leg. Understanding these potential contributors is key to finding the right treatment and achieving pain relief.
Diagnosis
A thorough diagnosis is essential for effective treatment. Your healthcare provider will typically:
- Take a detailed medical history, including your symptoms, activity level, previous injuries, and any relevant sports medicine evaluations
- Perform a physical examination, checking for tenderness, swelling, range of motion, and strength
- Order imaging tests (ultrasound, MRI, or X-ray) if a tendon tear, cyst, or other structural problem is suspected
Accurate diagnosis helps guide the most effective treatment plan and rule out more serious conditions (Versus Arthritis, 2023).
Treatment Options for Back of Knee Tendon Pain
Most cases of back of knee tendon pain can be managed with conservative, non-surgical treatments:
- Rest and activity modification: Avoid activities that worsen pain, especially running or deep squats.
- Ice therapy: Apply ice packs or a bag of frozen peas wrapped in a tea towel for 15–20 minutes after activity to reduce inflammation and prevent ice burns.
- Compression and elevation: Use a compression bandage and elevate the leg to reduce swelling.
- Pain relief: Over-the-counter medications such as paracetamol or ibuprofen.
- Physical therapy: A physiotherapist can design a program to improve flexibility, strength, and correct muscle imbalances, often recommending targeted strengthening exercises for the knee and surrounding muscles.
- Stretching and strengthening: Focus on the hamstrings, calves, and hip muscles.
- Supportive footwear or orthotics: May help correct biomechanical issues.
- Injections: Corticosteroid, PRP, or regenerative injections may be considered for persistent cases.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat back of knee tendon pain. Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with back of knee tendon pain.
As prolotherapy is helping to treat the root cause of back of knee tendon pain, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Case Studies
Case Study 1: Sarah, a 35-year-old runner, developed back of knee tendon pain after increasing her training intensity. She received physiotherapy and prolotherapy, which allowed her to return to running pain-free within three months.
Case Study 2: Tom, a 50-year-old office worker, experienced persistent pain behind his knee due to a Baker’s cyst and hamstring tendinopathy. After a combination of prolotherapy, stretching, and activity modification, his pain resolved and he returned to normal activities.
Case Study 3: Linda, a 42-year-old tennis player, suffered from popliteus tendonitis. She benefited from a tailored rehab program and prolotherapy, regaining full function and returning to her sport.
FAQs
What is the most common cause of back of knee tendon pain?
Hamstring tendinopathy and popliteus tendonitis are the most common causes, especially in active adults and athletes.
Can I exercise with back of knee tendon pain?
Gentle stretching and strengthening are usually safe and beneficial. Avoid high-impact or painful activities until symptoms improve.
How long does it take to recover?
Most people improve within 6–12 weeks with conservative treatment. Chronic cases may take longer and may benefit from prolotherapy.
Is prolotherapy safe for back of knee tendon pain?
Prolotherapy is considered safe when performed by a qualified practitioner. It is minimally invasive and has a low risk of complications.
When should I see a doctor?
If you have severe pain, swelling, redness, or cannot walk, or if symptoms persist despite self-care, consult a healthcare professional.
Conclusion
Back of knee tendon pain can be frustrating and limiting, but with the right diagnosis, exercises, and a comprehensive treatment plan—including innovative options like prolotherapy—you can achieve lasting relief and return to your active lifestyle.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let back of knee tendon pain control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating back of knee tendon pain, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with back of knee tendon pain and providing effective treatment options to alleviate them.
He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
Linkedin profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
References
- NHS. (2023). Knee Pain
- Versus Arthritis. (2023). Knee Pain
- Arthritis Foundation. (2023). Tendinitis
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.