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Hamstring pain behind the knee is a real problem, but many people are unaware of its severity. The hamstring muscle group spans the back of the thigh and consists of three muscles – Biceps Femoris, Semimembranosus, and Semitendinosus.

Hamstring Pain and Where It Hurts

Pain in the posterior aspect/backside of the knee has to do with one of three hamstring muscles. These can be roughly categorized as follows:

  • Pain in the lower portion of the hamstring (semitendinosus and semimembranosus) is typically due to an injury sustained at their origin, or where they attach; this may be referred to as ‘insertional pain’.
  • Pain located in the middle portion of the hamstring is likely related to a muscle strain.
  • Pain located in the upper portion of the hamstring (biceps femoris), almost always indicates an injury that is more severe.

Pain Behind Knee

‘Insertional pain’ behind the knee has to do with irritation at where one of two tendons attach – one for each hamstring muscle. The tendon attaches to the ischial tuberosity (aka- sit bone). This tends to happen with athletes that participate in a lot of sprinting activities or other ‘explosive’ movements. They might experience tearing or irritation, which causes pain at this insertion site.

Pain located in the middle portion of one or more hamstring muscles (semitendinosus and semimembranosus) is likely related to a muscle strain. These are typically due to excessive tension or improper conditioning of the muscle fibers.

The most serious condition- pain located in the upper portion of one or more hamstring muscles (biceps femoris), almost always indicates an injury that is more severe. This type of pain should not be ignored.

‘Lower hamstring insertional pain’ often has a gradual onset and can feel like a sharp or a knife-like jab in the back of the knee. It usually feels worse when going from sitting to standing, getting out of bed in the morning, running, climbing stairs, or sprinting.

Hamstrings Tendinopathy

Your hamstrings are the thick muscles in the back of your thigh that are responsible for the movement of your hip, thigh, and knee. The hamstrings are made of three distinct muscles: Semitendinosus, Semimembranosus, and Biceps Femoris. What is Hamstrings Tendinopathy? Tendons are thick pieces of connective tissue that connect muscle to bone. They function to transfer the force generated by muscle contraction into movement. Hamstring tendinopathy, also known as a “calf strain,” is an injury to the affected tendon. It usually occurs when you bend your knee or extend your leg, putting too much force on the hamstring tendon….

Read More About Hamstrings Tendinopathy

Pes Anserine Bursitis

Knee pain located at the lower inside of the knee can be caused by Pes Anserine Bursitis, which is irritation of the tendons that run on the inside aspect of the knee. Commonly mistaken for arthritic pain, meniscal pain, and sometimes nerve pain from the low back! Don’t be misdiagnosed, and let’s dive in below to get a better understanding of Pes Anserine Bursitis. The Pes Anserine Bursa is a bursa that surrounds 3 tendons of the leg. A bursa is a thin, slippery, sac-like film that contains a small amount of fluid. A bursa is found between bones and soft tissues in and around joints…

Read More About Pes Anserine Bursitis

Radial Meniscus Tears

The meniscus is an important fibro-cartilage structure within the knee that absorbs shock and provides cushioning. It has a semicircular ‘C’ shape and sits between the femur (thigh bone) and the tibia (lower leg bone).  The meniscus protects the two bony structures from weight, shock, and shear forces. Each knee contains two menisci, one on the outside (lateral) and one inside (medial). 

Read More About Radial Meniscus Tears

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