Rehabilitation & Recovery

7 Hidden Causes Of Calf Pain When Bending Knee

Calf Pain When Bending Knee

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Calf pain when bending knee joints are very common and could be a sign of muscle cramps, calf muscle strain, or something more serious like a blood clot.  

While it’s important to get an accurate diagnosis from your healthcare provider, we’ll look at some of the possible causes of pain to your calf muscle when you bend your knee.  


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The different causes of calf pain will carry different symptoms.  

For example, in the most severe cases with something like deep vein thrombosis, accompanying symptoms can range from swelling to your lower leg and veins to shortness of breath.  


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The Most Common Causes Of Calf Pain When Bending Knee Joint

Let’s consider some of the potential reasons why you might be experiencing pain to the back of your knee joint along with the typical symptoms.  

calf pain when bending knee

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Muscle Strains Or Tears

A calf muscle tear or strain is the most common cause of calf pain when you bend your knee.  

This usually happens following on from a sudden movement like running up the stairs or when playing a sport like tennis.   

Calf injuries begin with a sharp pain followed by a dull ache to the middle and back of the leg.  

Often, you’ll have a small, tender spot which sits between the gastrocnemius muscle and the soleus muscle.  

These are the two main muscles that make up your calf.

While this type of calf pain is only temporary, you can help relieve any discomfort by putting your heels in an elevated position using heel wedges.

Whether it’s a small calf tear or strain to your Achilles tendon you can also apply ice packs to the affected area to help manage any pain along with some very gentle stretches.  

Calf strains can take anywhere between 2 to 6 to weeks to feel better depending on the severity of the strain.  


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Compartment Syndrome

Your calf muscle is made up of four different compartments.  

Each of these compartments are made of fascia which contain their own muscle fibers and tendons.  

As well as the gastrocnemius and soleus, you also have the plantaris and tibialis posterior.  

When you exercise, all of the muscle compartments receive an increase in blood flow.  

When this increased blood supply can’t exit as it normally would this can cause a build up of pressure and lactic acid to the affected muscle.  

This is known as compartment syndrome.  

Typical symptoms include a sudden and severe pain to the muscle very soon after starting any form of exercise that involves your calf muscles.  

This pain will quickly subside when you stop exercising.  

In more extreme cases, you may notice a swelling, numbness or tingling down the back of your leg to your foot.  

This is because the blood flow is being restricted with pressure on the sciatic nerve.  

In such instances, surgery may be necessary to open up the compartment and release the built up pressure.  

Compartment syndrome is much less common than a calf tear and tends to affect people who do a lot of running and cycling where the calf muscles are being used excessively.  

However, it can also result from muscle trauma leading to problems with blood flow.  


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Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a blood clot which you can get anywhere in the body but they’re most common to the back of the lower leg and a bit closer to the back of the knee.  

The primary concern with blood clots is if they dislodge and travel to your lungs which may result in a pulmonary embolism.  

This is a potentially fatal condition that would require emergency medical attention.  

Blood clots can develop for several reasons including sitting for hours at a time.  

This is why you get encouraged to move around during long haul flights or perform simple calf exercises to boost your circulation.

Post surgery can also increase the risk of suffering from a blood clot or if you become more sedentary following on from an injury that means taking a lot of rest.  

If you have a blood clot to your lower leg, symptoms may include persistent lower leg cramps and the skin directly over the clot can feel warmer to the touch compared to the surrounding skin.  

Pain to your calf can sometimes become worse if you try and flex your foot upwards.  

A physical exam may include the Homan’s test whereby dorsiflexion is tested.  However, results are very often inconclusive and have to be followed up with an ultrasound which would confirm the presence of a blood clot.  


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Arthritis

The risk of developing arthritis increases as we get older.  

The most common form is osteoarthritis which is down to wear and tear as we age.  

It happens when the protective cartilage that cushions the end of the bones gradually wear down over time and is more common in seniors.  

A sign of knee arthritis is a bowing of the legs.  

This is because the inner part of the femur is larger and bears more weight causing it to wear down faster.  

When suffering from arthritis it can be painful to straighten the leg as well as bending the knee.  

Other signs to look out for are swelling around the knee cap and tenderness on the inside of the leg just beside the knee.  


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Baker’s Cyst

If you notice a bump on the back of your knee, this could be a baker’s cyst (also known as a popliteal cyst).  

This happens when the cartilage of the knee joint is torn or arthritis has set in resulting in inflammation and the build up of fluid.  

This synovial fluid then seeps out which causes a small marble sized lump to form just behind the knee which can lead to calf muscle pain.  

A treatment plan would usually involve applying ice to reduce swelling or something like a compression bandage to help relieve any discomfort. 

Sometimes aspiration takes place whereby the fluid is drawn out.  

However, the lump can redevelop again if the underlying problem is not addressed.  

So, whether it’s arthritis or a meniscus tear, either should be appropriately treated in order to prevent the continual build up of fluid.  


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Patellar Tendinopathy

Sometimes called jumper’s knee, patellar tendonitis is a fairly common injury that affects the patellar tendon.  

This tendon connects the knee with the shinbone.  

It tends to be more prevalent in those who undertake sports which involve a lot of running and jumping.  

For this reason, it mainly affects younger people.  

While pain is usually felt just below the knee cap, it can radiate to the calf muscle because of overcompensating your muscles during certain activities.

It’s also associated with a muscle imbalance between the muscles around the knee, especially the quadriceps.

Muscle wastage of the calf muscles and the quadriceps is sometimes noted to the affected leg.  

A common sign of knee tendonitis is knee pain when sitting for a long period of time and an increase in pain after high intensity activities.  

Treatment of patellar tendinopathy usually involves rest, ice, compression and elevation (RICE) and a course of physical therapy.  

If this form of conservative treatment doesn’t work, then cortisol injections may be necessary or, in rare cases, surgery to repair any damaged tissue.  


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Muscle Cramps

Calf muscle cramp is an involuntary spasm of the muscle and can be triggered by several different factors.  

These can range from dehydration, not warming up properly before exercise or poor footwear.  

In respect of exercise, inadequate stretching and warm-up beforehand can increase the risk of muscle cramps, especially if it involves repetitive knee bending.

Cramp is something we’re all likely to experience at some point in our lives and while it’s very painful, it’s not usually anything to worry about.  

The leading cause of cramp is down to dehydration so make sure to drink plenty of water throughout the day.  

It’s been suggested that taking magnesium supplements can help to prevent cramps.  

However, studies have shown this to be inconclusive.

One of the fastest way to relieve muscle cramping is to perform a self massage, this can be done using either your hands or you could try a foam roller.  


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Final Thoughts

Understanding the different causes of calf pain when bending the knee is important so that you can address and alleviate the discomfort.  

Whether it’s due to more common muscle strains or calf cramps, or the impact of underlying conditions, such pain can significantly disrupt daily activities and quality of life. 

By recognizing the potential causes, seeking proper diagnosis, and following appropriate rehabilitation and preventive measures, you can reduce pain and discomfort and improve the mobility to your knee. 

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