Posterior Knee Pain When Squatting: Causes and Treatments - Orthopedics

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Hello Ben-T.J. Chen,
Thank you for your inquiry regarding the posterior knee pain you are experiencing, particularly during squatting and cycling. Based on your description, it seems that your pain may be related to several potential causes, particularly given your history of trauma to the knee area.


Possible Causes of Posterior Knee Pain
1. Soft Tissue Injury: The trauma you experienced could have resulted in damage to the soft tissues around the knee, including muscles, tendons, and ligaments. The hamstring muscles, which run along the back of the thigh and attach near the knee, can become strained or injured, leading to pain during activities that involve bending the knee, such as squatting.

2. Baker's Cyst: Although you mentioned that there is no Baker's cyst, it's worth noting that these fluid-filled sacs can develop in the popliteal fossa (the area behind the knee) and can cause discomfort, especially when the knee is flexed. They can be associated with underlying joint issues, such as arthritis or meniscal tears.

3. Meniscal Injury: Given your history of knee trauma, there is a possibility of a meniscal tear, which can lead to pain, swelling, and mechanical symptoms such as locking or catching during movement. The posterior horn of the meniscus is particularly susceptible to injury during twisting motions.

4. Patellofemoral Pain Syndrome: This condition arises from issues related to the kneecap's alignment and movement, which can cause pain in the knee, particularly during activities that involve bending, such as squatting.

5. Synovitis: Inflammation of the synovial membrane can occur after trauma, leading to swelling and pain. This condition may be exacerbated by repetitive movements or prolonged positions.


Treatment Options
1. Physical Therapy: Since you have already undergone rehabilitation, it may be beneficial to revisit a physical therapist who specializes in knee injuries. They can provide targeted exercises to strengthen the muscles around the knee, improve flexibility, and enhance overall function. Focus on strengthening the quadriceps, hamstrings, and calf muscles while also addressing any imbalances.

2. Rest and Activity Modification: It is crucial to allow your knee to rest and avoid activities that exacerbate the pain. Modifying your activities, such as reducing the frequency of squatting or cycling, can help alleviate symptoms.

3. Ice and Heat Therapy: Applying ice to the affected area can help reduce inflammation and pain, especially after activities. Heat therapy can be beneficial before activities to help relax the muscles.

4. Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. However, it is essential to consult with a healthcare provider before starting any medication.

5. Injections: In some cases, corticosteroid injections may be recommended to reduce inflammation in the knee joint. This should be discussed with your physician.

6. Surgical Options: If conservative treatments fail and the pain persists, further evaluation may be necessary. This could include imaging studies such as MRI to assess for any structural damage that may require surgical intervention.


Conclusion
In summary, your posterior knee pain during squatting and cycling could stem from various causes related to your previous trauma. A comprehensive evaluation by an orthopedic specialist may be warranted to determine the exact cause of your symptoms and to develop an appropriate treatment plan. It is essential to address this issue promptly to prevent further complications and to improve your quality of life.

I hope this information helps you understand your condition better and guides you toward effective treatment options. Wishing you a speedy recovery!
Best regards,
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