Hamstring Tendon Causing Bad Knee Pain

Bigger Stronger Leaner Injuries and Rehab
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Hey all, i have been to a physio about my issues to try and get them sorted, but no luck at all. I have read a lot of articles but can’t find nothing on the matter.

Basically, i initially got refereed to a physiotherapist because i was having knee pain in the back of my knees, both of them. The pain is usually in the tendons on both knees, so im more than certain that’s causing the knee pain. It’s the tendons on the inner sides of the knee, im sure it’s the biceps fermois:

It’s ruining my life,
Cycling i can’t do as it causes pain in the front of my knee and in my knee caps, walking up stairs hurts my knees overall, the pain isn’t just from the back, it affects the front too, but im sure it’s coming from the back as that’s where the tendons are. I can’t run, i can’t squat, even bodyweight squat, squat stretches, feels like my knee is so unstable and in terrible pain, ive had this problem for a couple of years but it’s only more noticeable recently.

Another thing, recently, the right knee has become worse than the left, although they’re both a problem, i can just about fully extend/straighten my right knee and the pain is really bad and the knee is unstable overall. I have no idea of the cause, or if it’s linked, but my ankles have also been suffering lately, despite having good mobility and flexibility in those areas.

I read an article about get your butt in gear where one of the affected areas where overactive bicep fermois, but i have done mobility work and drills too and nothing is solving the problem.

Where recently the right knee has became worse, the physio said the hamstring tendon was extremely tight, i don’t know why, she believes that it’s not in anatomical position so every step i was walking, i was walking with a slight bend in my knee. I have done a lot of stretching for the knee, mostly hamstrings as advised, there has be minimal improvement in the pain.

Im really lost on what to do, and would love to get back to training soon.

If it helps im 19 years old.

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Anyone have some thoughts?

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I’m far from an expert here, but I’m wondering if maybe what you’re thinking is hamstring pain is actually an overly-tight iliotibial band, and you’re experiencing a pretty sever case of IT band syndrome. A couple of questions;

  • Firstly, if it is the hamstrings, have you tried foam rolling the muscle and its tendons?
  • Have you ever tried addressing your IT band with a foam roller?
  • Are your quads balanced? If the vastus medius (inner) quad is far weaker than the outer quads, your kneecap can track laterally, wearing away the cartillage beneath it. This causes a symtom known as chondromalacia patella (notably on the outer portion of the kneecap,) which could also be a possible explanation as to what you’re experiencing.
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how is your hip mobility? how is your femur internal / external rotation?

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Hi guys, thanks for taking the interest to reply as i am stuck and haven’t found anything similar online.

@watermelon - I have rolled both my IT band and hamstrings using a foam roller. My It band like most peoples was tight to an extent, but nothing severe and i can do it 1 legged without much trouble, i have also roll my hamstrings but don’t seem to have any tightness at all there. I’m guessing my quads are balanced, haven’t really been able to do much quad work at all lately, for months, mostly due to my right knee being unable to fully extend/flex, although the problem is in both knees, my right at the moment is worsen as i can’t fully extend/flex it without significant pain. Is there a way i can test my quads for imbalances? It’s worth looking into, as im open to all options to get to the bottom of this.

@alexus - My hip mobility is decent, just was doing a few drills from MM, especially the leg swings, knee raises im pretty good at, not so good at activating my glutes but it’s something im working on along with stretching the hips as is advised. Not too sure about femur internal external rotation, sorry, is there an accurate way to test it so i can get back to you on that?

Thanks both!

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Also interested to see how this plays out. While not in your exact situation (or near as severe) my knees have been giving me problems with seemingly no end in sight. Only during the past couple nights have I realized that sleeping in bed with my right knee full extended/flat causes some pain and discomfort. I know that I walk with a bend in my knee as well, so when you mentioned both of those I felt I could relate.

IT stretches and foam rolling really don’t do anything for me either. Ham curls have started to become painful for my right knee as well. Not sure if the tracking is off but I noticed during my last leg press session that my right leg seems to be bent outwards at the knee. If you were facing me it’d look something like this:

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Not quite that drastic, but it illustrates my point.

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Im not sure if a tendon of one of the abductors comes into play, when i take a wide stance and do windmills, it does feel good putting that weight on my knees.