Pain in the calf and the hollow of the knee
definition
Pain in the calf can often be attributed to discomfort in the hollow of the knee and in the entire knee joint. The knee joint is composed of a complex hinge joint and articular cartilage, which is prone to injury, as well as ligaments that give the joint stability. Sports such as skiing, in particular, place enormous strain on the menisci, collateral and cruciate ligaments.
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causes
The causes of pain in the calf and the hollow of the knee can be many. In addition to muscles, bones, joints, cartilage and ligament structures, vessels and nerves in the hollow of the knee can also be affected.
However, most commonly found in the knee are orthopedic problems. Stinging pain occurs particularly often in the hollow of the knee when running, which can be traced back to the calf. It is not uncommon for individual muscles to be overstrained. The muscle can be stimulated in the course of a faulty movement or a strong new load. When you start jogging after a long period of abstinence from exercise, such symptoms can appear quickly.
There may also be an injury to the knee joint. This often affects the menisci, the two cruciate ligaments or the inner and outer ligament. Excessive rotational movements in the knee can tear the cruciate ligaments, which can lead to instability and significant pain in the hollow of the knee.
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Many people have a so-called "Baker's cyst" in their knee. This is a bulging out of the joint capsule, which becomes noticeable as a palpable fluid-filled blister in the hollow of the knee. It can cause pain in the back of the knee with movement and pressure, especially if it is inflamed or even torn. At an advanced age, osteoarthritis, i.e. wear and tear on the knee joint, must also be considered. This can also be associated with a Baker's cyst and contribute to the pain.
More rarely, the pain in the calf and the hollow of the knee can be attributed to a thrombosis of the leg veins. Especially in old age, with long periods of physical inactivity, tendency to clot and many other conditions, blood clots occur more frequently. They can block the vein in the leg and cause painful inflammation. This is an acute and sometimes dangerous disease.
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Thrombosis as a cause of pain in the calf and the hollow of the knee
Thrombosis is an acute clotting of blood in a blood vessel, which creates a so-called "thrombus" that can block the vessel.
In most cases, thrombosis develops in the leg due to several unfavorable factors. The development of thrombosis is influenced by a low flow rate of the blood, as well as additional coagulation tendencies and previous damage in the blood vessel. Low blood flow occurs in the lower leg due to gravity, after long periods of sitting and standing or when bedridden. In addition, blood clotting is strongly promoted by old age, the birth control pill, smoking, obesity, cancer and pregnancy. In severe cases, a blood clot in the leg can break loose and travel through the heart to the lungs, where it can cause a pulmonary embolism. This is a dangerous complication in severe thrombosis.
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Pain in the calf and back of the knee from a Baker's cyst
The Baker's cyst is a bulging out of the joint capsule, which can appear favored by increased pressure in the joint or by inflammation and signs of wear and tear. The cyst is therefore also filled with synovial fluid and can often be felt in the hollow of the knee. The cyst may go unnoticed or be painful. Even in a healthy state, bending and stretching the knee can cause pain due to the supposed bulging foreign body. In the case of inflammation, in particular, there is severe pain in the hollow of the knee. The cyst can also tear. The cyst can then be surgically removed.
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Pain in the calf and back of the knee from tendinitis
In most cases, tendinitis in the knee is mechanical. Certain movements cause the tendon to rub against anatomical structures and become irritated. Gradually, the tendon swells, becomes increasingly painful and overheated. This is called inflammation. This can occur after many years of training in endurance sports or as a result of incorrect and excessive loads in new sporting activities. It is particularly important to protect the affected muscle for a certain period of time. Even after the pain has subsided, the tendon still needs time to heal completely.
Read more about this on our website Tendinitis in the hollow of the knee
Pain in the calf and the hollow of the knee after a fall
Falls can cause injuries to the legs and knees. The tendons and ligaments of the knee are robust and stable, but the heavy weight load can cause cracks and injuries even with a slight jerky twist. Sports that involve rapid acceleration, jumps or strong pressure and tensile loads on the lower leg represent the greatest risk of knee injuries. In addition to the frequent sports such as football and basketball, the knee is also severely affected by tennis and skiing.
With an existing Baker's cyst, a mundane fall can cause pain or cause the cyst to rupture. This often has to be surgically removed afterwards.
Read more on this topic: Twisted knees - is that dangerous?
Concomitant symptoms
The accompanying symptoms can vary with the cause of the pain in the calf and back of the knee. They also provide important information for making a diagnosis. The type and timing of the pain are decisive.
A pulling pain from the calf to the hollow of the knee during endurance sports indicates an irritated tendon. However, if there is swelling, overheating, redness and limited mobility in addition to the pain, inflammation is likely. In the case of injuries to the ligament structures in particular, instabilities in the joint are common. Even without pain, damage to the cruciate ligament can become noticeable due to the increased mobility of the lower leg. In the case of osteoarthritis that has existed for a long time, an audible rubbing and grinding of the bones can sometimes occur. Thromboses, on the other hand, are initially only unspecifically painful with possible swellings. If a shortness of breath occurs in this context, urgent action is required.
Swelling in the calf and the hollow of the knee
Swelling occurs when fluid accumulates in the knee area. This can be synovial fluid, blood, lymph, or other fluids.
In most cases of acute injuries to various structures of the knee, accompanying bruises appear. Rapid compression and cooling can reduce swelling. The swelling also restricts the function of the joint and increases the pain.
Synovial fluid can also cause this swelling. This is usually located within the joint capsule or any Baker's cyst. If one of these structures ruptures, the knee joint fills with the clear fluid.
Inflammation of the joint also promotes swelling. The inflammatory cells can produce a cloudy inflammatory secretion, which can arise especially in active osteoarthritis, inflamed tendons or Baker's cysts.
diagnosis
The diagnosis is made on the basis of a targeted external examination and, if necessary, with the help of diagnostic devices. A precise questioning of the symptoms and accompanying circumstances (anamnesis) with scanning and examination of the knee can in most cases already provide the most important suspected diagnoses. Accompanying circumstances, such as active endurance sports or a recent fall with injury, provide the decisive clues to orthopedic causes.
X-ray diagnostics can then be carried out, which can confirm a possible suspicion. A subsequent joint endoscopy, known as "arthroscopy", allows an exact diagnosis and offers the first options for direct treatment. With certain instruments, minor complaints can already be treated during arthroscopy. In order to diagnose a thrombosis, blood and ultrasound examinations must also be carried out.
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therapy
Therapy varies with the underlying problem. With slight irritation and inflammation, rest and protection are often the means of choice. Injuries to the menisci, collateral ligaments, or cruciate ligaments can be treated surgically or conservatively.
Smaller operations in the knee joint can now be performed with the help of an arthroscopy. The treatment options for jointoscopy are developing rapidly. However, this therapy method depends very much on the doctor's ability. In the case of advanced osteoarthritis of the knee joint with severe pain when moving, a knee prosthesis must be considered. This is a complete surgical replacement of the joint.
Read more on this topic: Operation of a knee prosthesis
Duration
The duration of the complaints depends on the success of the treatment. Slight irritations can be painless in just a few days. However, it is important to protect the knee for days to weeks after that. After an operation, you can be free of symptoms after just a few weeks. Even after a knee prosthesis, the load and mobility in the knee increase after a few weeks. Even if the prosthesis is the best treatment option for osteoarthritis, for example, complete freedom from symptoms is never guaranteed.
