I have a sharp pain behind my left knee that is only there when I point my toes up. Any ideas?

First off - I am trying to get an appointment with a sports doctor, but it may be a few weeks. I’m trying to figure out if this is something where I just need to stop training all together, or if massage and ice would be enough and I can keep training.

• There was no injury moment that I know of.
• It’s a sharp pain.
• It hurts only in the moment I point my toes up.
• It hurts the most at the very beginning of movement and then fades. If I point the toes up the pain will almost completely go away in about 4 seconds.
• It’s more on the inside of the back of the knee (closest to the other leg / right side of left leg)
• When I am done moving my foot all the pain goes away.
• If I massage my calf muscles there is a narrow line from my knee twords my ankle that hurts but everything else feels fine.
• If I push through I have full power - I can stand on my toes on the leg no problem
• The pain happens even if there is no weight on the leg
• So far stretching it helps reduce the amplitude of the pain when it happens. Resting makes walking hard


2 weeks ago I did a longer (5hr) ride with a 40min SS interval 1hr in. Nothing special, Iv’e done a lot of these. In the last hour the back of knee started having a sharp pain on each stroke as I straightened the leg.

I needed a rest week anyway so I took a few days off of it completely then did only z2 rides. After a week I didn’t feel anything out of the ordinary but kept on doing sub 2hr z2 rides only. On day 10 I tested it out with a 25min max effort and everything seemed fine.

2 days ago I did a 2hr training ride with 60min of 90% FTP SS intervals. All good - Nothing at all. I even did a minute sprint of about 180%. Today I was on a long ride that started with 3hrs of z2 and the pain came back a little bit. I stopped and massaged it. Then I did a 15min 100% interval and a 20min 85% interval back to back. The pain was kinda there, but I didn’t notice it until the last 10 min of the ride.

Now, It’s hard to walk unless I stretch it. Any ideas what it might be?

Could be some sort of overuse injury. Maybe this article can help. I had a similar pain caused by the old dura-ace pedals that were know knee killers. Had to get my foot out quick and twisted the wrong way. Took about 2 years to go away. Back of my knee hurts now just thinking about it.

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Had something similar. Turned out a Bakers Cyst. The fluid built up in the knee couldn’t drain due to swelling in the joint. Pushed Motrin for a few days and most of the pain gone. I’m now taking Motrin as a preventative before long rides and before bed after the ride. Knee feels a lot better and I can train like I want.

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Thanks all - I got a appointment for Monday so just waiting till then :crossed_fingers:

Update - Went to the doctor and they aren’t sure what it is but is very confident I’t not a tear or anything. They think it’s tendinitis or just overuse and that I need to go to PT and start some strength training.

Leg feels a lot better and I was given permission to stretch it (alleviates the pain a lot)

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Baker’s Cyst or bursitis (swelling of a bursa sack)

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Another update - My leg started to discolor in areas and swell, and the calf muscle hurts to touch it. I never had an injury or impact moment so they sent me in for a DVT (blood clot) check. They didn’t find one but they did find a deep venous incompetency in the common femoral vein. I’m being bounced around a bunch of doctors and we aren’t fully sure what caused it.

Right now about the only thing that seems clear is that is is not ligament related

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Heal quickly!

Ask your MD if you think there are any signs of popliteus issues - a small and often overlooked muscle in the back of your knee.

Just another update.
Not much changed other than I do have a valve issue in the leg but they don’t think it’s worth doing anything about. They think it is likely the discoloration and swelling is more likely from a small muscle tear than an valve issue. But I have a follow up in 6 weeks to make sure.

My personal guess based on a few things is that a nerve issue in my foot (Neuroma) was acting up had me pedaling in a way that caused the injury. I was trying to take pressure off the ball of my foot due to pain (I’m also seeing podiatrists to get this sorted too). I think maybe I ended up tearing some small muscle in the process.

PT is still unable to recreate any pain twisting the leg and what not and the knee seems good.

I do have some weak non-cycling muscles (some hip flexors, hamstrings, etc) so we are cross training now to strengthen them up in case that helps.

But generally the consensus is :man_shrugging:

I’ve been eating like I haven’t reduced my TSS (I’m about 50% of pre injury) and doing some harder riding just to try to keep as much fitness and muscle as I can. Seems to work ok, but Iv’e found my mental strength and motivation to train hard have decreased the most.

I’m doing a 53mi ride this weekend. That was previously a short weekend ride but it will be my longest in 5 weeks - I guess we’ll see what happens.


Final update I hope
Test results showed that I did have a minor vein issue but they don’t think that’s what caused the discoloration and swelling. They think somehow I tore a muscle enough to cause internal bleeding and swelling. But right now it’s been 2mo everything seems to be healed, and all the evidence is gone


I look forward to getting back to training