The biceps femoris tendon is one of the hamstring muscle tendons. Injury to this tendon causes pain at the outside, back of the knee.
Symptoms of biceps femoris tendinopathy
Symptoms include tenderness and swelling where the tendon inserts into the bone. With biceps femoris tendinopathy the tender area is to the outside back of the knee. If the other two tendons are involved there may be tenderness medially. There may be pain when trying to bend the knee against resistance as well as stiffness after exercise and the next day. The athlete will often have tight hamstring muscles.
Biceps femoris tendinopathy explained
The hamstring muscles consist of the biceps femoris, semitendinosus and semimembranosus muscles. These muscles are used to bend the knee and extend the hip backwards. Inflammation of the tendon at the point it inserts into the bone can result from a partial rupture that has not healed properly or through overuse, particularly from accelerating and decelerating activities.
Most commonly it is the biceps femoris tendon which is involved. This is the one hamstring muscle which attaches to the outside of the back of the knee.
The term tendonitis is most commonly used, however usually this is not strictly accurate. Tendonitis refers to an acute inflammation of the tendon where in actual fact unless the injury is very recent the pain is more likely due to longer term over use and degeneration of the tendon. A broader and more accurate term for this type of tendon injury is tendinosis or tendinopathy.
Treatment of biceps femoris tendinopathy
If the injury is recent or acute then rest and apply ice or cold therapy for 10 to 15 minutes every hour for the first 24 to 48 hours. Wearing an elastic type support can help reduce any swelling and support the joint. Later, once the initial acute stage has passed, or if the injury is a long term chronic condition then applying heat and wearing a heat retainer type knee support is likely to be more beneficial.
A doctor may prescribe anti-inflammatory medication such as ibuprofen during the early stages to reduce pain, swelling and inflammation although this less appropriate in the later stages of rehabilitation. Applying ultrasound or laser treatment can also help with the inflammation and healing process as can cross friction massage.
A full rehabilitation program consisting of stretching and strengthening exercises should be done as soon as pain allows. Gradually increasing the load through the tendon so it can cope with normal demands of sport is the aim. Eccentric exercises where the muscle contracts as it lengthens are very beneficial in treating tendinopathies.