Genu Recurvatum

What is Genu Recurvatum?

Genu recurvatum is also referred to as back knee or knee hyperextension. It is a type of distortion that affects the knee joint causing the knee to bend backward when the person is on a standing position. The recurvatum appearance is brought by the knees that are situated in a hyperextended position.

This problem is more commonly seen in women than in men. The posture is identified right away by just looking at the person from the side since the alignment of the legs is curved. From the front position, the recurvatum standing pose of the person could make the kneecaps look like they are pointing inwards.

Genu recurvatum knee hyperextension

This condition is considered as one of the problems that are hard to treat in sports medicine. Some athletes suffer an injury and have too much curve of their knee in a backward motion which can be quite difficult to handle.

It is very essential to tell the difference between individuals who had a growth plate injury back when they were younger and those who have bone issues with recurvatum, or in individuals who may have had muscle diseases involving the weakening of the quadriceps that results in the hyperextension of the knee.

What are the Symptoms of Genu Recurvatum?

A person with genu recurvatum may have difficulty in performing activities that requires endurance. Other symptoms may include:

  • A twinge of pain on the outer back part of the knee referred to as the posterolateral ligamentous
  • An aching pain in the inner-leg part of the knee known as the medial tibiofemoral joint
  • Knee gives away into hyperextension
  • A nipping feeling in the front part of the knee
  • Extension of the gait cycle

What are the Causes of Genu Recurvatum?

The injuries that resulted in genu recurvatum are usually caused by an unexpected impact to the extended knee following an injury to some structures of the knee or just the posterior aspect of the knee structures. Other causes involve:

  • A connective tissue disorder
  • Looseness of the knee ligaments
  • An inherited problem or birth defect
  • Joints of the knee are not stable due to ligaments
  • Femur and tibia is not properly aligned
  • Postural habits
  • Some medical diseases like multiple sclerosis, cerebral palsy, or muscular dystrophy
  • Length of the lower limb is not the same
  • Unusual position of the ankle and foot when walking

Types of Genu Recurvatum

Genu recurvatum can vary from mild, moderate, to severe and is divided into three types. These are:

External rotary deformity (ERD)

This is when the person’s foot is positioned in an equinovarus or walking on toe position which is how a horse also walks. The foot touches the ground on the outer edge of the foot. This kind of knee hyperextension is mostly common among stroke patients since the movements of their foot are not normal due to an atypical pattern of the muscle tone.

Internal rotary deformity (IRD)

This is when the person’s pacing is abnormal wherein the forefoot is rotated outward. In return, the person should overextend the knee for compensation and this will then lead to deformity.

Non-rotary deformity (NRD)

The foot and ankle are normally situated with the knee as the primary abnormality. This type of deformity is an injury that pushes the knee to bend backwards.

How is Genu Recurvatum Treated?

It is essential for a person to get a timely diagnosis of genu recurvatum and a proper treatment because if not, it could result to an increased damage of tissues.

Any cases of this condition will still place a strain on the knee so if the deformity is not treated, it could become permanent. The treatment will also depend on the severity of the problem. Treatment options include:

Physical Therapy

At the start, the physician might recommend physical therapy to enhance the strength of the quads to compensate for the back knee. The treatment involves gait training to help the person concentrate on the correct sequencing and keeping control on the limb. Another one is the proprioceptive training which can improve a person’s balance, coordination, and agility and prevent other injuries in the future.


This gives a favorable support to the knee since it can control the abnormal bending of the knee-joints and stabilizes the leg.


Physicians suggest this treatment to prevent further hyperextension of the knee.


In rare cases, a surgical treatment is required to repair the damage of the knee.


  2. Genu recurvatum – Definition, Types, Symptoms, Causes, Diagnosis, Treatment, Prevention, Pictures, This is how genu looks like at
  4. Abdelaziz TH, Samir S (2011). Congenital dislocation of the knee: a protocol for management based on degree of knee flexion. J Child Orthop. 5(2):143-149.
  5. Benson, Michael; Fixsen, John; Macnicol, Malcolm (2009-08-01). Children’s Orthopaedics and Fractures. Springer. pp. 495.
  6. Gorincour G, Chotel F, Rudigoz RC, et al (2003). Prenatal diagnosis of congenital genu recurvatum following amniocentesis complicated by leakage. Ultrasound Obstet Gynecol. 22(6):643-645.

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