Referred to as Knee Hyperextension or Back Knee, Genu Recurvatum is an extremely complex deformity of the knee-joint. Under this condition, the knee bends backward with an extensive extension in the tibiofemoral joint. It is mostly found in women.

Genu Recurvatum ranges from mild, moderate, to severe. Athletes are at an enhanced risk of developing Knee Hyperextension, as they are always prone to injuries. The deformity may also lead to several other conditions, such as, Knee Pain and Knee Osteoarthritis.

Types of Genu Recurvatum

There are three types of Genu Recurvatum :

Types of Genu Recurvatum

  1. External Rotary Deformity Recurvatum implies an elevated heel with the forefoot pointing inwards and foot remaining in an equinovarus position while walking.
  2. Internal Rotary Deformity Recurvatum occurs when the forefoot rotates outwards, forcing the patient to overextend the knee.
  3. Non-rotary Deformity Recurvatum implies abnormal positioning of the knee, with foot and ankle functioning normally.

Read Also: Synovitis Knee: Inflammation of the Synovial Membrane

Primary causes of Genu Recurvatum

    • Inherent laxity of knee ligaments
    • Knee Injury
    • Misalignment of ankle joint
    • Knee Joint Instability
    • Anterior Cruciate Ligament Tear
  • Weakness in the hip extensor muscles or quadriceps femoris muscle
  • Malunion of bones around the knee
  • Connective Tissue Disorders
  • The discrepancy in lower limb length
  • Birth/Congenital Defect
  • Certain diseases, such as, Cerebral Palsy, Muscular Dystrophy, and Multiple Sclerosis

Key Symptoms of Genu Recurvatum Syndrome

  • Pain in the inner-leg or outer back portion of the knee
  • Extension gait pattern
  • Poor proprioceptive control of terminal knee extension
  • Pinching in front of the knee
  • Difficulty in carrying out endurance activities

Also, read about: Athlete’s Foot Meaning here.

Which doctor to go to when facing this problem?

The subject matter expert for Genu Recurvatum Syndrome is an Orthopedic.

The doctor will carry out the following diagnosis:

  • History: The doctor will analyze the information related to the patient’s symptoms, previous injuries, and overall health condition.
  • Physical Examination: This includes examining the knee and analyzing the gait pattern of the patient.
  • Tests:  X-Rays and MRIs show detailed information on soft tissues and bones. A long leg X-Ray will provide information on the patient’s overall knee alignment.

Treatment Modalities Available for Management of the Disorder

Depending on the type and severity of Genu Recurvatum, the doctor may recommend the following treatment options:

  1. Physical Therapy: Initially, the doctor may suggest physical therapy to improve the strength of quadriceps to compensate for the knee hyperextension. This also includes gait-training procedures which help the patient to focus on proper sequencing and maintaining control on the limb. Other therapies include muscle-imbalance correction techniques and proprioceptive training.
  2. Orthoses: This provides optimal support to the knee. It protects the knee, stabilizes the leg, and limits abnormal hyperextension of the knee-joint, thereby enabling the patient to move actively and maintain a more harmonious gait pattern.
  3. Bracing: Doctors may suggest bracing of the knees to prevent further hyperextension.
  4. Surgical Treatment: Although rare, in severe cases, doctors may suggest a Proximal Tibial Osteotomy to decrease knee hyperextension and increase the functioning level of the knee.

Before going in for any time of surgery, we recommend you to go through the following Knee Replacement Surgery FAQ.

Known Complications

If left untreated, Genu Recurvatum will continue to strain the knees, damage soft-tissue structure of the knees, and result in increasing joint deformities. It may also lead to other disorders, such as, Genu Valgum, Genu Varum, and Knee Osteoarthritis.


Patients suffering from Genu Recurvatum deformity should undertake the following precautions:

  • Avoid activities that may impose a strain on the knees.
  • Strictly follow the physical therapy program as suggested by the therapist.
  • Regularly visit the doctor for a clinical examination

Also Read: Bipartite Patella (Knee Flexion Deformity)

Prevention of the Disorder from Happening or Recurring

Since Genu Recurvatum may occur genetically or due to an injury, it is not possible to prevent the occurrence or recurrence of the deformity. However, braces, orthoses, and rehabilitation help in limiting hyperextension of the knee-joint.

Risk to Family Members

Since Genu Recurvatum is a congenital deformity, it imposes a threat to the future generations.

Also Read: Knee Injury: Medial collateral ligament (MCL)

Support and Help given by the Caregiver

Since the deformity induces pain in the knee and makes it difficult for patients to carry out endurance activities, it is essential for caregivers to provide ample support and encouragement to the patient.

[author title=”Dr. Sunil Rajan” image=”″]Dr. Sunil Rajan is an Orthopedist at Apollo Hospitals, Vijay Nagar, Indore. He has an experience of 21 years in this field. Dr. Rajan has completed his MBBS from MGM Indore and MS – Orthopaedics from JMC Bhopal in 1996. Some of the services provided by him are Neck and Spine Biopsy, Spine Mobilization, Ligament and Tendon Repair and Knee Arthroplasty etc

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