Knee Hyperextension (Genu Recurvatum): Causes, Risks, and a Simple Quad Stretch for Relief

Introduction:

Knee hyperextension, or genu recurvatum, occurs when the knee joint extends beyond its normal anatomical limit.It can result from quadriceps weakness, ligament laxity, poor neuromuscular control, or postural imbalance.Over time, this condition increases stress on the posterior knee capsule and may lead to pain or instability.Physiotherapy focuses on restoring control, flexibility, and alignment.

Common causes:

• Quadriceps or hamstring imbalance

• Generalized joint laxity (common in females and athletes)

• Postural adaptation from prolonged standing or previous injury

• Incorrect gait mechanics or improper footwear

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At-home exercise: Wall-supported Quadriceps Stretch

1. Stand next to a wall for support.

2. Hold your ankle with the opposite hand (e.g., right hand to left ankle).

3. Keep your knees side by side, pelvis neutral.

4. Engage your core, hold 20–30 seconds, repeat 2–3 times per leg.

5. Avoid forcing the stretch or locking the supporting knee.

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Evidence-based guidance:

• Controlled stretching improves quadriceps flexibility and reduces anterior knee stress (Bennell et al., JOSPT 2018).

• Strengthening and proprioceptive training are key for managing knee hyperextension (Hewett et al., BJSM 2016).

• Early rehabilitation focusing on postural control prevents chronic strain on posterior knee structures (Kowal et al., Clin Biomech 2023).

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When to seek professional care:

Persistent knee pain, recurrent swelling, or visible hyperextension during walking warrants physiotherapy evaluation to address underlying control deficits and prevent further joint overload.

Conclusion:

A consistent stretching and strengthening program, guided by a physiotherapist, can reduce hyperextension, improve gait mechanics, and protect the knee from long-term damage.

References (abbreviated):

• Bennell KL et al., J Orthop Sports Phys Ther, 2018.

• Hewett TE et al., Br J Sports Med, 2016.

• Kowal M et al., Clin Biomech, 2023.