Genu recurvatum is the clinical term for hyperextended knees, a condition where the knee joint extends backward beyond its normal range of motion. While the knee naturally straightens to zero degrees, hyperextension pushes the joint backward, sometimes by 10 to 20 degrees or more. This altered alignment places undue stress on the joint structures and surrounding tissues. Addressing this issue involves conscious habit modification and targeted physical strengthening to restore healthy knee function and stability.
Understanding Genu Recurvatum
Hyperextended knees stem from underlying biomechanical factors, primarily ligamentous laxity. This refers to a natural looseness in the connective tissues that stabilize the knee. Ligamentous laxity is often a familial trait and is more frequently observed in women or individuals with generalized joint hypermobility. When ligaments are naturally long, they cannot provide the firm endpoint necessary to prevent the knee from pushing backward.
Muscle imbalances also play a significant role, as the body relies on passive structures like ligaments when active muscle support is lacking. Weakness in the quadriceps and hamstrings allows the knee to “hang” backward into hyperextension. This weakness is compounded by a deeply ingrained postural habit. Many people learn to stand by locking their knees completely, which requires minimal muscular effort but places the full weight onto the passive ligaments and joint capsule. This consistent reliance reinforces the hyperextension pattern over time.
Correcting Daily Postural Habits
The most immediate step toward fixing hyperextended knees is cultivating a constant, conscious awareness of standing posture. The goal is to move from a passive, locked-out position to an active, supported one. When standing, consciously avoid pushing the knee joint backward to its end range of motion, where the joint feels rigid and stable.
Instead, practice a subtle technique known as a “micro-bend,” keeping a slight, soft flexion in the knee at all times. This small bend engages the thigh muscles and takes pressure off the posterior knee capsule and ligaments. Visually, the knee cap should not appear pushed far back behind the line of the thigh bone.
Proper standing alignment involves stacking the joints vertically, ensuring that the ankle, knee, and hip are aligned with the ear and shoulder. To check this, look in a mirror or feel the weight distribution through the feet. If the weight is heavily biased toward the heels, the knees are likely hyperextended. Shifting weight slightly forward toward the mid-foot helps promote a more neutral knee position. This constant mental training must be applied throughout the day, especially during activities that involve standing for long periods or walking.
Strengthening Key Muscle Groups for Stability
Long-term correction of genu recurvatum depends on developing dynamic muscle control that prevents the knee from passively locking. The Quadriceps muscle group, specifically the vastus medialis obliquus (VMO), controls the final degrees of knee extension and ensures the joint tracks correctly during movement. Strengthening the quadriceps teaches the leg to actively hold a neutral position just before full extension. Simple movements like straight leg raises and half-squats, where the knee never fully locks, reinforce this controlled strength.
The Hamstrings, located at the back of the thigh, function as knee flexors and control the backward motion of the shin bone relative to the thigh bone. When hamstrings are strong, they act as a natural brake, preventing the knee from snapping into hyperextension, particularly during walking and running. Exercises such as standing hamstring curls or glute bridges are effective for targeting this protective function.
The Gluteal Muscles, including the Gluteus Maximus and Medius, provide proximal stability that directly influences knee alignment. Weakness in these hip-stabilizing muscles can cause excessive internal rotation of the femur, which destabilizes the knee and encourages hyperextension. Incorporating exercises like glute bridges and lateral step-ups helps coordinate hip and knee movements, allowing the powerful gluteal muscles to absorb ground reaction forces and prevent the knee from collapsing during weight-bearing activities.
When to Consult a Specialist
While self-management through postural correction and strengthening is often effective, certain signs indicate the need for professional evaluation. Consult a Physical Therapist or Orthopedist if the hyperextension is accompanied by persistent pain that does not improve with self-care within a few weeks. Pain that is sharp, especially at the back of the knee, suggests undue strain on the joint capsule or ligaments.
Immediate medical attention is necessary if you experience severe symptoms, such as the knee feeling unstable or “giving way,” sudden swelling, or the inability to put weight on the leg. These symptoms may signal an acute ligament injury, such as a tear to the posterior knee structures, which requires a specialized diagnosis. A specialist can accurately grade the severity of the genu recurvatum and recommend formal physical therapy, including specialized gait analysis and proprioceptive training. In rare, severe cases, a specialist may discuss advanced treatments like bracing or surgical correction.