Nine runners with varied experience but similar running-gait forms presented with the insidious and progressive onset of medial knee pain. Functional tightness of the semimembranosus (SM) tendon appeared to be a concomitant factor in the pain presentation of these patients. When evaluating atraumatic medial knee pain in runners, clinicians must consider bone stress injuries and atypical conditions. A functionally tight SM may induce pain and desmopathy of the medial collateral ligament through direct fiber entanglement or cause entrapment of infrapatellar branches of the saphenous nerve or both. Relieving SM tension resulted in short-term pain reduction while eliminating the overstride during the running gait over the long term appeared to prevent recurrence.
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