A less common cause of knee pain is a popliteal strain. However, recently at PhysioSports, we have seen 2 cases in higher level athletes.🥊⚽
Firstly, where is the popliteus muscle? It is found at the back of the knee, originating from the outer edge (lateral condyle) of the femur bone to the inner part of the tibia bone. Some muscle fibers insert into the lateral meniscus, which is a shock-absorbing cartilage & stabilizer of the knee. The popliteus is part of the complex postero-lateral corner of the knee which consists of many ligaments & soft tissue structures.
When we walk, the knee goes through a cycle of knee extension (straightening) & flexion (bending). Due to anatomical structures, during full knee extension, the femur internally rotates on the tibia to secure or “lock” the position, achieving stability. 🔩 The action of the popliteus is to externally rotate the femur on tibia (or internally rotate the tibia), thereby serving to “unlock” the knee joint to initiate bending. It is a subtle movement but plays a huge role in the stability of our knee joint. 🦵
The popliteus also helps prevent lateral meniscus injury, stabilizes the knee, & provide kinesthetic feedback. It is most active in standing with the knee bent 30-50 degrees, with the trunk turned towards the same side. To visualize this, it looks like the position of a soccer player just before kicking the ball.
Although it is a relatively small muscle, the popliteus can be strained. This can be called as tendonitis or tendinopathy. The pain is usually at the back & outer knee but may radiate downwards. There may be swelling & tenderness at the area, with “popping” during bending/straightening. This injury is seen mostly in athletes, & can occur with injury of other surrounding structures in the postero-lateral corner.💢
It may occur due to overuse or repetitive stress such as repeated knee movements in sports, or due to direct force to the knee when the tibia is fixed in external rotation. The pain is usually worse with downhill running, stairs, sprinting, & hopping. 🏃
Do check in with your physiotherapist if you suspect you have this injury. DM or contact us at 82182905 / 62620970 to find out more!📱
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📝1. Nyland, J., Lachman, N., Kocabey, Y., Brosky, J., Altun, R., & Caborn, D. (2005). Anatomy, function, and rehabilitation of the popliteus musculotendinous complex. Journal of Orthopaedic & Sports Physical Therapy, 35(3), 165-179.
📝2. Zabrzyński, J., Huri, G., Yataganbaba, A., Szwedowski, D., Zabrzyńska, A., Gagat, M., ... & Pękała, P. (2020). Current concepts on the morphology of popliteus tendon and its clinical implications. Folia Morphologica.
📝3. Kiel, J. (2021, August 26). Popliteus Tendinopathy: A Poorly Understood Cause of Knee Pain. Sports Medicine Review. https://www.sportsmedreview.com/blog/popliteus-tendinopathy-poorly-understood-cause-knee-pain/
📝4. Popliteus Tendinopathy. (n.d.). Physiopedia. https://www.physio-pedia.com/Popliteus_Tendinopathy
📝5. Langford, T. (2020, February 7). Popliteus: Assessment and rehabilitation. Sports Injury Bulletin. https://www.sportsinjurybulletin.com/popliteus-assessment-and-rehabilitation/#:%7E:text=The%20popliteus%20is%20the%20primary,unlocking’%20of%20the%20knee%20joint.
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