Knee Pain: Don't Forget Popliteus
Posted by Stuart Hinds on
Stuart Hinds explains the importance of popliteus trigger points when assessing and treating "Runner's Knee"
Trigger points in the popliteus are often associated with knee pain and too often, overlooked
[Latin: poples, ham]
The tendon from the origin of the popliteus lies inside the capsule of the knee joint.
ORIGIN
Lateral surface of lateral condyle of femur. Oblique popliteal ligament of knee joint.
INSERTION
Upper part of posterior surface of tibia, superior to soleal line.
Popliteus - Common Trigger Point Site
ACTION
Laterally rotates femur on tibia when foot is fixed on ground. Medially rotates tibia on femur when leg is not weight bearing. Assists flexion of knee joint (popliteus “unlocks” extended knee joint to initiate flexion of leg). Helps reinforce posterior ligaments of knee joint.
NERVE
Tibial nerve, L4, 5, S1.
BASIC FUNCTIONAL MOVEMENT
Example: walking.
TRIGGER POINT REFERRED PAIN PATTERNS
Localized 5–6 cm zone of pain (posterior and central knee joint), with some spreading of diffuse pain, radiating in all directions, especially inferiorly.
Popliteus - Typically refers pain to the back and middle of the knee.
INDICATIONS
Pain in back of knee squatting/ crouching/walking/running, pain behind knee/calf walking uphill and descending stairs, stiff knee on passive flexion/extension, plantar fasciitis, chronic calf shortening, low back pain, leg cramps.
CAUSES
Post-fracture, splinting, poor orthotics, prolonged driving, twisting sports (e.g. soccer, climbing, skiing, baseball, football), associated with many knee problems.
DIFFERENTIAL DIAGNOSIS
Avulsion. Cruciate ligaments (instability). Baker’s cyst. Osteoarthritis. Tendonitis. Cartilage (meniscus) injury. Vascular (deep vein thrombosis, thrombosis). Tenosynovitis.
CONNECTIONS
Hamstrings (biceps femoris), gastrocnemius (ligamentum patellae), plantaris.
Treating Runner's Knee Trigger Point Master Class: Click here for more info
About the author
Stuart Hinds is one of Australia’s leading soft tissue therapists, with over 27 years of experience as a practitioner, working with elite sports athletes, supporting Olympic teams, educating and mentoring others as well as running a highly successful clinic in Geelong.
Stuart has a strong following of practitioners across Australia and globally who tap into his expertise as a soft-tissue specialist. He delivers a range of highly sought after seminars across Australia, supported by online videos, webinars and one-on-one mentoring to help support his colleagues to build successful businesses.
In 2016, Stuart was awarded a lifetime membership to Massage & Myotherapy Australia for his significant support and contribution to the industry.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
Great content! I had an osteopath recently identify this muscle as a potential cause of the pain, or at least inhibitor to rehabilitation from a two-year long PFPS battle now, and following a loosening of it, the pain really subsided temporarily, though this had coincided with some vascular occlusion training during which I felt some (previously missing) VMO activation. Interesting to note, as you say, this muscle is often not addressed and my experiences certainly support this.
Are there any strengthening exercises that need or should be performed for the muscle or related issues or is this simply a releasing?