Saturday, January 16, 2010

The Popliteus Muscle – Why does the back of my knee hurt? Part 2

As stated in my previous blog there are numerous reasons why manual therapist, trainers and athletes should consider the Popliteus muscle in the rehabilitative process. Here we will discuss some exercises which can be used to rehabilitate the Popliteus muscle.

Often people think rehab is about getting stronger and will do an old approach of taking a dysfunctional muscle and simply exercising it. The problem is rehabilitation isn't often about strength as much as it is about educating muscles. You can have the strongest muscles in the world but can get injuries if you dont teach them to fire properly or to work in the manner they should. The Popliteus is a great example of this concept as you never see people "working out" their Popliteus.

As mentioned previously the Popliteus is a muscle used mostly for kinesthetic awareness and stability in the knee. When an athlete pivots quickly or changes direction the Popliteus is put to work. When observing the picture below you can see how the muscle acts as a connection between the medial and lateral knee structures.



This means as the medial compartment experiences tension and the lateral side experiences compression the Popliteus receives this sensory feedback and stabilizes the knee. The opposite is also the same when the lateral side experiences tension and Medial experiences compression. This type of interaction occurs in the knee constently as an athlete brings the knee from flexion to extension and when performing pivoting moves.



So we need to rehabilitate it in a way that allows it to learn this function. However, how do you teach this function without putting stresses on the knee in an injured patient?

Exercises for the Popliteus

Exercises should consist of non-weight bearing and weight bearing exercises.

1. Using a resistant band attach one end to a stable service and the other around the forefoot of the affected leg. Using a wall for support begin the exercise with the affected leg unsupported at the patients side. From the start position begin flexing the knee and bringing the foot behind the stance leg as if attempting to touch your toe to your opposite hip. This creates flexion of the knee and internal rotation of the tibia. This motion will contract and activate the Popliteus. Now return to the starting position slowly to also train the Popliteus to contract eccentrically as well.



2. Stepping task - This exercise is used for progression and performed to challenge the Popliteus in a more functional manner. Using a small step up place one foot on the step allowing the knee to be maintained in a slightly flexed position. With the opposite leg off of the step bring yourself to a fencer type of stance.




Now while maintaining the supported knee in flexion begin different stepping manouvers. First going to 3 oclock back to start, 12 oclock and then 9 oclock. This exercise trains the Popliteus on how to prepare for cutting motions which will involve a forceful planting of the foot and manoeuvring in different directions.

The exercise can be further challenged by using verbal or visual cues to create a spongtanoise stepping action as apposed to the patient knowing where they will be going. Tossing a ball or using a racket can also make things more sports specific depending on the athlete. In addition, one can challenge the exercise by adding a blindfold to remove visual stimulus.

Once a patient displays proper technique in this exercise they may now progress to the same exercise above but using an unstable service.

3. Stepping Task Unstable Surface

4. The last exercise is done to train the Popliteus in a manner that challenges it to receive tension and then create a reflexive contraction. This involves a series of jumping task using pylons.

Standing alongside a pylon with one foot supported the patient jumps to the opposite side. The patient now has three options upon landing.

a) Land on the opposite leg they took off from allowing the Popliteus to be trained concentrically
b) Land on the same leg they took off from allowing the Popliteus to be used in a concentric to eccentric manner
c) Do option b followed by quickly jumping to the opposite side of the pylons allowing the Popliteus to be trained concentrically to eccentrically and then quickly concentrically again. This emulates a very quick stopping task or explosive take off manouver which man occur in multiple sports.




In summary, these are just a few quick exercises that can used in preseason training for athletes or any patient with knee problems. Dr. Wayne Button, BSc, DC


Nyland, J. (2005). Anatomy, Function, and Rehabilitation of the Popliteus Musculotendinous Complex Journal of Orthopaedic and Sports Physical Therapy DOI: 10.2519/jospt.2005.1414

31 comments:

  1. Excellent article on therapy and wellness of the knee. I like how your blog provides information to the public dealing with injuries. I would greatly appreciate it if you stopped by my health blog. The site is http://healthy-nutrition-facts.blogspot.com/ Have a wonderful day and stay healthy!

    ReplyDelete
  2. Great Blog Wayne. I find knee complanits are so common with people, they don't even mention it because they have been figthing with knee pain for so long. Popliteus is a muscle that mostly gets ignored and therefore not properly rehabed.

    ReplyDelete
  3. Hey wayne..
    This post is the one of the best posts on wellness..

    Thanks
    Generic Viagra, Kamagra Online, Generic Levitra

    ReplyDelete
  4. Very informative. I hurt my knee about 4 years ago. It is not fully functional yet. I still need to do more exercise and your article helps a lot. Thanks.

    ReplyDelete
  5. Thanks for your tips on injury prevention. One way of sticking to these tips is regular monitoring

    ReplyDelete
  6. Awesome post.Hey ,I have checked out your blog.Its really nice.I like it.If you have time please check out mine.



    african american rhinoplasty

    ReplyDelete
  7. Awesome post - injured my popliteus a year ago. Still very weak, though i've been playing tennis on it although at the time didn't know i had damaged this muscle.

    I can feel the popliteus when doing the jump land onto the same leg. Does this mean I should strengthen the muscle before doing this exercise.

    ReplyDelete
  8. Hello! Very glad I found this post and hope it call help with my popliteus injury. Have pain in the back of my knee and I can't run, bad stability in the kne. I did an MRI wich should that there was nothing wrong with the ligaments or miniscus, then I met a sports doctor who said it was the popliteus. The first excersise here, do you have any idea of how often I should do it now during my rehab? Sorry about the spelling, obvisously not native english speaking. =)

    ReplyDelete
  9. I am writing a swedish article about popliteus injuries - and here is all the information I needed. I will give you a backlink when my article is done :)
    Best,
    Fred, Kinesiotape

    ReplyDelete
  10. Great Blog Wayne. I find knee complanits are so common with people, they don't even mention it because they have been figthing with knee pain for so long. Popliteus is a muscle that mostly gets ignored and therefore not properly rehabed.

    ReplyDelete
  11. This is so helpful for people like me who love playing sports such as basketball and volleyball. I usually get a lot of muscle pains and I don't usually get professional treatment like professional athletes, but reading stuff like this one is helpful for me to deal with any kind of pain.

    Sienna Christie

    ReplyDelete
  12. Thank you for this informative blog post. Knowing your free tips and exercise methods will help many people not just to move efficiently, but also to develop the wellness of the knee. Let's just hope that people reading your blog can perform your method correctly. Otherwise, they'll just strain themselves. I would suggest a person who wants to try this must perform some stretching first in order for their muscles not to strain easily.

    ReplyDelete
  13. Good one, thanks for sharing information, exercise is one of the best technique to get rid of any pain, many never know how exercise plays a effective role for sports person, so i suggest to focus on exercise but do it in right way

    ReplyDelete
  14. Thanks for your tips on injury prevention.This post is the one of the best posts on wellness.
    sports doctor new york

    ReplyDelete
  15. Exercises are must for everyone I'll say it is not limited to sports persons only.

    ReplyDelete
  16. The contents has provided meaningful information thanks for sharing info if you want more information something like visit chiropractor tampa get more details.

    ReplyDelete
  17. Exercise makes you strong and health that's why everyone should do exercise at-least half an hour to stay healthy and fit. Recurrent Abdominal Pain

    ReplyDelete
  18. My brother plays a lot of sports. He is always getting injuries. He has recently been having pain in the back of his knee. This has never happened to him before. He was wondering what it could be. I will share this post with him.
    Gary Puntman | http://www.aportho.com

    ReplyDelete

  19. Popliteal or key to knee flexion is a muscle that originates from the back of the tibia and inserts onto the lower part of the femur.This muscle is more vulnerable to injuries and sprains during sports or any other active body movement time. As you said, there are several exercises which helps to regain strength and function in the popliteal muscle.

    ReplyDelete
  20. I hurt my knee a couple weeks ago and I couldn't figure out how to help it feel better. I've never tried these exercises, but I am going to try most of them later tonight to see if they are able to relieve any of the pain. I really think the stepping task one is going to help a ton. Thanks for the great information and tips! http://www.personalfootcarellc.com

    ReplyDelete
  21. Do not go for pharmaceuticals drugs for this. You can find better options with non narcotic pain killers.

    ReplyDelete
  22. I always wanted to find out that why my back side of knee is so hurting. Now I came to know, Your blog helped me a lot. Thank you for sharing.Sports Strapping Tape Australia

    ReplyDelete
  23. I had ACL reconstruction 2 weeks ago. I've been pushing myself to get better. I thought it was normal for the back of my knee to be sore, but last night my leg began locking any time I straightened it after standing still for a few seconds. It feels like a muscle is seizing. I guess I have some careful work to do. Thanks for the article.

    ReplyDelete
  24. Amazing blog.This is the first time i read your blog.I appreciate your effort. Thank You for sharing this information.Which is really useful.Till next time keep updated on Sports Strapping Tape

    ReplyDelete
  25. Thanks for sharing such a nice piece information with us. Best Stem cell therapy in NYC

    ReplyDelete
  26. Here is a great herbal doctor who cured me of Hepatitis B. his name is Dr. Imoloa. I suffered Hepatitis B for 11 years, I was very weak with pains all over my body my stomach was swollen and I could hardly eat. And one day my brother came with a herbal medicine from doctor Imoloa and asked me to drink and I drank hence there was no hope, and behold after 2 week of taking the medicine, I started feeling relief, my swollen stomach started shrinking down and the pains was gone. I became normal after the completion of the medication, I went to the hospital and I was tested negative which means I’m cured. He can also cure the following diseases with his herbal medicine...lupus, hay fever, measles, dry cough, diabetics hepatitis A.B.C, mouth ulcer, mouth cancer, bile salt disease, fol ate deficinecy, diarrhoea, liver/kidney inflammatory, eye cancer, skin cancer disease, malaria, chronic kidney disease, high blood pressure, food poisoning, parkinson disease, bowel cancer, bone cancer, brain tumours, asthma, arthritis, epilepsy, cystic fibrosis, lyme disease, muscle aches, cholera, fatigue, muscle aches, shortness of breath, alzhemer's disease, acute myeloid leukaemia, acute pancreatitis, chronic inflammatory joint disease, inflammatory bowel disease, Addison's disease back acne, breast cancer, allergic bronchitis, Celia disease, bulimia, congenital heart disease, cirrhosis, fetal alcohol spectrum, constipation, fungal nail infection, fabromyalgia, (love spell) and many more. he is a great herbalist man. Contact him on email; drimolaherbalmademedicine@gmail.com. You can also reach him on whatssap- +2347081986098.

    ReplyDelete
  27. Hello, I read your post in which you have given useful information about knee injury. Mostly such injuries happen when we are playing sports, I know all this because my elder brother gets a lot of injuries while playing sports. For which, we contacted Sellwood Chiropractic Clinic in Portland, where the doctor provides the best chiropractic care for sports injuries. If you have any injury such as accident injury, labor injury, chronic headache, chronic health problems or personal injury, etc. then you can contact - 503-405-8744.
    Sports Injuires Chiropractor Portland OR

    ReplyDelete