The Popliteus enigma
The popliteus is a small flat triangular muscle that sits in the back of the knee joint. Its primary motor roles are knee internal rotation (twist inwards) and assists with knee flexion, and it can also externally rotate the femur and leg when the foot is fixed on the ground.
Causes of injury
It is usually injured due to a large force on a weight-bearing knee that may also injure ligaments and capsule leading to a potentially unstable knee.
The popliteus may also be injured due to repetitive compression and tension due to particular types of knee joint motions such as when practising Brazilian Jujitsu (BJJ).
These ‘unusual’ knee movements result in an inflamed popliteus tendon. This will be felt as pain or a tightness in the back of the knee and/or a tightness when the knee is bent and maybe some swelling in the knee. An MRI scan would be the best way to detect this injury.
Treatment
- Rest with Non-Steroid Anti-inflammatories for 4-6 weeks.
- An ultrasound-guided steroid injection into the tendon can also be useful if step 1 doesn’t help.
- Deep trigger points and myofascial release of the popliteus.
- Look at other actors such as stiff hips or ankles.
- Rehab exercises to re-strengthen the popliteus.
At In Touch Physio, we have seen this type of injury a few times and have had good success treating it. So if you think that these signs and symptoms are familiar then please give us a call and let’s fix this enigma.