Injuries: Popliteal
When we talk about knee injuries, we often think of problems like ligament tears, meniscus tears, or patellar tendonitis. However, there's a small muscle at the back of the knee that, while rarely discussed, can cause pain and functional limitations: the popliteus muscle .
What is the popliteus muscle?
The popliteus is a small, deep muscle located behind the knee, more specifically in the posterolateral region. Its main function is to unlock the knee, allowing the transition from extension to flexion. It also acts as a joint stabilizer, especially during movements involving knee rotation or sudden changes in direction.
Causes of popliteal injuries
Popliteal injuries are uncommon, but can occur in some specific situations, such as:
- Running on steep descents
- Rapid changes of direction (e.g., soccer, trail running)
- Direct trauma to the back or side of the knee
- Muscle imbalances or lack of neuromuscular control
- Posterolateral knee instability
Types of popliteal injuries
-
Muscle strain
Small tears in the popliteal muscle fibers caused by excessive strain or sudden movement. -
Popliteal tendinopathy
Inflammation or overuse of the popliteus tendon, usually caused by repetitive use. -
Posterolateral knee syndrome
Includes popliteal injuries associated with other structures, such as the lateral collateral ligament or joint capsule.
Symptoms
Symptoms can vary, but the most common are:
- Pain in the back and side of the knee
- Deep , hard-to-localize pain
- Worsening pain when going down stairs or running downhill
- Feeling of instability or “weakness” when flexing the knee
- Sensitivity to touch in the posterolateral area
Diagnosis
Diagnosis is based on clinical evaluation, and an MRI is often necessary to confirm the injury and rule out other pathologies. Given the muscle's depth, it's not always easy to identify by palpation alone.
Treatment
In most cases, treatment is conservative :
- Relative rest and activity modification
- Apply ice for the first 48-72 hours
- Gentle, progressive posterior chain stretches
- Neuromuscular strengthening and control exercises
- Gait and running re-education (if applicable)
Severe cases, such as a complete rupture of the popliteus tendon , are rare and may require surgical intervention.
Useful exercises in rehabilitation
- Gentle knee mobilizations
- Leg raise with knee slightly flexed
- Strengthening the hamstrings, glutes and calves
- Side plank with leg raise (works posterolateral stabilization)
- Proprioception work (e.g., one-legged balance)
Conclusion
Although little known, popliteus muscle injuries can be quite debilitating if not diagnosed and treated properly. Attention to detail and an individualized approach are essential, especially for athletes or physically active individuals.
If you have pain in the back of your knee that doesn't improve, see a healthcare professional for a thorough evaluation.
