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Popliteus – Pain & Trigger Points

The popliteus is a small muscle in the lateral and posterior compartment of your knee. If it is tense or carries active trigger points, it can cause pain in the hollow of the knee.

You can relieve these tensions and trigger points with a self-massage.

On this page you will learn everything you need to know about self-massage, as well as …

  • which ailments this muscle can cause,
  • where it is located,
  • which functions it provides,
  • how it gets overloaded.

You will read some Latin names with which might not be familiar. Please don’t be scared. You’ll understand everything, I promise.

I try to draw up my texts in a way that helps you to understand them easily. Unfortunately, every now and then, we cannot avoid some Latin names.

1. Pain Patterns & Symptoms

1.1 Pain patterns

Trigger points in the popliteus can cause pain in the hollow of the knee.

However, it’s very unusual that the popliteus causes problems without other muscles of this area (upper and lower leg) being involved.

These muscles are called

  • Gastrocnemius (muscle at the calf)
  • Biceps femoris (muscle at the posterior lateral compartment of the thigh)

Mostly, problems in the popliteus are only identified when the trigger points in these two muscles have been deactivated.

1.2 Symptoms and ailments

The pain described above occurs mainly under strain.

Examples:

  • Crouching down
  • Running
  • Going downstairs
  • Going downhill

2. Origin & Insertion

The popliteus has a triangular shape, lies in the hollow of the knee and runs from the lateral side of your knee to your shinbone. Thus, it connects the thigh with the lower leg.

Origins:

  • Lateral condyle of the femur/thigh bone
  • Knee joint capsule
  • Lateral meniscus
  • Fibula head

Insertion:

  • Upper rear area at the tibia

Innervation:

  • The muscle is innervated by the nervus tibialis.

3. Function

The functions of this muscle are not easy to understand without some knowledge of functional anatomy, but I will try to explain them anyway.

  • Medial/inward rotation of the tibia with fixed/”immobile” thigh
  • Lateral/outward rotation of the thigh with fixed/”immobile” shinbone
  • Knee flexion

3.1 Medial rotation of the tibia

While sitting, your thigh is more or less immobile. Especially in contrast to the lower leg, which bears less weight.

If the popliteus contracts, then not the thigh will move, but the lower leg, since there is less inertia. Less resistance has to be overcome. For this reason, the lower leg moves first.

The inward rotation of the tibia is shown in the following two pictures.

1
2

3.2 Lateral rotation of the thigh

In standing position, it is your lower leg that bears more weight. On your thigh, on the other hand, there is much less strain. Therefore, it can be turned outwards by the muscle.

This is only a very small movement that most of you have probably never noticed before.

Unless you practice yoga very consciously –  in some postures the lower leg will be twisted against the thigh and the muscle will be strongly contracted.

1

Right thigh neutral.

2

Right thigh in slight lateral rotation.

4. Popliteus – Trigger Point Activation

In most cases, the popliteus is overloaded by sport activities.

Especially in those with many turns and changes of direction, as this leads to rotation of the lower and upper leg.

Overall if the muscle is not used to the strain, trigger points may quickly be developed.

But even jogging can overload the muscle, as it is involved in stabilization of the knee against excessive rotation with every step.

Some examples:

  • Soccer
  • Basketball
  • Running
  • Skiing
  • Dancing

Ruptures of the posterior cruciate ligament (PCL): Another factor that leads to trigger points in this muscle is ruptures of the PCL. This occurs very rarely, though.

The popliteus supports the PCL in its function of not allowing the lower leg to move too far back in relation to the thigh. It thus limits the ability of the lower leg to move backwards.

If there is a tear in the PCL, this also represents a high mechanical stress for the muscle, which can activate trigger points.

5. Palpation

As it is very difficult to distinguish the muscle from the surrounding muscles, and this is not necessary for the massage, we will skip this chapter.

In the next step, you will learn where and how to place your hands to massage the muscle.

6. Self-massage of the Popliteus

  • Grasp your lower leg with both hands and put your thumbs together.
  • Now press into the lower lateral side of the hollow of the knee and into the lateral side of the calf.
  • Slide your thumbs over the muscle and seek for painful tensions.
  • It is important that you move the skin over the muscle, but not slide with your thumbs over the skin.
  • Massage each of these points with a few short massage strokes. These should only be performed from just before to just after a painful point.

Tip: Take your time and perform the massage gently. You are in a sensitive region of your body.

Start with short and gentle massage sessions, increase the pressure and duration of the massage slowly, and listen to your body’s reactions.

If you heed this advice, your body’s reactions will be less intense. Thus, you will have a lesser risk of irritating this sensitive region, and always have enough time to observe.

References

  • Calais-German, Blandine. Anatomy of Movement. Seattle: Eastland Press, 1993. Print
  • Davies, Clair, and Davies, Amber. The Trigger Point Workbook: Your Self-Treatment Guide For Pain Relief. Oakland: New Harbinger Publications, Inc., Print
  • Simons, David G., Lois S. Simons, and Janet G. Travell. Travell & Simons‘ Myofascial Pain and Dysfunction: The Trigger Point Manual. The Lower Extremities. Baltimore, MD: Williams & Wilkins, 1993. Print.
  • Schünke, Michael., Schulte, Erik, and Schumacher, Udo. Prometheus: Lernatlas der Anatomie. Stuttgart/New York: Georg Thieme Verlag, 2007. Print