- Dr. Brian Abelson DC |
Popliteus Muscle - “The Key of the Knee”
Updated: Nov 1, 2022
In this blog we will focus on the popliteus muscle. The popliteus muscle is often called "The Key of the Knee" because it is responsible for "unlocking" the knee when the leg is in an extended position. Besides this "unlocking" function the popliteus muscle also helps to perform several critical actions during the gait cycle. Before we go over some of those actions let's discuss some basic anatomy and biomechanics related to this important structure. This next section is for us anatomy geeks, feel free to skip to the following section!
ANATOMY & BIO-MECHANICS
The popliteus originates at the lateral condyle of the femur and the posterior horn of the lateral meniscus. The popliteus muscle runs inferiorly and medially in the direction of the tibia. The muscle inserts on the tibia just proximal to the soleal line and just below the tibial condyles. The popliteus muscle is innervated by the tibial nerve.
The popliteus muscle unlocks the knees by laterally rotating the femur on the tibia when the foot is in contact with the ground. When the leg is not in contact with the ground, the popliteus medially rotates the tibia on the femur. It is NOT uncommon for the function of a muscle to change, depending on surface contact and position.
Popliteal Fossa Anatomy
Want to learn more about the anatomy behind your knee? Check out our "Popliteal Fossa Anatomy Video".
THE MULTI-FUNCTIONAL POPLITEUS MUSCLE
The popliteus muscle performs multiple functions during the normal gait cycle. To get a better understanding of how important the popliteus muscle is to the gait cycle consider these four important functions. (1)
The popliteus muscle helps produce external rotation of the femur in the propulsion phase of gait.
The popliteus muscle assists the PCL (posterior cruciate ligament) in preventing forward glide of the femur on the tibia.
The popliteus muscle aids the calf muscle (gastrocnemius) with deceleration extension of the knee.
The popliteus muscle assists the subtalar joint in internally rotating the tibia (initial contact during the stance phase of gait).
Running Tip: Over-striding while running is a common way to stress the Popliteus muscle.
Gait Cycle: Want to learn more about the different phases of the gait cycle? Read Dr. Abelson's blog "Designed to Run - The Human Gait Cycle".
CLINICAL CONSIDERATIONS
Signs and Symptoms
Injury to the knee commonly involves the popliteus muscle. The most common signs and symptoms of a popliteus injury are:
- General pain over the back and lateral side of the knee (especially over the proximal aspect of the popliteus tendon). (4)
- Pain on resisted knee flexion or internal rotation (Supine). There may also be pain with resisted external rotation of the leg with the patient's hip and knee flexed to 90 degrees (This is call a positive Garrick Test). (4)
- Pain directly over the popliteal space (fossa). (4)
Knee Examination - Effective Orthopaedic Testing
This video demonstrates some of the common causes of knee pain and how to diagnose them using orthopaedic examination procedures.
RECOMMENDED ORTHOPAEDIC REFERENCE BOOKS
Orthopaedic Physical Assessment – David J. Magee https://amzn.to/3zgu0za
Dutton'sOrthopaedic: Examination, Evaluation and Intervention, Fifth Edition https://amzn.to/3st1AOv
Motion Specific Release
There are many ways to use manual therapy to release restrictions in the popliteus muscle. In the video below Dr. Abelson demonstrates one way to do this from a weight bearing position.
The Popliteal Squat Release - Motion Specific Release™: Anytime there is a knee injury you should suspect involvement of the popliteus muscle. Fortunately there are some very effective soft tissue procedures that can be used to help resolve a popliteus injury and improve its overall function.
Popliteus Muscle Release - Motion Specific Release
The popliteus muscle is often called "The Key of the Knee" because it is responsible for "unlocking" the knee when the leg is in an extended position. Besides this "unlocking" function the popliteus muscle also helps to perform several critical actions during the gait cycle.
The Kinetic Chain
In addition to treating the popliteus muscle, we often have to assess and treat the surrounding soft tissues and joint structures in a larger kinetic chain. The following videos demonstrate related protocols we often use on our patients.
Knee Release Protocol - Motion Specific Release
Each case of knee pain should be assessed and treated as a unique dysfunction that is specific to that individual. Certain cases will only involve local structures, while other cases can involve a much larger kinetic chain. The MSR procedures I am demonstrating are very effective at addressing knee pain. (Available for the public Jun 8th 2022)
The Power of Chiropractic Adjustments
Chiropractic Adjustment are powerful tools. When patients who suffer from chronic back pain receive care, at regularly pre-planned intervals, (Chiropractic Maintenance Care), then they do much better as compared to patients who only receive care during episodes of acute back pain.
Increasing Knee Joint Mobility - 4 Point Knee Joint Mobilization (MSR)
Increasing Knee Joint Mobility - Increasing knee joint mobility is critical if you are going to effectively address the body's full kinetic chain. In fact, we greatly reduce the effectiveness of any myofascial treatment if we don’t also address restrictions in joint mobility.
RECOMMENDED REFERENCE BOOKS
Netter Atlas of Human Anatomy https://amzn.to/3SQYWgx
Functional Atlas of the Human Fascial System - Carla Stecco https://amzn.to/3TE1EqP Functional Anatomy: Anatomy, Kinesiology, and Palpation https://amzn.to/3f49Xgn
The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns and Stretching Joseph E. Muscolino – https://amzn.to/3SAh5Pl
Anatomy Trains: Myofascial Meridians for Manual Therapists https://amzn.to/3SCkhtZ
Joint mobilization/manipulation extremity and spinal techniques https://amzn.to/3DxqCCs
The Trigger Point Manual - https://amzn.to/3gFDDRu
Knee Rehab Exercises
The following "Knee Rehab" playlist contains some of the exercises that often prescribe to our patients suffering form knee pain. First we have them focus on mobility, then strength, and finally balance and proprioception.
CONCLUSION
The popliteus muscle is called "The Key of the Knee" for a very good reason. Besides being involved in "unlocking" the knee when the knee is in an extended position, it also helps to perform several critical functions during the gait cycle.
Anytime there is a knee injury you should suspect involvement of the popliteus muscle. Fortunately, there are some very effective soft tissue procedures that can be used to help resolve a popliteus injury and improve its overall function. The "Key" to getting the greatest benefit from these procedures, is to a consider larger kinetic chain relationships when implementing those procedures.
References:
Mann RA. Biomechanics of running. In Pack RP (ed). Symposium on the Foot and Leg in Running Sports. St. Louis:CV Mosby, 1982:26.
THE POPLITEUS MUSCLE AND THE LATERAL MENISCUS, The Bone and Joint Journal, https://doi.org/10.1302/0301-620X.32B1.93
The Popliteus Muscle, JONATHAN FITZGORDON https://corewalking.com/knee-stuff-popliteus-muscle/
Covey DC. Injuries of the posterolateral corner of the knee. JBJS. 2001 Jan 1;83(1):106-18.
DR. BRIAN ABELSON DC.
Dr. Abelson is the developer of Motion Specific Release (MSR) Treatment Systems. His clinical practice in is located in Calgary, Alberta (Kinetic Health). He has recently authored his 9th and 10th publications which will be available later this year.
Kinetic Health strives to adhere to the best research evidence available, while combining clinical expertise with the specific values of each patient, in a inter-professional and collaborative care environment.
Make Your Appointment Today!
Make an appointment with our incredible team at Kinetic Health in NW Calgary, Alberta. Call Kinetic Health at 403-241-3772 to make an appointment today, or just click the MSR logo to right. We look forward to seeing you!
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