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Popliteus Audio

Integrated functional anatomy of the popliteus. Attachments, nerves, palpation, joint actions, arthrokinematics, fascia, triggerpoints, and behavior in postural dysfunction. Examples of common exercises and mobility for the popliteus muscle.

Popliteus

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I have almost completed my CPT certification and am half-way through the Human Movement certification to inform my massage practice. The different modalities of reading, watching audiovisual materials, and attending live or recorded webinars have been important to my learning style and for review.

Brookbush Institute has the most detailed, specific and effective tools for online learning for movement and/or bodywork professionals. I love the combination of the videos as well as the text available online.

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I have my personal trainer certificate through here and am almost finished my human movement specialist certification. Overall, the education that Brookbush has packaged together for clinicians and trainers is invaluable. I am a physio assistant so coming from more of a rehab background I appreciate that this education has been beneficial both as a trainer and in a rehab setting. I love that I have been able to do all learning at my own pace and able to work around my schedule. Thank you for setting up this platform! Highly recommend :)

I have been a massage therapist for 10 yrs and I feel like all the “pieces” I’ve learned throughout the yrs have been put into place and can see the full picture. I am also a member to tons of great content since I love to learn! I plan to get my CPT through them as well.

I have been following Brent Brookbush for nearly a decade- back when I was a personal Trainer and now as a Physical Therapist. BBI is an incredible resource for any movement nerds and corrective exercise specialists! The information is thorough with multiple real world applications. I am looking forward to an in-person Manual Therapist course the second they do one a little bit closer to Virginia ;)

I have taken both the Human Movement Specialist and Certified Personal Trainer certificate programs and have found the value in understanding the how and ways the body moves and functions and from evidence, non-biased, outcome, conceptual, theoretical, and practical approach to helping my clients/patients look better, feel better, and move better.

Over the last years I've returned time and again to Brookbush Institute for stellar coursework as I've worked toward a Human Movement Specialist certification. (I'm currently ACE CPT, and in training with Anatomy Trains for Structural Integration Manual Therapy.) Every Brookbush Institute module is fantastic and each one includes detailed informational videos, written descriptions of how to-do, and, more importantly, why to-do!

I am a 70 yr old chiropractor and no other healthcare provider was able to come up with an exercise protocol particular to my structural and balances and muscle deficits and keep me in the game. And as for continuing education on human skeletal movement, the website is phenomenal full of great exercises for particular mechanical dysfunction.

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Having courses count towards different certifications makes it so users can transition seamlessly from one certification to another. In my case, going from earning the BI CPT to earning the BI HMS was an easy decision and I am proud to have earned both certifications. I have also had the pleasure of going to a Live HMS workshop that was well taught by Instructor Boettcher and that was excellent to see how the methods and techniques are implemented.



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We learn principles in academia, we learn cool new modalities via whatever specialty certification, but BBI really concentrates on the nuances of passive treatment and they do a fantastic job. The format in which BBI instructs soft tissue specialists (DPTs, Chiros, ATs) like myself feels like almost like an apprenticeship. You get a thoroughly detailed explanation of the “why’s”, and a visual comprehension of how to apply. Personally, I believe application is where the good and the great are distinguished.

Brookbush has been incredibly helpful since I was in massage school and now as I’m in my career! I run my own practice and it gives me the resources I need to not only improve what I already know, but also help me navigate better, more efficient ways of treatment.

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Challenging concepts are explained in very understandable terms without dumbing down the material, and I find this program to be superior in quality to other personal training programs.

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This course describes the anatomy and integrated function of the popliteus muscle. This muscle originates on the lateral femoral condyle and inserts on the posterior surface of the tibia (behind the knee), underneath the lateral collateral ligament (LCL), and biceps femoris tendon. The popliteus muscle is innervated by the tibial nerve. Interesting fact, the popliteus is one of the only muscles to exist inside and outside of a synovial joint capsule, with the muscle lying partially within the knee capsule and the popliteus tendon inserting outside of the knee capsule.

The popliteus muscle crosses the tibiofemoral joint (knee joint) and contributes to tibial internal rotation (medial rotation), femoral external rotation in a closed chain, and potentially knee flexion. It is also believed that the internal rotation force generated by the popliteus muscle and popliteus tendon play an essential role in “unlocking the knee” following the “screw home mechanism” that locks the knee joint during full extension. This course also describes the role of the popliteus muscle in tibiofemoral (knee) arthrokinematics, fascial integration, postural dysfunction, and subsystem integration.

Sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.) must be aware of the integrated function of the popliteus for the detailed analysis of human movement, and the development of sophisticated exercise programs and therapeutic (rehabilitation) interventions. Further, this course is essential knowledge for future courses discussing injury prevention and physical rehabilitation (e.g. popliteus strain, popliteus injury, popliteus tendinitis, knee pain, knee tendinitis, muscle strains, lateral meniscus tear, scar tissue development), the synergistic function of knee muscles (e.g. the contribution of the popliteus, semimembranosus, semitendinosus, and medial gastrocnemius muscles to medial rotation of the knee, and the effect altered knee mechanics can have on low back pain), and popliteus specific exercises and techniques (e.g. the combination of hip abduction, tibial medial rotation, and knee flexion during tibial internal rotator activation).

Brookbush Institute’s most recommended techniques for the Popliteus (see videos below):

The popliteus muscle sitting behind the knee 

 Course Description: Popliteus

Location of popliteus, collateral ligaments, anterior cruciate ligament, tibia and fibula

https://upload.wikimedia.org/wikipedia/commons/d/d8/Gray352.png

The muscle on the posterior side of the lower leg, including the popliteus, tibialis posterior, and toe flexors

Attachments & Innervation: Popliteus

The tibia with the attachment of the popliteus and soleus highlighted

Where is the Popliteus Located?

The popliteus in a deep compartment by the origin of the soleus

Palpating the Popliteus

Introduction to the Popliteus

Knee: Tibial internal rotation (femoral external rotation in a closed chain), may contribute a small amount of force to knee flexion (3, 8, 16).

Based on the attachments of its complex insertion, may play a role in pulling the lateral meniscus posteriorly during knee flexion (18).

A cadaver dissection displaying the popliteus, tibialis poterior, and toe flexor muscles

https://upload.wikimedia.org/wikipedia/commons/b/b0/Slide2ACCA.JPG

Stabilizes the knee, specifically resisting a varus force via its intricate relationship with ligaments of the lateral knee (16, 17). May play a role in stabilization of the fibular head (proximal tibiofibular joint) via the popliteofibular ligament (19) and potentially the LCL in some individuals. The popliteus may have a role in increasing capsule tension via the oblique popliteal ligament.

The popliteus eccentrically decelerates tibial external rotation, a function which may serve to protect ligaments of the medial knee, including acting as a secondary restraint to the PCL (11, 18). The popliteus may also resist knee extension, although its contribution would be insignificant.

The popliteus acts synergistically with the tibial internal rotators (medial stabilizers of the knee) to eccentrically decelerate tibial external rotation. This synergy also includes semimembranosus & semitendinosus, 

, sartorius, and medial gastrocnemius. The popliteus is the only tibial internal rotator that does not aid in resisting a valgus force.

This muscle may be part of an intricate system of muscles that create tension and reinforce the capsule during motion, including the vastus lateralis, vastus medialis obliquus, 

 via the iliotibial band, semimembranosus, and gastrocnemius.

A more significant synergistic relationship may exist between the semimembranosus and popliteus via the tendinous expansion of the semimembranosus and the oblique popliteal ligament.

Cadaver dissection of the posterior compartment of the knee (popliteal fossa)

Arthrokinematics

Popliteus Muscle Actions

My Fascial Hypothesis: Large fascial sheaths not only play a role in the transmission of mechanical force but may also play a role in dictating the function of muscular synergies. This is likely caused by reducing or increasing tone of invested musculature via reflex arcs formed between mechanoreceptors embedded in the connective tissue and the attached musculature. In this way, my view of fascia differs slightly from noted expert on the subject Tom Myers. I think of these large fascial sheaths (specifically the thoracolumbar fascia, iliotibial band, and abdominal fascial sheath) as nature's "motherboard." A place for mechanical information to be communicated to the nervous system for more efficient recruitment of the muscular system. Despite having a slightly different philosophy it does not change the fact that fascia plays an important communicative role in the human body and we have Tom Myers to thank for his work.

Image of the fascial system of the body connecting muscles

Lateral Ligaments of the Knee: The popliteus has an intricate and complicated relationship with several of the lateral ligaments of the knee, including the arcuate popliteal complex, popliteofibular ligament, the lateral collateral ligament (LCL), and potentially the coronary ligaments of the lateral meniscus. It would be interesting to device a research study that recorded muscle activation of the popliteus in response to increased tension in these lateral ligaments - perhaps increased tension would signal an increase in activity (similar in response to muscle spindle activation) as part of a mechanism that protects the knee against varus force.

Popliteal Fibular Ligament: Similar to the example above it is worth considering how posterior and anterior glide of the proximal tibiofibular joint, relative to ankle plantar and dorsiflexion, or eversion and inversion, affects muscle activity of the popliteus via the tibiofibular ligament. It is known, that inversion and eversion of the foot and ankle are intricately paired with tibial internal and external rotation at the knee (inversion with tibial external rotation, eversion with tibial internal rotation). The fascial relationship between the popliteofibular ligament and popliteus may be a clue to the relative muscle activity and length of the popliteus in 

 specifically, relative to the excessive eversion (pronation) seen in this movement impairment.

As mentioned above, this muscle may be part of an intricate system of muscles that creates tension and reinforce the knee joint capsule during motion, including the vastus lateralis, vastus medialis obliquus, 

 via the iliotibial band and semimembranosus. Although this type of relationship differs from the fascial meridians discussed by Myers (6), or the myofascial synergies, discussed in my 

 articles (originally described by Vleeming et. al. (14), it is worth considering how investment in the joint capsule itself may affect recruitment strategies and activity. For example, would increased tension in the joint capsule stimulate receptor activity that results in reflexive facilitation of investing musculature, while effusion stimulates receptor activity that results in reflexive inhibition?

Notice the location of the popliteus relative to other muscular and vascular structures. - https://www.kenhub.com/en/library/anatomy/popliteus-muscle

Fascial Integration

Clinically, trigger points and over-activity of the popliteus have been reported as a source of posterior knee discomfort, and trigger point pain (8); however, the excessive tibial external rotation is seen in 

 would suggest a relative increase in length. The popliteus is long in the majority of postural dysfunctions; however, relative changes in activity are hard to determine.

 the popliteus plays no significant role.

Lumbo Pelvic Hip Complex Dysfunction (LPHCD)

, the popliteus plays no significant role - unless 

 or SIJD is the cause of movement impairment contributing to a client/patient's primary complaint of knee pain. The popliteus is lengthened by femoral (hip) external rotation on a fixed tibia, implying a relative increase in length in those exhibiting this dysfunction.

, the popliteus is relatively lengthened via excessive tibial external rotation. Further, the complaints of knee pain relative to 

 suggest that this muscle is intricately involved in not only the knee but lower leg mechanics. Despite clinical reports of tenderness upon palpation and trigger point development, relative changes in activity are hard to determine and have not been studied relative to movement patterns, dysfunction, and pathology. The function and relative change in length in 

 of this muscle imply that including this muscle in techniques to increase 

 will enhance relative length. Release techniques may prove beneficial; however, it is likely safest to only apply release techniques manually. (Self-administered techniques may prove detrimental to the tibial nerve, common fibular nerve, popliteal artery and vein, and popliteal lymph nodes which course over the popliteus.)

, this muscle has a propensity to become 

. The majority of muscles that adopt a compensatory increase length become under-active; however, trigger point laden muscles generally exhibit an increase in activity. Static release and active release may be attempted if it is believed that the muscle is over-active; however, release techniques should likely be limited to manual administration, as self-administered techniques may be hazardous to the popliteal neurovascular bundle and lymph nodes. Posterior to the anterior tibia on femur mobilization may also be incorporated to reduce activity, either manually or self-administered. As this muscle would be affected by the tibial internal rotation activation exercise recommended below, it is doubtful that individual consideration needs to be given to this muscle (outside of manual release).

Meniscal injury (especially lateral meniscus)

Peroneal nerve entrapment (at fibular head)

Acute popliteus injuries rarely occur in isolation, usually occurring with PCL injury (16).

Popliteus tendinopathy is highly correlated with tenosynovitis and activities that require downhill walking or running. The popliteus may act to prevent excessive anterior glide of the femur over the lateral tibia (16).

Signs of Altered Length/Tension and Tone:

 - Outside of normal range (0 - 5°) is likely a sign of dysfunction

For instructions on palpation head back to the top of the page. Trigger points are likely felt just inferiomedial to the popliteal fossa, deep to the proximal portion of the medial gastrocnemius head. Note: self-administered release of the popliteus is not recommended due to the popliteal neurovascular bundle and lymph nodes lying on top of this muscle.

Popliteus Trigger Points http://3.bp.blogspot.com/--42UA3WzSjY/T5utktbGfdI/AAAAAAAAAbw/3DVaz20YCn4/s1600/muscle-popliteus.jpg

Postural Dysfunction and the Popliteus

Tibial Internal Rotator Activation

Quick Tibialis Anterior & Tibial Internal Rotator Activation

Self-administered Knee Mobilization: Posterior to Anterior with Extension

Taping for Popliteus/Tibial Internal Rotator Activation

Exercises and Techniques for the Popliteus

Phillip Page, Clare Frank, Robert Lardner, 

Assessment and Treatment of Muscle Imbalance: The Janda Approach

NASM Essentials of Corrective Exercise Training

NASM Essentials of Personal Training: 4th Edition

Diagnoses and Treatment of Movement Impairment Syndromes,

David G. Simons, Janet Travell, Lois S. Simons, 

Travell & Simmons’ Myofascial Pain and Dysfunction, The Trigger Point Manual, Volume 1. Upper Half of Body: Second Edition

Joint Structure and Function: A Comprehensive Analysis: Fifth Edition

Florence Peterson Kendall, Elizabeth Kendall McCreary, Patricia Geise Provance, Mary McIntyre Rodgers, William Anthony Romani_

Carolyn Richardson, Paul Hodges, Julie Hides. Therapeutic Exercise for Lumbo Pelvic Stabilization – A Motor Control Approach for the Treatment and Prevention of Low Back Pain: 2nd Edition (c) Elsevier Limited, 2004

Movement, Stability & Lumbopelvic Pain: Integration of research and therapy, 2e (c)

Osti M, Tschann P, Kunzel KH, Benedetto KP. (2013). Posterolateral corner of the knee: microsurgical analysis of anatomy and morphometry. Orthopedics. 36(9): e1114-1120.

Jadhav SP, More SR, Riascos RF, Lemos DF, Swischuk LE. (2014). Comprehensive review of the anatomy, function, and imaging of the popliteus and associated pathologic conditions. Radiographics. 34: 496-513.

Chuncharunee A, Chanthong P, Lucksanasombool P. (2012). The patterns of proximal attachments of the popliteus muscle: form and function. Medical Hypotheses. 78:221-224.

Hirschmann MT, Muller W. (2015) Complex function of the knee joint: the current understanding of the knee. Knee Surg. Sports Traumatol Arthrosc. 23: 2780-2788.

Thaunat M et al. (2014). The arcuate ligament revisited: role of posterolateral structures in providing static stability in the knee joint. Knee Surg. Sports Traumatol. Arthrosc. 22: 2121-7.

Bibliography

Questions, comments, and criticisms are welcome and encouraged

Popliteus

Related Courses:

Course Description: Popliteus

Introduction to the Popliteus
3 Sub Sections

Popliteus Muscle Actions
1 Sub Section

Fascial Integration

Postural Dysfunction and the Popliteus

Exercises and Techniques for the Popliteus
4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Popliteus

Related Courses:

Course Description: Popliteus

Introduction to the Popliteus3 Sub Sections

Popliteus Muscle Actions1 Sub Section

Fascial Integration

Postural Dysfunction and the Popliteus

Exercises and Techniques for the Popliteus4 Sub Sections

Bibliography

Related Courses:

Comments

Guest

Introduction to the Popliteus
3 Sub Sections

Popliteus Muscle Actions
1 Sub Section

Exercises and Techniques for the Popliteus
4 Sub Sections