Popliteus Tendinitis

Popliteus tendinitis is a knee condition that causes pain in the back of the knee. It results from damage or irritation to the tough cord of tissue at the back of your knee (popliteus tendon).

Popliteus tendinitis is common in runners.

What are the causes?

This condition is caused by stress on the popliteus tendon. This can result from:

• Training too hard.
• Running too much without proper training.
• Running downhill.

What increases the risk?

This condition is more likely to develop in people who have weak thigh muscles.

What are the signs or symptoms?

The main symptom of this condition is pain in the back and outside of the knee. Running downhill makes the pain worse. Other symptoms of this condition include:

• Swelling behind the knee.
• Tenderness when pressing behind the knee.

How is this diagnosed?

This condition may be diagnosed based on your symptoms, your medical history, and a physical exam. During your exam, your health care provider may check for tenderness behind your knee. Your health care provider may also order an ultrasound or MRI to check for swelling in your tendon.

How is this treated?

This condition may be treated by:

• Resting the knee until pain and swelling go down.
• Avoiding activities that make pain worse.
• Taking medicine to help with pain and swelling.
• Getting medicine injected into your knee.
• Doing range-of-motion and strengthening exercises (physical therapy) when pain and swelling improve.

In some cases, surgery may be needed.

Follow these instructions at home:

Managing pain, stiffness, and swelling

• If directed, apply ice behind your knee.
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Raise (elevate) your knee above the level of your heart while you are sitting or lying down.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.

General instructions

• Do not use any tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. Tobacco can delay healing. If you need help quitting, ask your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Warm up and stretch before being active.
• Cool down and stretch after being active.
• Give your body time to rest between periods of activity.
• Make sure to use equipment that fits you.
• Be safe and responsible while being active to avoid falls.
• Do at least 150 minutes of moderate-intensity exercise each week, such as brisk walking or water aerobics.
• Maintain physical fitness, including:
  • Strength.
  • Flexibility.
  • Cardiovascular fitness.
  • Endurance.

Contact a health care provider if:

• Your symptoms get worse.
• Your symptoms do not improve.

Popliteus Tendinitis Rehab

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Gastroc, standing

1. Stand with your hands against a wall.
2. Extend your left / right leg behind you, and bend your front knee slightly. Your heels should be on the floor.
3. Point the toes on your back foot slightly inward.
4. Keeping your heels on the floor and your back knee straight, shift your weight toward the wall. You should feel a gentle stretch in the back of your lower leg (calf).
5. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise B: Soleus, standing

1. Stand with your hands against a wall.
2. Extend left / right leg behind you, and bend your front knee slightly. Your heels should be on the floor.
3. Point the toes on your back foot slightly inward.
4. Keeping your heels on the floor, bend your back knee and shift your weight slightly over your back leg. You should feel a gentle stretch deep in the back of your lower leg (calf).
5. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise C: Gastrocsoleus, standing

1. Stand on the edge of a step on the balls of your feet, and hold onto the rail for balance.
2. Slowly lift your healthy foot, allowing your body weight to press your left / right heel down over the edge of the step. You should feel a stretch in your left / right calf.
3. Hold this position for __________ seconds.

Repeat __________ times with your left / right knee straight and __________ times with your left / right knee bent. Complete this stretch __________ times a day.

Exercise D: Hamstring, standing

1. Stand with your left / right leg fully extended and your foot resting on a chair.
2. Arch your lower back slightly.
3. Lean forward at the waist, leading with your chest, until you feel a gentle stretch in the back of your left / right knee or thigh. You should not need to lean far to feel the stretch.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise E: Hamstrings, supine

1. Lie on your back.
2. Loop a belt or towel over the ball of your left / right foot. The ball of your foot is on the walking surface, right under your toes.
3. Straighten your left / right knee and slowly pull on the belt to raise your leg until you feel a gentle stretch behind your knee. Do not allow your knees to bend. Keep your other leg flat on the floor.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise F: Hamstrings, doorway

1. Lie on your back in front of a doorway with your left / right leg resting against the wall and your other leg flat on the floor in the doorway. There should be a slight bend in your left / right knee.
2. Straighten your left / right knee. You should feel a stretch behind your knee or thigh. If you do not feel that stretch, scoot your buttocks closer to the door.
3. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise G: Quadriceps, prone

1. Lie on your abdomen on a firm surface, such as a bed or padded floor.
2. Bend your left / right knee and hold your ankle. If you cannot reach your ankle or pant leg, loop a belt around your foot and hold the belt instead.
3. Gently pull your heel toward your buttocks. Your knee should not slide out to the side. You should feel a stretch in the front of your thigh and knee.
4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise H: Hamstring, isometric

1. Lie on your back on a firm surface.
2. Bend your left / right knee about __________ degrees.
3. Dig your left / right heel into the surface as if you are trying to pull your heel toward your buttocks. Tighten the muscles in the back of your thighs to “dig” as hard as you can without increasing any pain.
4. Hold this position for __________ seconds.
5. Release the tension gradually.
6. Allow your muscle to completely relax for __________ seconds.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise I: Hamstring curls

1. Lie on your abdomen with your legs straight.
2. Tighten the muscles in the back of your thigh to bend your left / right knee to an “L” shape (up to 90 degrees). Keep your hips flat against the surface that you are lying on.
3. Hold this position for __________ seconds.
4. Slowly lower your leg to the starting position.

Repeat __________ times. Complete this exercise __________ times a day.

If told by your health care provider, do this exercise while wearing ankle weights. Begin with __________ weights. Then increase the weight by 1 lb (0.5 kg) increments. Do not wear ankle weights that are heavier than __________.