The popliteus muscle

[ladyblue]

When I was at my PT last week ,the therapist had me lie on my stomach and tried to straighten my leg. It was extremely painful and he decided to spray a freezing agent on the back of my leg and stretch it.(Instead of freezing it --man did it burn!) He said that there was a problem with the popliteus muscle behind the knee and due to the severe arthritis that I had, it was really bad. They gave me a heel cup to wear (but I have worn them before plus $100 orthotic insoles that I wore in my shoes) and told me to bring in what the other doctors had given me to use. Has anyone else heard of this and what can I about it!?! I want to be able to walk without all the pain I have been experiencing. Still barred from going back to work and the scar tissue has re-formed itself even though I have been doing my exercises...they even have me in an aqua-chamber that I walk on a treadmill while I am in the water. All I know is that my hair keeps getting grey and my nerves are becoming more frazzled!

 

[Jamie]

Ladyblue.....I am so sorry to hear of these latest challenges for you! I'm not much help in regard to what they told you about the popliteus muscle, but I just wanted you to know I will be thinking of you and saying a prayer that this can get resolved so you can move forward. You have been through a lot and are a strong and determined person! Keep after it and try not to let it get you down.

 

[Doug]

LadyBlue, I Found the attached site and it may shed some light on your issue I'm sorry for your plight. It has got to be frustrating.
It got me interested because I've had problems in that area. I assumed it was a tight IT band. That pain was the main reason I decided to give up my practice in martial arts. I go to see my O.S. for a follow up tomorrow.

broken link removed: https://www.sportsinjurybulletin.com/archive/popliteus.html

 

[JenniferG]

Well according to doug's article, if it is the popliteus muscle, he/she should be massaging it gently not spraying stuff on it and pushing.

 

[skichick63]

Yes, I had a 15 degree extension lag pre-TKR and used a heel wedge which helped me walk, but in the long run shortened my hamstring and I.T. band and everything at the back of my knee was tight.
My PT has chosen to ultrasound the area, and this along with prone-hanging stretch has made a huge difference in my flexibility. Hope this helps.
Barb

 

[edk]

prone-hanging stretch
Barb

Is a prone-hanging stretch where you lay face down with your lower leg off
the table and they weight your ankle?

 

[Doug]

I wondered the same thing. I googled it and didn't find anything that would seem to be for the knee area.

 

[skichick63]

Is a prone-hanging stretch where you lay face down with your lower leg off
the table and they weight your ankle?

Yes - prone hang -- lay face down on a firm surface (therapy table is best). Make sure knee & knee cap are OFF the table. If you only have your bed at home to hang off, try putting a pillow and then something firm over that then hang off it. The bed is better than nothing though.

I don't need to use a weight on my ankle, as I have in the past for my ACL surgeries. I find the weight makes it ache too much and I end up resisting it. Just hanging and letting the muscles relax and fatigue is often enough to make the difference. I get my knee to minus 2 degrees every time I do this after starting at around 10. I do two five minute hangs at a time and it's after the second one, that the knee goes straight. Sometimes I stretch with an ice pack on the back of my knee. Follow it up with ice on the back of your knee afterwards.

Good luck,
Barb, RN and new knee owner. (ROM: minus 2 to 128 4.5 weeks post op.)

 

[Doug]

Thanks Barb, I had assumed it was something like your description. I did that and then modified it somewhat last night. I half rolled on my side so I would put some pressure on the outside rear of the knee. I was on the edge of the bed so I let the leg hang over the edge.

 

[JenniferG]

I just came from PT and asked about the popliteus muscle, and we talked about degrees with extension. My PTs say that anything past 0 degrees is actually hyperextension and not good, may actually cause injury to that muscle.
I also asked him about the freezing agent. They have it but do not use it. He said it does burn and his experience is that they get much better results "finessing" than forcing. It may take a little more work and time, but causes less trauma and potential injury to already agrevated areas.

 

[Jamie]

Jenn, My therapist said some of the same things as yours regarding extension beyond 0 degrees. Neither she nor my surgeon was concerned that I get to exactly zero. They were quite happy with 2 degrees and pronounced me ready to go forth into the world. My key factor was not the number, but whether or not I was limping. At 2 degrees I had no limp and I was happy.

 

[ladyblue]

I was at 120 the last time I went to PT. He said that he is more worried about the straightening then he is about the bending of the knee. All I know is that I am still stiff and sore plus I have a severe limp (have had a limp since March)and the back of my knee is really bruised. When I had my manipulation last month (#2 that is) the OS told me that I had 3 weeks of PT left (this is my third week)and that I should "suck it up and deal with the pain"! At the last doctor appointment his PA said that they were thinking of going in arthroscopically and take out the scar tissue. I told him no more surgeries that I would deal with things as they are. I go back on June 3rd...wonder what is next!

 

[Doug]

Ladyblue,
I went to my 4 month check up to day. Given the site of my problem he said it could be either the popliteus muscle or the IT band connection point. What ever it is, when he pressed deeply on it, I almost flew out of the chair. He recommended I keep doing what I'm doing, and keep the possibility of a scope in December or January. At first blush, I thought he was crazy but since I've had nine other scopes that isn't a big deal for me. Kind of like an oil change.

 

[Josephine]

Oil change, Doug! How very apt! The you just got to watch this ...

Oil change gone wrong

 

[gatiger]

Jose, I liked the part right at the end when the guy walks in front of the car and waves his hands like, "Stop".I really don't think that was necessay at that point.

 

[Josephine]

Yes! .....................

 

[skichick63]

Jenn, My therapist said some of the same things as yours regarding extension beyond 0 degrees. Neither she nor my surgeon was concerned that I get to exactly zero. They were quite happy with 2 degrees and pronounced me ready to go forth into the world. My key factor was not the number, but whether or not I was limping. At 2 degrees I had no limp and I was happy.

Minus 2 is normal for me, just as it measures on the other side.

 

[Jamie]

SkiChick....I was not implying that your extension of -2 was somehow abnormal. I was responding to Jenn to let her know that my therapist (who incidently has a normal negative hyperextension like yours) said the same thing hers did and that it is not always necessary for a person to achieve zero to function very well in day-to-day activity. I'm sorry if you misunderstood my response.

 

[ladyblue]

I am a little upset now because since I started PT with a new group of therapists things were going good. This past week on the first day the therapist put me in the hydrotrack and then used the game ready on me but now manipulating it for me. Second session the therapist (different from my original one) worked it but wasn't pushy or mean. For my third session, they did the hydrotrack then the PT was really nasty and didn't care that he was really hurting me.After twisting me every which way but loose, he put me on a bike then used the Game Ready on me. Haven't seen the first therapist in 2 weeks and apparently they forgot all about the politeus muscle. I am so ready to give up! I have fallen twice this past month because 1) my other leg is weak and is severely arthritic and 2) my TKR leg is still week and causes me to have a great deal of pain. I go to see my OS on June 3rd and I am going to tell him that something has to be done because I cannot take the pain anymore!

 

[Jamie]

Ladyblue....I'm so sorry to hear about what you have been through. Is there any way you can make your therapy appointments so that you stick with the same person? That seems to be an important thing in my book. Maybe we're just lucky here, but in both my husband's and my therapy, they assign you a person and that is who sees you all the time unless you opt to change or substitute. I agree that you need to talk with your doctor .... maybe even by phone before your visit, if that is possible. You should not be in agony from your therapy....a little pushing yes, agony no! Good luck and keep us posted!