Popliteus Tendinitis

with Rehab

ExitCare ImageTendonitis is a condition that is characterized by inflammation of a tendon. A tendon is the soft tissue that connects muscles to the skeletal system allowing for body movements. Popliteus tendonitis affects the popliteus tendon, which connects the popliteus muscle to the thigh bone (femur) near the knee. The popliteus muscle helps bend and rotate the knee. Popliteus tendonitis is often caused by a tendon tear (strain). Strains are classified into three categories. Grade 1 strains cause pain, but the tendon is not lengthened. Grade 2 strains include a lengthened ligament due to the ligament being stretched or partially ruptured. With grade 2 strains there is still function, although the function may be diminished. Grade 3 strains are characterized by a complete tear of the tendon or muscle, and function is usually impaired.

SYMPTOMS

  • Pain in the knee, specifically the outer (lateral) and back (posterior) portions.

  • Pain that worsens with use of the popliteus muscle (standing on a slightly bent knee or rotating the knee).

  • A crackling sound (crepitation) when the tendon is moved or touched (uncommon, except when tested just after exercising).

CAUSES

Popliteus tendonitis occurs when damage to the popliteus tendon elicits an inflammatory (healing) response. Popliteus tendonitis is often an overuse injury.

RISK INCREASES WITH:

  • Activities that require extensive running or walking downhill.

  • Poor strength and flexibility.

  • Failure to warm-up properly before activity.

  • Flat feet.

PREVENTION

  • Warm up and stretch properly before activity.

  • Allow for adequate recovery between workouts.

  • Maintain physical fitness:

  • Strength, flexibility, and endurance.

  • Cardiovascular fitness.

  • Learn and implement proper training regimens and sports technique.

  • Arch supports (orthotics) for individuals with flat feet.

PROGNOSIS

If treated properly, then the symptoms of popliteus tendonitis usually resolve within 6 weeks.

RELATED COMPLICATIONS

  • Prolonged healing time, if improperly treated or re-injured.

  • Recurrent symptoms that result in a chronic problem.

TREATMENT

Treatment initially involves the use of ice and medication to help reduce pain and inflammation. The use of strengthening and stretching exercises may help reduce pain with activity. These exercises may be performed at home or with referral to a therapist. Many individuals find that the use of a compression bandage or a knee sleeve helps reduce symptoms. If you have flat feet, then your caregiver may recommend arch supports. It is important to learn/modify techniques for running uphill/downhill that do not aggravate your symptoms. If symptoms persist for greater than 6 months despite conservative (non-surgical) treatment, then surgery may be recommended to remove the tendon sheath (lining).

MEDICATION

  • If pain medication is necessary, then nonsteroidal anti-inflammatory medications, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medication within 7 days before surgery.

  • Prescription pain relievers may be given if deemed necessary by your caregiver. Use only as directed and only as much as you need.

HEAT AND COLD

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain and immediately after any activity that aggravates your symptoms. Use ice packs or massage the area with a piece of ice (ice massage).

  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or soak the injury in warm water.

SEEK MEDICAL CARE IF:

  • Treatment seems to offer no benefit, or the condition worsens.

  • Any medications produce adverse side effects.

EXERCISES

RANGE OF MOTION (ROM) AND STRETCHING EXERCISES - Popliteus Tendinitis

These exercises may help you when beginning to rehabilitate your injury. Your symptoms may resolve with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Restoring tissue flexibility helps normal motion to return to the joints. This allows healthier, less painful movement and activity.

  • An effective stretch should be held for at least 30 seconds.

  • A stretch should never be painful. You should only feel a gentle lengthening or release in the stretched tissue.

ExitCare Image STRETCH – Gastroc, Standing

  • Place hands on wall.

  • Extend right / left leg, keeping the front knee somewhat bent.

  • Slightly point your toes inward on your back foot.

  • Keeping your right / left heel on the floor and your knee straight, shift your weight toward the wall, not allowing your back to arch.

  • You should feel a gentle stretch in the right / left calf. Hold this position for __________ seconds.

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

ExitCare Image STRETCH – Soleus, Standing

  • Place hands on wall.

  • Extend right / left leg, keeping the other knee somewhat bent.

  • Slightly point your toes inward on your back foot.

  • Keep your right / left heel on the floor, bend your back knee, and slightly shift your weight over the back leg so that you feel a gentle stretch deep in your back calf.

  • Hold this position for __________ seconds.

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

ExitCare Image STRETCH – Gastrocsoleus, Standing

Note: This exercise can place a lot of stress on your foot and ankle. Please complete this exercise only if specifically instructed by your caregiver.

  • Place the ball of your right / left foot on a step, keeping your other foot firmly on the same step.

  • Hold on to the wall or a rail for balance.

  • Slowly lift your other foot, allowing your body weight to press your heel down over the edge of the step.

  • You should feel a stretch in your right / left calf.

  • Hold this position for __________ seconds.

  • Repeat this exercise with a slight bend in your right / left knee.

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

ExitCare Image STRETCH - Hamstrings, Standing

  • Stand or sit and extend your right / left leg, placing your foot on a chair or foot stool

  • Keeping a slight arch in your low back and your hips straight forward.

  • Lead with your chest and lean forward at the waist until you feel a gentle stretch in the back of your right / left knee or thigh. (When done correctly, this exercise requires leaning only a small distance.)

  • Hold this position for __________ seconds.

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

ExitCare Image STRETCH – Hamstrings, Supine

  • Lie on your back. Loop a belt or towel over the ball of your right / left foot.

  • Straighten your right / left knee and slowly pull on the belt to raise your leg. Do not allow the right / left knee to bend. Keep your opposite leg flat on the floor.

  • Raise the leg until you feel a gentle stretch behind your right / left knee or thigh. Hold this position for __________ seconds.

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

ExitCare Image STRETCH - Hamstrings, Doorway

  • Lie on your back with your right / left leg extended and resting on the wall and the opposite leg flat on the ground through the door. Initially, position your bottom farther away from the wall than the illustration shows.

  • Keep your right / left knee straight. If you feel a stretch behind your knee or thigh, hold this position for __________ seconds.

  • If you do not feel a stretch, scoot your bottom closer to the door, and hold __________ seconds.

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

ExitCare Image STRETCH - Quadriceps, Prone

  • Lie on your stomach on a firm surface, such as a bed or padded floor.

  • Bend your right / left knee and grasp your ankle. If you are unable to reach, your ankle or pant leg, use a belt around your foot to lengthen your reach.

  • 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/or knee.

  • Hold this position for __________ seconds.

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

STRENGTHENING EXERCISES - Popliteus Tendinitis

These exercises may help you when beginning to rehabilitate your injury. They may resolve your symptoms with or without further involvement from your physician, physical therapist or athletic trainer. While completing these exercises, remember:

  • Muscles can gain both the endurance and the strength needed for everyday activities through controlled exercises.

  • Complete these exercises as instructed by your physician, physical therapist or athletic trainer. Progress the resistance and repetitions only as guided.

ExitCare Image STRENGTH - Hamstring, Isometrics

  • Lie on your back on a firm surface.

  • Bend your right / left knee approximately __________ degrees.

  • Dig your heel into the surface as if you are trying to pull it toward your buttocks. Tighten the muscles in the back of your thighs to "dig" as hard as you can without increasing any pain.

  • Hold this position for __________ seconds.

  • Release the tension gradually and allow your muscle to completely relax for __________ seconds in between each exercise.

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

ExitCare Image STRENGTH - Hamstring, Curls

  • Lay on your stomach with your legs extended. (If you lay on a bed, your feet may hang over the edge.)

  • Tighten the muscles in the back of your thigh to bend your right / left knee up to 90 degrees. Keep your hips flat on the bed/floor.

  • Hold this position for __________ seconds.

  • Slowly lower your leg back to the starting position.

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

OPTIONAL ANKLE WEIGHTS: Begin with ____________________, but DO NOT exceed ____________________. Increase in1 lb/0.5 kg increments.