Rethinking the Popliteus in Knee Rehab
In this episode of the Unreal Results podcast, I explore the anatomy and clinical significance of the popliteus — the small, often overlooked muscle that unlocks the knee and why it may be a missing link in lateral knee pain, shin splints, post-surgical inhibition, and chronic joint irritation. I share reflections from my own ACL-deficient knee during an 8 week plyometric intensive and how restoring dynamic confidence changed not just my performance, but my joint symptoms. We’ll also explore how the popliteus interfaces with the fibula, meniscus, joint capsule, and even the SI joint and why treating it in isolation rarely creates lasting change.
In this episode, you’ll learn:
Why the popliteus is central to unlocking knee flexion in closed-chain movement
Why this muscle becomes hypertonic after injury and why releasing it isn’t enough
How posterior capsule, fibular motion, and meniscal connections influence knee pain
Practical ways to combine manual therapy and yielding plyometrics for better outcomes
If you’ve ever wondered why the popliteus keeps “tightening back up,” this episode will help you understand what it’s protecting and how to work with it instead of against it.
Resources & Links Mentioned In This Episode:
Ep. 8: Unlocking The Fibula
Ep. 21: Easily Restore Knee Extension After Injury or Surgery
Ep. 25: The Peripheral Heart
Ep. 78: Easily Restore Knee Flexion After Injury or Surgery
Ep. 79: The Deeper Impact of Plyometrics w/ Matt McInnes Watson
Ep. 138: The Link Between Potassium and Shin Splints
Squat Warmup Video
Tutorial to Improve Knee Flexion Video
Book I Mentioned: New Manual Articular Approach: Lower Extremity by Jean-Pierre Barral & Alain Croibier
Sign Up For A Barral Institute Course (Tell them Anna Hartman sent you!)
Learn the LTAP® In-Person in one of my upcoming courses
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there and welcome. I'm Anna Hartman and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs in the nervous system on movement, pain and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello. Hello and welcome back to another episode of the Unreal Results Podcast. Um, where are we at in life? Uh, doing good, San Diego. Uh, we had a couple weeks of rain and now we're back to being America's finest city and, uh. Beautiful Sunshiny Day. Daffodils are available at Trader Joe's, so it is officially spring and that makes my heart happy.
Daffodils are my favorite flower. They're only available for like three, four weeks outta the year. Um, but yes, they're my favorite. So it's always my, the best time of year when I'm in town and Trader Joe's starts bringing those in 'cause it's like. They're like $2 and 79 cents for 10 of them. Can you get any other flowers that cheap?
And it's ironic actually, that the flowers are that cheap because like, since they're only around for a very short period of time, you'd think that they would be, be then more expensive. But I guess it's also like they're so many and you just have to like sell 'em, get rid of 'em. Um, the fun fact of like why I even love daffodils so much is, um, growing up in Northern California. My dad's family, my, my family on my dad's side, um, actually owned a daffodil farm and we just had fields and fields of daffodils. And, uh, at a very young age, I have memories of learning how to properly pick a daffodil to be sold and distributed, um, to the stores. And, and so for a long time too, um, you know, we eventually sold that farm um to a company. And then that company was like actually the provider of the majority of daffodils at like Trader Joe's and Whole Foods and store stores like that. So always makes me feel, uh, like a little bit of home. But yeah, that is my love for daffodils is just growing up in fields and fields of daffodils in the spring and um, the smell of them.
It's funny 'cause it's like. It's not like a really fragrant floy smell. Like orange blossoms, like orange blossoms, leaving in Arizona for so long in the spring orange blossoms. So good. Um, but that's a very floy smell. Daffodils have a little bit more of a naturey smell to them, like a grass smell. Um. Also a little bit of floral fragrance, but like very, it's a very different, um, smell.
And I do love the smell of them, but mainly I love the smell of them because they remind me of home and it is the smell of daffodils. So anyways, um, this is always my favorite time of year. Um, yeah, daffodil season. So what else? My, um. My football player had a very fun Super Bowl party celebration this past weekend.
He, um, lives in San Diego in the off season, so it was really great to be able to celebrate with him and just had a wonderful time. Um, fun Anna was unlocked, is sort of like just add a little alcohol and she comes out real, real well. Um, but really fun. And it is like, the next day was like, he texted me and he's like, how are you feeling?
Like, you know, it sounds like everybody's, you know, pretty hungover. And I was like, actually I feel pretty good. I mean, was I a little hungover? Yes. But I also just like slept in and I was fine. Was my brain not fully functioning? Yeah. But like. Really, I felt so good and it kind of was like mind blowing a little bit.
I'm like, why do I feel good? I had a lot to drink last night. I was really drunk. And then I have two little hacks, and then a third one that I think is actually the real Culprit Corp culprit of why I felt so good and. The first two hacks are, um, and this is not a, um, paid promotion. This is just, I like it and I feel like it helps, is the supplement called The Daily Dose.
Um, and it's a li a liquid two ounce liver support supplement, and it's like ginger, turmeric, milk thistle, dandelion, like high concentrate. And I literally swear by it when I drink alcohol. If I don't drink very, like, here's a caveat to, I don't actually drink that often. Um, but when I do and I drink that after, like before bed, like when I get home and I drink that two ounces before bed, I feel so much better.
Um, and it's kind of crazy to me that like that little of amount of stuff could help your liver, but. And that seems to be true. And then the other real secret, obviously this is not a secret like to hydrate before bed and not just hydrate with water, but hydrate with electrolytes. And for me specifically, that is the magic electrolyte of potassium.
I have a whole podcast episode on that. I'll have Joe link in the show notes. But, um. I do a glass of potassium, a thousand milligrams of potassium, two ounces of the daily dose, and I'm set. And I, I really did feel great the next day. And then, um, my like greasy, hungover food is my go-to is a croissanwich sandwich from Burger King and a Coke.
Um, and you better believe that I Uber, eat Uber, eat it, DoorDash, Uber Eats. Um, that to my house Sunday morning. But I was thinking about it too, like. Even, even though I know those things always help, like I even felt like so good that I was like, what is going on? And I am, um, like eight or nine weeks into, um, subcutaneous um, injections of glutathione, which is a, you know, your body's like quote unquote master antioxidant and it's very supportive to the liver and the lungs and like your detoxifying organs. And so I'm like, I wonder if just my general load of glutathione, um, is very helpful and why I didn't feel terrible as well. So, um, those are my, um, hacks, non-supported by research and, um, just my anecdotal experience of how to deal with a hangover. You know, with that said.
It is not like I'm telling everybody to drink. Drinking is a poison, but to each their own. I enjoy it. I enjoy the libations every once in a while. Definitely not as much as I used to when I was younger, so, um, oh, so the other, there's two reasons. I'm probably going to be recording two podcast episodes today, and you're both a little bit inspired by the party and not, and it has nothing to do with alcohol and being hung over. But the first one inspired by the party because, um, normally after a night out, and we were, we were literally at the party for like, 11 hours. It was a long party, so it was on my feet, you know, and then lot like dancing at parts of it.
Like normally I would wake up the next day and like, not only would I not feel good from drinking the alcohol and like maybe eating crappy food, but um, I, my joints would also hurt and often my back would hurt. Um, so like my knees, my feet, and my back would hurt from the dancing. And I actually had, had zero of that.
And I was like, oh, that's fascinating. Now, number one, that also could be the glutathione potentially. Um, because as I've started taking the glutathione, um, my inflammatory general inflammatory markers and my blood work has gone down significantly. So it could be that, but also today was the eighth week of.
The plyos intensive course that I have been in with Matt McInnes Watson, and I've talked about it already on the podcast before. Matt was a guest podcast guest, um, a couple years ago. Um, I'll have Joe link Matt's episode in the po in the, um, podcast notes too. But, um. I also think that I felt so good because my body has like been training for dynamic movement and so I was like not sore from the eccentric load and dynamic movement that is dance and that was like really cool for me.
That was a really cool like thing of like wow. And honestly too, and I've kind of shared this every week of the podcast that I've been recording over this eight weeks is like, I feel so good. And last week, the last three weeks especially, I have like been like so feeling so good during the plyo intensive practical courses or practice practical sessions.
And it's like, I don't know if it's because. It's been, you know, it was like that five week mark that, that your body's adapting and changing and like you're making gains, or it was also like. Previously, like every week, because of the Super Bowl playoffs, I was traveling on Monday and had a really big travel, like a big day on Monday, didn't get great sleep.
And then Tuesday morning would wake up and like do plyos. And so my body did not love that. And at the beginning too, I was even trying to like return to running. And so the first five weeks of it, I didn't feel great for many reasons. Um, and then week five. Or no, week six, I guess it was six, seven. Yeah, week six was the first week of the pie intensive that I didn't travel on the Monday and it's the best I felt.
And then same thing for the week after. And then this week, which we just finished this morning, and um, so who know? I'm, I mean, I'm sure it's like anything, like it was confounding variables that, or compounding variables that like led to that. No travel, better sleep. Um, five weeks of training and, you know, that's why I felt better and it did last week's session really had me thinking because, you know, so we'll do, especially as the plyos get like more intense.
Like, we'll do some plys and then we will come back to the camera and we'll talk about our experiences. Especially our cohort was very small, and so we all got the opportunity to share like how it felt in our body, what our thoughts were like, what we saw in each other's videos, that kind of thing. So, um.
Uh, when, when we would come back to the camera, you know, my, my, my computer is on the floor for this class. 'cause I don't know if you've ever done virtual sessions with people, but the best way to see someone's full body on Zoom is actually put the, put the, put the camera, whether it be your phone or the computer, put it on the floor.
So, computer is on the floor. So in between when we come back to the, the closer to the computer to talk, I would either lay on my stomach in a prone position with my, you know, with my chest propped up looking at the camera. Or I would, um, be in like a quadruped position and sometimes in a quadruped position I would be doing like quadruped rocking, so rocking back into knee flexion.
And that is in general too, like. The most painful thing for my knee is full loaded knee flexion. And last week when I was rocking back, I noticed like, huh, actually my knee. This feels really good on my knee. And that's strange because I haven't done anything really to make it feel good, because usually if I'm going to feel semi comfortable in loaded knee flexion.
I've had to do a series of exercises to make it feel more comfortable. In fact, I'll have Joe link in in the show notes. I have a, a video that I created for Instagram a few years ago of like my warmup for squatting motions in the gym, which was like, um, obturator nerve glide, lateral ankle tilt, and medial hip glide, I think, and then quadruped rocking with, I would cross my knee or cross my other foot over my, an ankle that of the knee that I was loading to keep it in internal rotation because what I found is as I rocked back in knee flex.
My tibia was not internally rotating. It was kind of stuck in this actual rotation, and that was really creating a lot of knee pain, both posterior lateral knee pain and like anterior knee pain. And so I would cross my foot under and rock back, and this would really stretch out my anterior compartment of.
Um, lower leg and really help support a more comfortable knee position. And so actually I had two videos that I'll have Joe link in the show notes, that one with the, the tutorials for the warmup. And then I did another full like tutorial video on just improving knee flexion. In that aspect. And so I also believe I have a whole podcast episode about improving knee flexion, improving knee extension.
So I'll make sure those are in this podcast show notes along with unlocking the fibula. And you'll see why these all relate to each other in a second. Like, let me land the plane. So last week I was noticing like, wow, I can rock back in knee flexion and it feels good and I don't have to. Fix my foot, fix my tibia position.
It's just like there, it's just internally rotated and it was, it really got my wheels turning in my head of like, what is happening? And so concurrently to me feeling these experiences in my body. Um, in, in the knee flexion, but then also within the plyo intensive, like every week, just feeling so much better and more confident in loading my knee eccentrically and, and then eccentrically coming out and like being reactive.
And, um, to give you context of this too, is, um. I'm sure I've said it before on the podcast, but in that my knee that hurts specifically is my left knee. And um, I don't have an ACL. I am ACL lists and, um, I have a significant amount of arthritis, um, and degeneration in my patellafemoral joint. So, um. That's like the concept.
So I'm also, because I lack the intrinsic stability of the joint without an ACL, um, I have a lot of inhibition on that leg, um, of dynamic movement. Changing, like especially dynamic movement outside my center of mass. And then also single leg dynamic movement is very painful, very not comfortable with like a lot of inhibition.
So over the weeks I've been noticing like my athleticism and my comfort on both my legs, but especially my left leg has improved so much and it's just been like so nice to feel. And along with that, my knees. My knee was hurting less and less even on my walks and things like that. And um, so in addition to that realization of the quadruped rocking, um, I was like, wow, why is my, like, this is amazing that my knee is feeling so good.
And so I got to think about it. And, um, especially, you know, when it comes to like. An inhibition standpoint. Um, it's this like, and with the plyometrics a little bit of getting over the inhibition was twofold for me specifically, is we did, um, the deep tier exercises that Matt teaches, which is basically like oscillating, yielding into ecel e accelerated.
That's like eccentric and decelerating deceleration at the same time, but the yielding into an eccentric load, um, and then finding rhythm within that. Um, and then just in general, doing higher volume repetitions of a little bit more rhythmic things, deeper emotions helped me overcome this co contraction.
Around the joints. That was limiting my movement from this, like pain inhibition or even this inhibition of like, not trusting it due to proprioceptive, you know, disinformation or, um, just a history of this is how I injured my leg, right? Like one of the, one of the main movements that I was very inhibited on was.
A single leg hop and it's like single leg bound, not as much. Single leg hop, a lot more, of course, it's more force. It's faster limb speed. There's a lot of other factors that require more strength and stability in a hop versus a bound. But it was like a significant change in inhibition. And when we did these yielding plyometrics to a level of fatigue. It broke through that sort of ability for my muscles to like inhibit me. And then I was able to really yield into it. And I, I, that was a really big day to me, for me to find rhythm and reactivity and elastic ness in me and then like build trust and get to feel like, oh, I'm actually like way stronger than I think I am.
Um, when I actually allow my muscles to. Express their full strength capacity instead of being in that co contracted inhibited state. And then it got me thinking too of like, okay, how is this relating to the actual internal parts of my knee feeling better? And so this is where my thought process also went to.
What I'm seeing with a lot of my clients right now, which is the guys, my Navy guys who have a lot of, um, knee lateral knee pain, whether it be meniscus, IT band, patellafemoral driven pain and or currently or previous to that lateral knee pain, having a history of shin splints. And so, you know, I'm doing a lot of manual therapy on them and I'm noticing a lot of the times when I am working on them, like I'm drawn to the popliteus, and when I work on the popliteus they like things start feeling so much better. And that's when I had this realization of like, oh my gosh. That's one of the main drivers happening probably within my knee during this plyo intensive is because we've decreased inhibition. My popliteus is now actually doing its job and um, the job of the popliteus. So it's like, okay, 20 minutes we've landed the plane.
The episode is gonna be on the popliteus, but so the job of the popliteus muscle, you know the popliteus is a deep muscle. It's part of your deep posterior compartment of your lower leg. Um, it's part of your deep frontal line and anatomy trains, but it's a deep muscle, um, that is actually part of your knee capsule as well.
And its job is to unlock the knee joint from extension. And so what was really interesting about this too is, you know, so this is like, it unlocks the screw home mechanism. The screw home mechanism is what happens when you fully extend your knee into full knee extension. There is a locking mechanism that sort of does this little rotational component to maximize end range external rotation of the tibia for full extension of the knee and the popliteus muscle is the muscle that turns on to unlock that rotational component. And it is an oblique muscle, which I'll, I'll show you sort of the lines of it in a second, but an oblique mo muscle that controls tibial and femoral rotation.
And so, um, it's job is to unlock the knee. And I was on a walk the other day. And I was walking behind this older couple and the man had a knee brace on. And the knee brace, I posted it on Instagram because it was just funny because the knee brace was on top of his jeans. It wasn't even a knee brace, it was a, like a neoprene sleeve, but with like straps around it, kinda like a brace.
Um, it was on top of his jeans, not on his skin. And it was also had, like, has every knee brace does when you put it on top of clothes. It. Had dropped down via gravity and now was on his tibia. Not really his knee joint at all. But what was apparent with his walking too was, um, he had a limp and specifically he had a limp where you could tell he was limited in the um flexion. At the at, at the, you know, as you're walking, you go through terminal knee extension, toe off, and then your knee needs to flex in order for it to swing back underneath you to take a step. And what was happening was there was a delay or an inhibition on that unlocking of his knee from extension deflection.
And so that was what was creating this limp. And I was like, oh my gosh, that there we go again, popliteus is in action. His knee is not unlocking easily and so that's created this limp. And I'm like, yeah, this is what's happening. More than likely with so many of my people. That are having knee pain and, um, regardless of where the knee pain is, is because of a lack of this popliteus being able to do its job.
And so why does that happen? We talked about a big inhi inhibition piece, and then the, in the like. Neurological inhibition piece to it too, is that because the populus muscle is integrated with the knee joint capsule, it is a witness to any sort of internal derangement of the knee. And when you start looking at the ligamentous complex of the posterior knee joint, it is actually very connected to the patellofemoral joint as well.
And so it's like, that's why it's like it's a witness to literally anything going on in the knee. Because of that, but it's also a witness to anything going on in the lower leg and the ankle because of the connection of the fibula to the knee joint and to the popliteus and to the rest of the leg. And you could go one step further if you take the other end of the fibula and connect it up to the other parts of it, it connects into the SI joint.
They're now we're like, oh, the popliteus then could be a witness to really any sort of issue within the entire lower extremity and also the visceral and the central nervous system because of its relationship to the SI joint. And so. This is like fascinating to me is, is like, oh, this little muscle that honestly gets a little neglected in the world of knee rehab and, um, knee care.
And I, and I think the reason why it gets neglected is because, um. A little bit. It can be, it can feel like you're chasing your tail a little bit because of it being a witness to things. You can release it all you want with deep tissue, self massage, drying, needling, all the things, and it just gonna tighten right back up for the most part.
And I think that's been a little bit too of the more profound thing that the plyo intensive has like provided me is a reminder of. How powerful movement is and how powerful feeling safe is and decreasing inhibition is to allow the muscles to do their own job. And because, and I, and again, going back to like how my knee feels, because my popliteus is now doing its job better from a musculo-skeletal point standpoint, it is not so hypertonic. It is not so reflexively tight, and it is therefore too, making my knee feel better. So even though it's a witness. To anything going on in the joint. It also is going to be a driver of a lot of general knee pain, right? This is the cycle we get in.
You have something wrong with your knee joint, your body protects itself, it tighten things up, it limits your mobility, and then that creates even more like problems change in dynamic alignment, change in movement patterns, more pain, et cetera. And so it's a little bit of like chicken or the egg is like, do we release a popliteus to make your knee feel better, or do we just make your knee feel better and your popliteus lets go, or what we're more than likely gonna have to do. And what I am feeling in my own body is a combination of the two. And so, I mean, I work on, like I said, I work on guys' popliteus a lot and for me. Understanding what I've learned in the p the plyo intensive has been too, is like, okay, so for these guys that I'm drawn to, their popliteus over and over again, they have some sort of inhibition going on, whether it be from an internal derangement in the knee itself or somewhere else, visceral neural neurovascular, entrapment ankle like, like mechanical, wherever it's coming from. That's a little bit of my job to figure out where it's coming from so I can apply a better intervention. But then also too, I need to like, how can we train the popliteus more in, its like in the wild, in its natural environment to support general health of the knee and the lower extremity.
So and a little bit is, goes back to like understanding its true function, which is unlocking the knee joint into flexion in a closed chain position. Does it have a role in open chain? Sure. Because every muscle does, when you, when you take it from closed chain to open chains, it can reverse its action and do something different.
Open chain popliteus internally rotates the tibia, but the, the place where it really counts and the thing that it's really doing is. When the foot is connected to the floor, it is allowing the knee to unlock externally rotating the femur to allow for knee flexion. And so, um, this is where it's like these yielding plyometrics I think can be so powerful.
Is one, not only just like warming up the movements and the bigger muscles like the quads and the hamstrings and the gastroc and the soleus but it also starts to like really train this unlocking of the joint, which is so important for the arthrokinematic of the entire lower extremity. So that's my thoughts and I'll, let's go over the anatomy a little bit.
Um, so I have my bones. Tibia, this is right leg. Um, so medial malleoli tibial tuberosity Here, the popliteus attaches on the medial border. Of the posterior side of the tibia on what's called the so so soleal line. The line that the soleus also attaches to this is also why I am very passionate about the popliteus because I think it has a ton to help support.
You know, when we talk about unlocking the knee joint. Into knee flexion. That also means we are talking about allowing anterior translation of the tibia, anterior translation of the tibia on the ankle, AKA knees coming over your toes, which has to happen when you're absorbing forces, decelerating, cutting, changing position, like moving through space in a forward direction.
And, um, I have, I'll have Joe link it in the show notes to a whole episode on soleus. That talks about this too, and how important it's totius as an anterior translator of the tibia versus a calf raiser. But anyways, here is the soleal, this green line goes from the medial edge to a little bit more center, and then it attaches to the femur.
On the lateral side, oops, sorry, which is actually this side, the lateral side, the popliteus comes from, that line comes up and it actually goes around here and attaches more lateral, anterior, lateral, then posterior. So we'll see if we can drop the rest of it on here.
So you see when the lower leg is fixed and it pulls, it's going to pull the, um, femur into lateral rotation, which is this lateral rotation. This popliteus is deep to the lateral head of the gastroc, which attaches higher up just above the femoral condyle on the femur, right, so that attaches more posterior.
The popliteus attaches very much lateral, closer to anterior side. Now, this also means we gotta put the fibula on. Because the fibula matters a lot because of the fibula. See, I don't have enough hands now, but the fibula kind of rides down here and it has ligaments that are going up here and back here into the joint capsule and one of its ligaments, there's a arcuate ligament, which arcuate It is one of the anatomy words for like oblique rotational.
One of the arcuate ligaments from the fibula actually articulates with the popliteus You have multiple crua of this ligament, I think three crua of the popliteus ligament that attach into the joint cap, the posterior joint capsule and the popliteus itself. And um, so therefore this is like, just shows you how much, again, the fibula and the fibula motion affects the knee joint and the unlocking of the knee joint as well as just the um, knee joint capsule itself. There's ligaments that go here too. Not only do they attach into the pop lius, but there is a ligament that goes popliteus to lateral meniscus fibula to me later meniscus. And then on lateral and medial meniscus, you have ligaments that go around the front to the patellofemoral joint and attach.
What is that mind blowing to you? Because it kind of mind blowing to me, so. I think you know, our understanding of these, the posterior joint capsule of the knee and the role of the populus and the role of the soleus just, and the way that everything articulates around the knee joint itself, the knee capsule itself is just like, there's so much more to learn because then you bring in the hamstring component of it too.
Now we can look at semimembranosus and the way it comes in and attaches into the joint capsule, into the meniscus, into the popliteus, and we start to see, oh, there's this also, this like balancing connection to, to between the hamstrings, the capsule and the function of the knee joint, and then. Again, I always think like, how does this relate?
Going back to manual therapy or going back to surgery, and we see this too, a lot of the inhibition and the tightness we see on popliteus limiting knee extension, um, limiting knee extension and limiting knee flexion. We also see with the hamstrings, hamstrings are like reflexively so tight. Post knee injury, post knee surgery, and again, because they're a witness to the joint, they are part of the joint and so.
You know, this is also why we can't just always look at muscles as like this black and white, like either a muscle's tight or it's not. And if it's tight, we need to smash the shit out of it to help it out. It's like, yes. And is there another way or is the muscle, is the body more intelligent than we're giving it credit for and is doing this for a reason?
So what is the reason? Is it just the internal derangement and what's going on with the joint, or is it coming from something else and. To what degree of this protective pattern or this inhibition can we then train? Can we then train the body in a way to feel safe to overcome this inherent protective pattern of inhibition?
And that's really where Matt's work comes in. And I think it's so important because I could have probably released my popliteus every day for eight weeks and probably not felt as good as I do now. Having let it sort of release itself in a way from overcoming the inhibition and reminding my body that I have the strength to feel fine in my knee when I'm loading my knee dynamically.
I just have to like, let it feel that and give it different variety of variables within that time to allow it to, to express that and feel safe in it. So. With that said, I have been playing around with like, okay, how can I support someone releasing their popliteus two, because I, I don't actually wanna discount the fact that when I can manly, get in there and, um, do manual therapy to help the popliteus and the specifically to the ligaments around the fibula and the posterior capsule and the popliteus and the posterior capsule.
Um. When I can do manual therapy there, it can be very powerful to then like, give a little opening of space to then do these exercises and get more out of them. And so, um, you know, previously I'd say the most classic way to release popliteus from a self massage standpoint is stuffing a ball between behind your knee and going into full flexion.
And for most people whose popliteus are like, really need it. We can't tolerate full flexion. And so it's like how else can we do it? And also is that the best way? And the best way I think I've been playing around with it is going back to understanding where even the connections are and can we get the ball there And it's like, can I get the ball here?
Which is like above the fibula, not quite all lateral, a little bit posterior. Can I get the tenderness area here? That posterior capsule area where the fibula F comes in and the end of the popliteus and the collateral ligaments and arcuate ligament. Can I get the ball in there? And the best way I found is to sit on the edge of the table and wedge the ball.
Find my fibular head. Go up a little bit more towards the fibula, right? 'cause fibular head's gonna be down here. So I go up more towards, sorry, the femur. And then I actually externally rotate my whole leg, holding my leg and knee extension. And then I let my leg bend into flex and I go flexion and extension while in a turned out position, wedging the ball in there.
That has felt like the best way to get at it. And then the second best way has been, can I use a yoga block in a ball lying on my side? So the top leg, the leg I'm targeting is the top leg of my side. I'm not laying on that leg, I'm laying on the other leg. And can I get the ball in this sweet spot? Can I access this soleal here and really get the insertion of the popliteus and it's a deep muscle, right? So. Depending on how malleable, how supple your tissues are, unite might not be able to reach the soleal line on the tibia very well. Right. There's some gastroc soleus to get through a little bit. There's um, some, you know, the deep, the, the deeper muscles attach around there too.
So it's like, you know, there's a lot there. And I showed this video on, um, I showed this video actually on. Not a video, a picture of me trying to do this on Instagram the other day. And I asked people, do you know what I'm targeting? And of course, one, it was hard 'cause I had like dark colored yoga pants on.
So it's even hard to like be like, is that even your knee joint? But I was trying to wedge the ball into here and some people are like, oh, pes anserine.. But I'm like, actually no pes anserine gonna attach more anterior on the bone. I'm posterior medial. Okay. Posterior medial, and I'm trying to get this so line right, so this is the front of my leg.
Here's tibial tuberosity, right? This is, this is gonna be over kind of where Gertie's Tubercle is for pes anserine. And then I am continuing more medial and then more posterior, which is, it's like I'm not quite all the way if I'm too posterior. Now, that's too bulky. If I'm going straight in from the posterior, that's gonna be really challenging to do.
So it is gonna be easier access from like the medial side of the leg. So I'm going medial side of the leg, but aiming a little bit more posterior up at the top, and then as I come down the soleal line. It is more anterior, but we have even more muscle bulk down there. So the closer we are to the knee joint, the less bulky we have and the more opportunity I think we can get in there and actually access the border of the popliteus.
Um, and the popliteus itself, because that's where the most of the muscle bulk is from the populus too, to, to have an effect on that end. So the seated one on the table when we're up closer to the femur, um, that's targeting more of the tendon and the posterior capsule ligament piece to it, and then down in the tibia.
On the medial border, we're targeting more of the muscle itself. So not an easy spot to get and especially, and then if you're doing manual therapy, I think prone is the best way to access it. Um. Yeah, prone is the best way to actually set. And actually one of my guys I've been wor, I've worked on, hi, he's, he's, I've worked on him a lot.
I know his body very well. I know his muscles very lo well. We've like undid a lot of layers so I can actually palpate a lot deeper and I'm realizing like this thing I've been feeling on the back of his knee that I was like, is this a cyst? Is this, I'm like it. He has a foot. fabella. Um, a fabella is a sesamoid bone that lives in the tendon of the popliteus as it attaches up by the femur area, like it's posterior femur.
So it's like right where the, the tendon, right where the popliteal tendon comes around the corner of the femoral condyle, there's a pub in, in. Anywhere between 18 and 87% of the population. The research really varies on how many people have a flaa, but um, there's a fabella bone, which is a sesamoid bone that acts very similar to other sesamoid bo bones in our tendons.
Um, from a, um. Mechanical pulley standpoint. And I'm realizing now that I'm like, oh, I feel his fabella on his leg. And interesting enough, I think he has a fabella on his right leg, but not on his left leg or what I'm feeling on his right leg around the flaa is a fabella that is like bigger. Or more inflamed perhaps, because you can get like a inflammation around the, this sesamoid bone.
It's just like you can any sesamoid bone. But it's definitely different on him side to side. And, but now that I've realized that, I'm like, oh, I don't have to keep pushing so hard at it because it's a bone and I'm not gonna change it. And it does now that I, now that I like, realized that that is where the fabella is, I was like, oh yeah, no wonder that felt like bone right there.
It literally is a bone. 'cause I used to be like, why is this femoral condyle come so posterior? Like, why can I feel it so well? But I'm like, oh, it's this fabella Um, anyways, so some of the, I always like to share pictures of where the anatomy of, where I like see the pictures and like have a better understanding of these complexes and like.
I like on the internet, I just Google stuff and I look at all the images, right? I Google popliteus and then I click on images and I look at all the images. And each image gives you a different reference, especially when you can't get into the cadaver lab and see. And even a cadaver, every cadaver's gonna be different, right?
Like this guy, he has a fabella. Maybe I don't, or maybe you, I don't know. Um, but, um, I like, I, I really love Ken Hub. That is a internet resource for anatomy. I go, that's probably like, I'll look at all those pictures and then I'll find the one with Ken Hub and then I'll click on Ken Hub and I'll read all the anatomy around that too.
Um, and then I go to some of my textbooks and of all the textbooks I pulled out, um, the one that actually I thought gave me the most information was. This Baral book. So it is from Jean Pierre Barral and Elaine Crower. Um, it is their new manual articular approach of the lower extremity. So this is a series of classes they have called New manual Articular Approach.
I've actually only taken the um, manual articular approach of the spine and pelvis and it was a great class. I would love to take the lower extremity course. I would love to take the upper extremity course. Unfortunately they don't offer them that often in the United States, which totally sucks. But, um.
Either way, you can get the book and the pictures in this book were, um, the pictures of this book were so helpful in seeing these connections to the popliteus, the fibula, the posterior capsule in different, um, visuals of it. Like, I love this, this like side view is like so good, but, um, 10 of 10 re recommend their books.
Um, 10 of 10 recommend their classes. And actually they, I'm so, I'm so terrible at emails. They actually reached out to me, oh, like eight months or so ago and asked if, um, I'd have a guest, one of their teachers on, as a guest podcast actually specifically to talk about their manual articular classes. So maybe I'll return their email and have that happen.
But in general, um. You know, 10 of 10 recommend. As usual, whenever you sign up for a Barral course, if you're new to the Barral Institute, I would love for you to, um, let them know that I recommended you. Um, and I get a small, um, credit towards my education, so I get like maybe a 10% credit. So it's like their intro class is like, I don't know, 600 bucks.
I get $60 credit towards a future class. So, um, I would appreciate that. Not necessary. I recommend it 'cause I love it, not because I get credit for it, like obviously too, like who would want credit for a class that they don't love? Um, but yeah. I just found a little sticker in this book, the Movement Maestro.
Shout out Shante Cofield. Uh, that's it. Hope you enjoyed it. And, uh, definitely check out Matt's next upcoming plyo intensive cohort. I think it'll be cohort number four. He's amazing, brilliant, like a wonderful human, but he has a brilliant mind and he really loves to share this work and he has so much to share.
And, um, every time I work with him, listen to him. I learn a lot and it gets me thinking and I just am so grateful that I found him and I just wish I could have all of my athletes work with him. That's it for now. See you next episode.