What is popliteus tendinopathy?

What the popliteus does

The popliteus is a small, flat muscle at the back of the knee, below the crease. Its tendon runs diagonally up and outwards, passing inside the joint capsule to attach to the outer side of the thigh bone. It also connects to the lateral meniscus.

It has two main jobs: it rotates the knee slightly to unlock it from a fully straight position, and it helps stabilise the outer back corner of the knee, resisting rotation and the thigh bone sliding forward when you go downhill.

Who tends to get it

• Runners who add downhill sessions, trails or sloping roads
• Hikers and walkers doing long descents
• Players in sports with repeated cutting and pivoting, such as football and padel
• People who overpronate or have weak hip muscles, which can increase knee rotation
• Occasionally after a twisting injury or in people with posterolateral ligament laxity

How it is diagnosed

The diagnosis is mostly made from the history and examination. The surgeon feels for tenderness over the tendon at the outer side of the knee, often with the leg in a figure-four position, and tests resisted rotation. Ligament tests check the posterolateral corner and other structures.

An MRI or ultrasound can show changes in the tendon and, importantly, rules out a lateral meniscus tear, a cyst or a ligament injury, which can cause pain in the same area.

Treatment in outline

Treatment usually means reducing downhill load, then a progressive strengthening programme for the hamstrings, calf, quadriceps and hips. Most people improve over weeks to a few months. Injections are occasionally used in stubborn cases, and surgery is rarely needed for tendinopathy alone.

At Aman Hospital in Doha, Dr. Gelber confirms the diagnosis and works with your physiotherapist on a graded return to running and sport.