Lateral Knee Pain

Physio observations

 

If a physiotherapist says that '... what you say is changing from one day to the next...', then think Popliteus. It seems to me that as the Popliteus can change its function depending on whether it is acting as an origin or insertion point, AND the patient is involved with differing physiotherpy exercises, then a good physiotherapist should be able to detect ambiguities in patient's pain responses that may result from the change of function. This is discussed by:

http://www.wheelessonline.com/ortho/popliteus_muscle

 

action: 

           - unique w/ a reversal of its origin and insertion w/ proximal attachment (origin) is its tendinous portion while its muscle belly sits distally; 
           - its primary f(x) is internal rotation of knee, unlocking of knee being accomplished by virtue of contourof articulation & retracting of posterior aspect of lateral meniscus; 
           - rotates the tibia medially on the femur & femur laterally on the tibia, depending on the one fixed; 
           - in a minority of pts, it withdraws the meniscus during flexion, and provides rotatory stability to the femur on the tibia; 
           - helps to brings the knee out of the position of full extension; 
           - helps with posterior stability of the knee in preventing posterior translation of the tibia on the femur; 
           - prevents excessive external rotation of the tibia during knee flexion from 20 - 130 deg, 
           - resists excessive varus rotation of the tibia during flexion from 0 - 90 deg

 

 

A new physiotherapy action plan has highlighted some new and some old issues:

 

• I seem to be balancing with all my weight over my heel,

• As I walk, there is 'pressure' near my little toe that is producing hard skin,

• I feel as if, or rather I am tipping forward, no matter how straight I am standing,

• My knee clicks once when going downstairs, but also several clicking movements towards medial posterior aspect of knee near bottom of stairs,

• Lateral ankle is often very painful and swollen,

• Further swelling at medial 'lump' in knee,

• Very painful at back of knee,

• Good leg relaxes after door squat exercise, but bad, right leg does not.

 

 

It seems to me that, xxxxxxxxxxxxxxxxxxxxxxxx