The knee is considered the most complex joint in the body. It has 4 bones coming together to form the joint – the femur, the tibia, the fibula and the patella. Quite a few muscles surround the knee – the quadriceps (4), the hamstrings (3), gracilis, sartorius, the IT band, the gastrocnemius, plantaris and the popliteus. There are the major ligaments of the medial and lateral collateral, the anterior and posterior cruciate and the little known coronary ligaments securing the medial and lateral menisci to the tibial plateau. There are 11 bursa that protect against friction between adjacent moving structures. And there is the joint capsule.
Wow! That is a lot of anatomy! And I am not even naming all of the structures!
The alignment of the knee can be affected from below by the feet or above by the hips, ilium and sacrum or even further up the spine.
Energetically the knees are part of our root chakra. Am I feeling grounded and connected to the earth? to my community? Do I feel stable and secure? Do I feel supported by life, family, community or do I feel all alone in the world?
Knees have a sub chakra of their own which can reflect the level of my flexibility or control. They can also be about moving forward.
Problems with the knee can stem from imbalances in any of the above – structure, emotion or energetics.
On the structural level, one little known culprit of knee dysfunction is the popliteus muscles. The popliteus muscle is a small muscle located at back of the knee joint. It originates at the lateral condyle of the femur and the posterior horn of the lateral meniscus. From there it runs medially and inferiorly towards the tibia and inserts above the origin of the soleus muscle.
It is described as the “key” that unlocks the knee and allows it to move. In particular, it pulls the lateral meniscus back so that the meniscus isn’t crushed between the tibia and femur bones as the knee flexes. It also is involved in internal rotation of the tibia. The popliteus muscle can potentially be injured in any force to the knee as well as chronic locking of the knees. Problems with the popliteus muscles would manifest as pain in the back of the knee or knee locking.
To release this muscle, have your client lie face down on the massage table. Flex the knee. I like to sit on the edge of the table and support the foot against my shoulder so that I can use two hands. Wiggle your fingers down through the two heads of the gastrocnemius to contact the popliteus muscle. It is a small muscle running diagonally lateral to medial. Use your magical powers of intention and anatomical visualization to reach the muscle. Be careful to not press into the space directly behind the knee as there are blood vessels there. Move a little bit inferior to the ‘V’ between the two gastrocnemii. Search for tension in the muscle. If you want to make sure you are on the popliteus muscle, you can muscle test with tibial internal rotation. “Sit” on the muscle or use transverse strokes to coax the muscle to relax.
Encourage your client to be aware of locking their knees when standing on resting their legs on a hassock while watching TV.
Don’t underestimate the significance of this small but important muscle.
Enjoy the exploration!
You can learn this technique and many more in the upcoming Orthopedic Bodywork for the knee June 24 and 25, 2017 in Bend, OR.