Question: Cornell Addresses Popliteus & ACL Issues for athletes

Hey Cornell!!! How are you?!?! I MISS YOU AND TRAINING!! I actually have a very imortant question. Haha I strained my papliteous or however you spell it in the back of my knee, the sports medicine place on campus also told me that my ACL’s are very loose and im scared!!! I was wondering if you could tell me some workout or something to help strengthen my knees?!?! I do not need to get hurt so please let me know(: thanks and i hope you and the family are doing well!!!

Laura D.

Hi Laura, thanks for the question. We certainly miss you here as well! Hope all is going well for you at school and with soccer. So, i’m going to attempt to answer your question as best I can & the simplest way possible.

So here it goes:

1st of all your “popliteus”….lol, is a small muscle that runs just behind the knee under the hamstring & calf muscles. It is known to have a number of different functions helping stabilizing the knee. Here are three of its most major functions:

Internal rotation of the tibia in an already extended knee.
External rotation of the femur on a tibia that is in place, as in the stance phase of running.
Helps to bring the knee out of full extension

here is a picture of your polpiteus below

What does this means to you?? We it simply means that this muscle however small it is, plays a very important role in your ability to perform as a soccer athlete and you must make every effort possible to get it healthy or it could lead to major issues.

The best and most effective way to treat this injury is through massage therapy stretch & ice. You must get very active on having it worked on because its not a muscle that will rehab itself. Usually extending your knee is a major issue and as a result stiffness at the distal hamstring (right behind the knee) may occur. Having the athletic trainer work on it or even a massage therapist would be best. There are some ways you could try to do it your self, but this would require a lax ball or any other self myofascial release alternative that is pointy enough to get into that spot. I’d have it worked on 3 times a day at least and try to minimize the amount of high speed running and jumping (and any other aggravating exercises) you do until it feels better.

Here is one stretch we use that could help make a world if difference:

AIS or active isolated hamstring stretch (the 1st stretch of the 3)

The muscle itself will weaken if the hamstrings are not balanced (strength wise) and or if there is excessive pronation of your lower leg while running. This means that when you run, the cyclical motion your leg assumes is slightly off causing the stress of impact to aggravate that muscle in particular. So balancing out the mobility/strength of the hamstrings, quads and the lower legs will be critical to your health while running and jumping.

You also mentioned your Athletic trainer saying your ACL is lose. Here may be the reason why!

Women have what we call a greater “Q-angle”. The Q-angle simply represents the distance from the outside of the hip bone to the distance of the outside of the knee. The illustration below should help explain what it looks like:

Women due to having “child bearing hips” have a greater susceptibility to having knee issues due to exploitation of the Q-angle. The greater the Q-angle, the greater the risk of injury to the individual. As you can see this outward pressure on the knee capsule can present quite a problem of steps arent taken to resolve the issue. So this issue, along with the fact that your probably doing a ton of training (on a weak popliteus), can be a reason your ACL feels weak or compromised. This is very serious and you should focus your attention of single leg exercises that help stabilize the knee by improving the strength of the VMO. Your VMO is a quad muscle that sits just on the outer portion of the knee and has the shape of a tear drop. By improving the strength of the (Vastas Medialis Oblique) you will notice a considerable change in knee and ankle stability allowing you to run safer and a lot more sound! Here is your VMO pictured here;

So we want to get to work on your legs Laura. It seems that youre experiencing some weaknesses that arent good and therefore strength is your #1 goal. Next to that you’ve got to concentrate on mobility of the hamstrings, especially right behind the knee.

That said, here are some of my favorite exercises to address your issues.

Some of my favorite knee stability/strengthening exercises:

#1 -TKE – Terminal Knee Extension with a band!

#2 – Heel Touches

#3 -Rear leg Elevated Split Squat – from a bench/box

#4 -Single Leg Squat to box/bench

Once you begin to gain more stability in the knee joint, your focus should be on linear and lateral stability of the knee because in sports you are constantly cutting and landing at various speeds and at various angles. Its important to slowly introduce the ligaments and tendons to this dynamic exercise so that you dont risk injury. Here are a few exercises that are dynamic and very good at re-establishing good movement patterns useful for good on the field performance.

#1 -2inch run w/ mini band abduction

#2 – Single leg mini hurdle hop

Laura, this would be a good list for you to begin with. The exercises listed are only some of the MANY one can use to help with the knee issues you’ve been experiencing.

I’d lay out the exercises in this fashion (using the ones I have mentioned above):

Everyday:

Do 100 TKE’s each knee and 50 Heel touches

2 days a week, on your leg workout days. Include 3 sets of 8-12 Rear Leg elevated Split Squats. I’d lay off heavy squats for a few weeks, if you’re even doing them as to not aggravate the knee any further. I’d stay with the single leg work for the quads and do Swiss ball leg curls with the AIS Hamstring super set.

Then move into your Single leg squat to the box. 3 sets of 8 reps with light weights will work great.

Here is your layout:

1a – TKE’s x100 each knee

1b – Heel Touches (on a 2-3inch box) x50reps each leg

2a – Rear Leg elevated Split Squat 3×8 each legs 20lb weights

2b – AIS Hamstring stretch x3 reps each leg

3a – Single leg squat to box

3b – Mini band linear walk

4. Swiss Ball Leg Curls – 4×12

5. Planks & Lower back work & any sled dragging/pulling options you may have.

There you go! Just remember to give it time and stay consistent on it. Stay away from aggrivating it and get those legs STRONGER!

I hope this helps you!