You sometimes get asked some funny questions when you are an anatomist, an exercise professional and a trainee massage therapist. They usually start with ‘I’ve got this pain here…’ and I love the opportunity to do a bit of detective work and try and identify the issues although I always start my answers with ‘I’m not a medic or a physio but…’
This week’s was a new one.
A friend had developed a pain in the back of their knee after a spin class. We did the usual hamstring test, that was fine. Test the calves, they were fine. I asked them to point exactly to where it was hurting and then put on those x ray specs that have been honed through years of dissection and text book study. Then you get that sinking feeling when they point to an area where you cant think of what is below the skin. Its a fossa; a gap full of fat, blood vessels etc. Your mind cant help moving towards the fascia and the concept that everything can affect everything else.
Then is struck me – what exactly had they done? Could they rotate their tibia against resistance? No they couldn’t.
They had not adjusted the saddle on their spin bike and had spent an hour in a class repeatedly going from full locked out extension of the knee to bent. What muscle is that going to exhaust?
Our good friend popliteus. Its only role in life is to unlock the knee. When you full straighten your leg your femur actually rotates medially and locks into place. To unlock it you need to rotate it laterally a little bit to start with. If you spend a long time doing this then its going to start aching.
Its usually bought on by a direct blow to the knee or repeated use, a common running injury. It would appear that it can be a spinning injury too. Take the time and adjust your saddle.