Pain in the popliteal fossa is a frequent problem in our daily life, and many people complain of pain in the popliteal fossa accompanied by a strong pulling sensation, so how to deal with this problem, we should start with the popliteal fossa. The popliteal fossa is a diamond-shaped depression in the posterior region of the knee. The upper outer border is the biceps femoris tendon, the upper inner border is mainly the semitendinosus and semimembranosus, and the lower inner and lower outer borders are the medial and lateral heads of the gastrocnemius respectively. The popliteal fossa from top to bottom is: the upper and lower femoral condyles, the posterior part of the knee capsule and the popliteal oblique ligament, and the popliteal muscle. The popliteal fossa contains important blood vessels and nerves, from superficial to deep: tibial nerve, popliteal vein and popliteal artery. The common peroneal nerve also crosses the superior border near the head of the fibula. The tibial nerve is located at the most superficial surface of the popliteal fossa and is divided from the sciatic nerve at the superior angle of the popliteal fossa, descending along the midline of the popliteal fossa to the inferior border of the popliteal muscle through the tendon arch of the flounder muscle and into the posterior region of the calf. The common peroneal nerve is another terminal branch of the sciatic nerve, which generally starts from the superior angle of the popliteal fossa, travels along the medial border of the biceps femoris tendon and downward, crossing the surface of the lateral head of the gastrocnemius muscle to the underside of the fibular head and wraps around the fibular neck, where it divides into the superficial and deep peroneal nerves. The common peroneal nerve is close to the bone surface at the peroneal neck, with no muscle tissue covering the surface. When the common peroneal nerve is injured, it causes paralysis of the muscles of the anterior and lateral groups of the lower leg, resulting in foot drop. The popliteal artery is a continuation of the femoral artery and is located most deeply, immediately adjacent to the popliteal surface of the femur and the posterior portion of the knee capsule. The popliteal artery lies medial to the tibial nerve in the upper part, lies anterior to the nerve in the middle, and turns lateral to the nerve in the lower part. The popliteal vein is formed by the anterior and posterior tibial veins and is located on the deep side of the tibial nerve. The small saphenous vein is located at the inferior angle of the caruncle and injects into the popliteal vein through the popliteal fascia. The popliteal vein ascends to the femoral vein at the fissure of the retractor tendon. What we call popliteal pain is often caused by injuries to the hamstrings (biceps femoris, semitendinosus, semimembranosus), gastrocnemius, metatarsus, popliteus and hallux valgus, so for these patients we generally have the following points that must be addressed: medial femoral condyle – medial head of the gastrocnemius lateral femoral condyle –metatarsal, lateral head of gastrocnemius, popliteus lateral tibial plateau – semimembranosus and popliteus lateral fibula – hallux valgus muscle The following is a description of the above muscular injuries manifested by Symptoms: The popliteus group is composed of the semitendinosus, semimembranosus and the long and short head of the biceps femoris The popliteus is located in the superficial layer of the posterior thigh and is a powerful hip extension and knee flexor with a pike shaped muscle belly. The biceps femoris is the lateral hamstring muscle, divided into the superficial long head and the deep inaccessible short head; the superficial semitendinosus and the deep broad semimembranosus form the medial hamstring muscle, among the tendons of the three muscles, the semitendinosus tendon is attached to the posterior medial tibial condyle and forms the “goose foot” together with the tendon of the femoral book muscle and the tendon of the suture muscle. The function of the biceps femoris is to extend the hip joint, assist in external rotation of the hip joint and posterior tilt of the pelvis; the function of the semitendinosus and semimembranosus is to flex and internally rotate the knee joint and extend the hip joint. Painful injuries to the semitendinosus and semimembranosus muscles are located in the lower hip and its adjacent thigh and along the posterior medial aspect of the thigh and knee, reaching the upper part of the medial calf. In contrast, the semimembranosus muscle ends at the medial meniscus, and sustained contraction causes dysfunction of the medial meniscus; pain from injuries to the long and short heads of the biceps femoris muscle is concentrated posterior to the knee and can extend upward to the posterior lateral thigh and even to the transverse gluteal region. The popliteus is thin and flat triangular in shape and is the base of the distal popliteal fossa. Its proximal fibers attach to the lateral femoral condyle and its distal fibers attach to the proximal tibia and are homologous to the pronator teres muscle of the forearm. Its function is to flex and internally rotate the knee joint and posteriorly pull the lateral meniscus. It is also known as the key to the knee joint because of its role in releasing the knee girdle. Muscle injury pain can be concentrated at the back of the knee. The popliteus muscle stops at the lateral meniscus and continued tension can lead to dysfunction of the lateral meniscus. After a knee injury, there is often hypertonicity due to strain on the ligament or cartilage posterior stop, or shortening due to persistent contraction. Hamstring injuries often manifest as pain and strangulation behind the knee when the patient squats and flexes, runs, or goes up and down stairs. Hamstring damage can further lead to popliteal tendinitis, tenosynovitis, and popliteal vein thrombosis. The gastrocnemius is the most superficial muscle located at the posterior aspect of the calf, covering the flounder muscle, the contours of which are clearly visible at the calf. The origin is located at the medial and lateral femoral condyles forming the medial and lateral heads, which are divided downward into two separate muscle bellies, with the popliteal artery often passing near the medial head. Its tendon fuses with the flounder tendon to form the Achilles tendon, which attaches to the heel bone. Muscle injury pain may extend from the ipsilateral dorsum of the foot to the posterior medial ankle and calf, posterior lateral knee and distal posterior thigh, manifesting as dorsal foot or even arch pain, nocturnal paroxysmal calf spasms and intermittent claudication. Metatarsal muscle: The metatarsal muscle of the pike belly is small, with weak fibers, and is a very small muscle at the back of the knee, with the distal end attached to the heel bone. Its main function is to assist the calf muscle in plantarflexing the ankle joint. Muscle injury pain is mainly concentrated on the posterior aspect of the knee, but can sometimes extend to the dorsal aspect of the calf and mid-thigh. Predisposing factors in life include exposure to cold, prolonged uphill climbing, walking on the beach, hard soles, and prolonged plantarflexion of the ankle joint. It manifests as pain at the back of the knee joint. The hallux valgus muscle is located at the back of the calf, deep in the gastrocnemius muscle, and is mainly attached to the proximal fibula and the posterior side of the mid tibia, and together with the gastrocnemius muscle, it forms the triceps calf muscle and is fused distally to form the Achilles tendon attached to the posterior side of the heel bone. Its main function is plantarflexion. Painful muscle injuries are primarily located on the posterior and plantar surfaces of the foot and often involve the distal Achilles tendon and the posterior aspect of the knee joint. This may manifest as swelling of the foot or ankle, limited dorsiflexion of the foot, or pain behind the knee joint when walking up or down hills. The above-mentioned muscles are prone to cause pain in the popliteal fossa on the posterior side of the knee, and the pulling sensation they describe is nothing more than tightness in the medial and lateral popliteal muscles and the medial and lateral heads of the gastrocnemius muscle. Try to deal with several of these causes and you will receive some results. Note: When dealing with the popliteal fossa, be careful with the tibial nerve and popliteal artery to avoid injury to them.