There are many patients with knee pain, and a significant proportion of them come to the doctor with complaints of popliteal fossa pain. Doctors often ignore patients’ complaints and care only about anterior knee pain and not posterior knee pain, leaving patients without satisfactory treatment. There are four fascial points in the gastrocnemius muscle that can cause symptoms. 1, the first fascia point of the gastrocnemius muscle is located above the calf, one-fifth of the medial head of the gastrocnemius muscle. It causes pain in the lower back of the thigh and the inner posterior aspect of the popliteal fossa, especially in the sole of the foot (pain under the arch). 2.The second fascia point of the gastrocnemius muscle is located in the first third of the lateral head of the gastrocnemius muscle, which causes pain in the lateral popliteal fossa and lateral calf pain. 3.The third fascia point of the gastrocnemius muscle is located at the medial head of the gastrocnemius muscle, below the attachment point of the medial femoral condyle, which is equivalent to the medial side of the transverse popliteal stripe. It can cause pain in the medial popliteal fossa. 4.The fourth fascia point of the gastrocnemius muscle is located at the lateral head of the gastrocnemius muscle, below the attachment point of the lateral femoral condyle, which is equivalent to the lateral side of the inferior popliteal transverse stripe. It will lead to lateral popliteal fossa pain. Injury to the fascial point of the gastrocnemius muscle can lead to calf cramps, especially at night. Causes of injury Overexertion, climbing, bicycling, walking in soft fields, exposure to cold, wearing high heels, prolonged driving. Anatomy The gastrocnemius is a muscle that spans two joints and is divided into a medial and lateral head, with the medial head starting at the medial condyle of the lower femur and the lateral head starting at the lateral condyle of the lower femur and fusing downward with the hallux valgus muscle to form the Achilles tendon. It ends at the heel tuberosity. Innervation: innervated by the tibial nerve, from the L3-S3 nerve. Examination 1.Static assessment: observe whether the gastrocnemius muscle is atrophied and observe whether the ankle is inversion or valgus. 2.Gastrocnemius compliance check: the patient is lying supine facing upwards with the knee joint straightened, ask the patient to do extreme foot dorsiflexion, observe and investigate whether it reaches 30° and whether it induces pain on the posterior side of the calf. If the gastrocnemius muscle becomes short, it will lead to limited dorsiflexion and induced posterior calf pain during dorsiflexion, but the effect of posterior femoral group muscle tension on the gastrocnemius muscle should be excluded. 3, palpation examination: palpation examination has many false positives and requires objective palpation with moderate force. The patient is instructed to lie prone and palpate the medial and lateral heads of the gastrocnemius muscle at the medial and lateral ends of the transverse stripe respectively, the incidence of the medial head is much higher than that of the lateral head, and the sensitive pressure points are concentrated in the medial head of the gastrocnemius muscle, about 10 cm below the popliteal transverse stripe, which corresponds to the upper one-half to one-third segment of the medial head of the gastrocnemius muscle. Treatment 1.Manipulation therapy: for young, short duration of the disease patients manipulation therapy is effective. ① Superficial fascial relaxation method: the patient is in the prone position and the manipulation is performed in the direction perpendicular to the muscle fibers. Each time 5-10 minutes, with stretching. ②Stretching treatment: Ask the patient to stand in the standing position, with the foot following the ground, toes on the wall or steps, knee straight, back straight, stretching the triceps muscle of the calf, the patient feels a pulling sensation on the back side of the calf is appropriate, between 30-50 seconds each time, 5 times as a group, several times a day class. Stretching treatment is suitable after manipulation and acupuncture treatment. 2, acupuncture treatment: patient prone position, acupuncture treatment on the sensitive fascia points at the muscle belly, pay attention to observe the beating of the muscle, most of which occurs in the superficial layer. The direction of needle: can be in the sensitive fascial point on the vertical needle, and to look around the beating point. 3, silver needle treatment: silver needle cloth needle point is located over the transverse striae both ends of the upper and lower 10 cm can be cloth needle, equivalent to silver needle popliteal after the cloth needle area. Pay attention when entering the needle medially, do not injure the popliteal artery and tibial nerve. Pay attention to the pressure for 3-5 minutes after the needle is released to prevent hematoma.