title: Popliteus strain with concurrent deltoid ligament sprain in an elite soccer athlete: a case report.
abstract: METHODS
  Case Report (Differential diagnosis).
  
  
  OBJECTIVE
  Differential diagnosis of knee pathology after trauma may be difficult when diagnosing an isolated popliteus strain and concurrent medial deltoid ligament sprain. Upon a thorough search of the published literature, the authors found no reports delineating a popliteus strain in professional soccer in the United States. The joints most affected by injury in soccer players are the knee and ankle joints. The purpose of this case report is to describe the presentation of and difficulties encountered in diagnosing a popliteus strain in a Major League Soccer athlete.
  
  
  METHODS
  During an in-season away game, an outside defender was slide-tackled from behind when his right shank was caught in an externally rotated position underneath himself and the opposing player. The initial point of contact was made to the proximal third of the posterior right shank with an anteromedially directed force. The medial longitudinal arch of the foot was forced into a more midfoot pronated position and the subtalar joint was forced into eversion.
  
  
  METHODS
  The athlete was diagnosed with a moderate strain of the right popliteus muscle with a concurrent medial deltoid ligament sprain of the right ankle. This mechanism of injury, pain with passive knee flexion and internal rotation during McMurray's test, pain with Garrick's Test and magnetic resonance imaging (MRI) study confirmed the diagnosis. The athlete returned to full ninety-minute game participation after an intensive 15-day rehabilitation program.
  
  
  CONCLUSIONS
  This case is unique because the injury manifested itself at multiple joints and specifically involved the popliteus muscle. The mechanism of injury can be associated with many other soft tissue injuries to the knee, and thus, may not lead the clinician initially to consider the diagnosis of a popliteus strain. Diagnosis of this entity may be difficult due to the possible shared attachment of the popliteus muscle to the lateral meniscus, and the lack of available testing methods to assess damage to the popliteus muscle.
  
  
  METHODS
  Level 5.
authors.affiliation: Student Physical Therapist, Duke University Durham, NC, USA.
authors.forename: Cody James
authors.initials: CJ
authors.lastname: Mansfield
authors.forename: Josh
authors.initials: J
authors.lastname: Beaumont
authors.forename: Lorena
authors.initials: L
authors.lastname: Tarnay
authors.forename: Holly
authors.initials: H
authors.lastname: Silvers
keywords: Ankle; differential diagnosis; knee; professional athlete; soccer