Knee Exercises

Rehabilitating a damaged knee can be difficult. Many times exercises can aggravate or irritate the knee cap and increase pain. In an effort to deal with this problem we have devised the following knee exercises. The exercises are into three groups. You should begin with group one. When group one can be done easily and without pain you can proceed to group two. When group one and two can be done easily you can proceed to group three.

GROUP 1 EXERCISES

1. Isometric quadriceps contraction

2. Straight leg raise without weights

3. Hip abduction strengthening

4. Hip Adductor strengthening

Straight Leg Raise Without Weights

Position: Initially the exercise should be done while Iying down. Once the exercise can be done comfortably Iying down, you can do the exercise sitting. The opposite leg may be bent to a position of comfort but not more than 30 degrees.

Repetitions: Start with ten repetitions. Do the exercise very slowly. Increase the number of repetitions by one per day for the first week. After the first week increase the number of repetitions by 20% per week.

Exercise: Contract the muscle by isometrically by contracting the quadriceps muscle (as you did in the first exercise). After a two count ( one thousand, two thousand ) begin slowly lifting the leg. Do not bend the knee more than 30 degrees. Lift the leg to at least 45°. Going higher than 45° will stretch the back of the leg but will not add to quadriceps strengthening.

Hip Abductor Strengthening

Position: Lying on your side. Leg straight or the leg may be bent to the position of comfort.

Repetitions: Start with five repetitions. Increase by one per day for the first week. Then increase by 10% per week after the first week.

Exercise: Slowly lift the leg sideways raising the leg. Obtain an angle of at least 30 degrees. Hold the leg in that position for a count of two (one thousand, two thousand). Ankle weights can be added when you can do at least 25 repetitions with ease. Start with a one pound weight. Add weight in one pound increments

Hip Adductor Strengthening

Position: Sitting.

Repetitions: This exercise can be done to your hearts content. It has no potential to increase your knee pain.

Exercises: Sitting with the knees touching and feet slightly apart. Push the knees together tightly. Hold for a count of 5 then relax. Repeat as tolerated.

GROUP TWO EXERCISES

1. Straight leg raise with weights

2. Leg extension

3. Isometric quadriceps strengthening

4. Hamstring strengthening- quadriceps stretching

Straight Leg Raise with Ankle Weights

Position: Same as straight leg raise without weights. Exercise may be done sitting or Iying down. Opposite leg may be bent or straight.

Repetitions: Start with five repetitions. Increase as with straight leg raise without weights.

Exercise: This exercise is done exactly the same as the straight leg raise without weights except that one adds ankle weights. Start with a two pound weight. When you can comfortably do 25 repetitions increase to three pounds. Remember that increasing two to three pounds represents a 50%increase in weight. From three pounds go to five pound by using the two and three pound weights together. From five pounds go to seven and then to ten pounds.

Weight recommendation: Use a 2 lb., 3 lb. and 5 lb. ankle weight
None—2 Ib.—3 Ib.—5 Ib.— 7 Ib.—10 Ib.

Leg Extension Exercises

Position: Sitting. A stool or bench may be used to rest the leg at the bottom of the bent position.

Repetitions: Start with ten repetitions with no weight. Increase repetitions until you reach 25. Then add ankle weights as follows:

2 Ib.—3 Ib.—5 Ib.—7 Ib.— 10 Ib.—15 Ib.—20 Ib..—25 Ib.

Increase the weight when you can do 25 repetitions.

Exercise: The starting position is sitting with the leg straight out in front of you. Slowly bend the leg to 45 degrees. The knee should not bend beyond 45 degrees because this may cause increased knee cap pain. After 45d egrees is reached reverse directions and begin straightening the knee. When full extension is reached hold the leg straight for a count of two. Then start the exercise over again.

Isometric Quadriceps Strengthening

Position: Sitting. One leg on top of the other

Repetitions: Start with ten repetitions. Increase the number of repetitions as your strength increases.

Exercise:

Part 1: Start with your right leg straight. Put your left leg and foot over the top of the right leg. Push down with the left leg and up with the right leg. Hold the contraction for a count of three. Relax for a count of two, then repeat the exercise.

Part 2. Repeat the same exercise with the knee bent 30&Mac176;.

Part 3. Repeat the same exercise with the knee bent 45&Mac176;.

Part 4. Repeat the exercise with the left leg on the bottom and the right leg on top.

Hamstring Strengthening - Quadriceps Stretching

Position: Lying face down.

Repetitions: Start with ten repetitions. Increase the number of repetitions one per day until you reach 25. Then add weights as follows:

31b.—51b.—71b.—101b.—151b. —20 Ib..—25 Ib.

Exercise: Lying face down start bending the affected knee. Slowly bend the knee until you feel pain or a pulling sensation. Hold that position for a count of 3. From that posi tion try to increase the amount of bend in your knee by contracting the hamstring muscles. The hamstring muscles are the muscles on the back of your leg. Pull as hard as you can tolerate then relax. Repeat the exercise again. Both legs should be exercised.

GROUP THREE EXERCISES

1. Hip Abductor stretching.

2. Hamstring stretching.

3. Standing press.

4. Quadriceps stretching.

Hip Abductor Stretching

Position: Lying on your side at the edge of a bed or exercise table. Your back should be toward the edge of the table.

Repetition: Start with ten repetitions. Increase as tolerated. Beware: if you are out of shape this exercise will cause you to be stiff the day after the exercise.

Exercise: Position yourself at the edge of a bed or table. Your back should be facing the edge of the table. Drop the upper leg behind you and let the leg drop down as far as it will go. Let the leg hang down over the edge of the table or bed. Let the leg hang down as long as it is comfortable. (From this position raising the leg strengthens the hip abductor muscles.)

Hamstring Stretching

Position: Sitting at the side of a bed, chair or table. The left leg is placed on the bed, the right leg is bent over the edge of the bed. The leg being stretched is straight. The leg not being stretched is bent. This position will avoid stressing the back.

Repetition: Repeat the exercise at least ten times. Increase the force and number of repetitions of the exercise as tolerated. Do no more than 25 such stretches at a time.

Exercise: Sit on the side of a bed, one leg over the edge of the bed the other straight in front of you. Lean toward the outstretched leg attempting to touch your toes. Keep your back straight. Do not bend your head for ward. If you can touch your toes then go beyond. When you feel the pulling at the back of your knee slow the stretch down and hold that position for a count of three. Then increase the stretch by leaning farther toward your toes. Go as far as you can and hold for a count of two. Release the stretch slightly for a count of three and then lean back into the stretch. Try not to let the tension completely off of the hamstring during the rest periods. In that way the hamstring will be under stretch throughout the exercise.

Standing Press

Position: Standing leaning against a wall.

Repetition: Start out with ten repeti tions. Increase both the length of time that you maintain the position and number of repetitions as tolerated. Increase one repetition per day for the first week then by 10% per week thereafter.

Exercise. Start by leaning against a wall. Bend your knees allowing you body to slide down the wall. Initially slide down the wall until your knees are bent 15 degrees. This may not seem like a lot but this exercise can be very irritating to the patella and you must proceed with caution. Once at 15 degrees hold that position for a count of 5, then slide back up the wall to the standing position. There are two parts of this exercise that can be increased. The first is the length of time that you hold the position at the bottom of the press. The second is the distance you descend the thus the amount of bend in your knees. Both should be increased slowly. Increasing the amount of knee bend is more likely to increase knee pain.

You should not bend your knees greater than 45 degrees. Further flexion (bend in your knees) can cause increased patellar pain.

Quadriceps Stretching

Position: Lying face down.

Repetition: Do no more than ten of these stretches. This exercise puts a lot of stress on the patella.

Exercise: Lying face down grab your ankle by reaching behind you. Pull the ankle toward your buttocks. Increase the pull for a count of 3. Relax for a count of 2 then repeat.