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Knee Rehabilitation / Strength Training for the Knee

 This handout is to help you rebuild the strength of the muscles surrounding the knee after

injury. It is intended as a guideline to help you organize a structured approach to

strengthening the knee.

 Precautions When Exercising

 

·    Avoid pain at the patellar tendon

• Avoid pain and/or crepitus (grinding) at the patella (kneecap)

• Build up resistance and repetitions gradually

• Perform exercises slowly, avoiding quick direction change and impact loading

• Exercise frequency should be 2 to 3 times a week for strength building

• Be consistent and regular with the exercise schedule

Before Staring Your Workout

 • Warm-up prior to exercising by stationary cycling, elliptical machine or treadmill

• You are “warmed – up” when you have started sweating

• Gently stretch all muscle groups next (see attachment for recommended stretches)

• Do exercises involving multiple muscle groups

• Do aerobic workouts after strength workouts

• Cool-down by stretching after exercise

 

Progressive Resistance Exercise (PRE) Principle

 

• To build muscle strength and size, the amount of resistance used must be gradually increased

• The exercises should be specific to the target muscles

• The amount of resistance should be measurable and gradually increased over a longer period of time

• To avoid excess overload and injury, the weight or resistance must be gradually increased in increments of 5 to 10 %

• Resistance can be increased gradually every 10 to 14 days when following a regular and consistent program

• Adequate rest and muscle recovery between workout is necessary to maximize the  benefit of the exercise

• If the PRE principle is followed too strictly, the weights potentially will go higher and higher

• At a certain point, the joints and muscles will become overloaded and injury will occur

• This eventuality can be avoided by refraining from using excessive weight during strength training

 

Basic Knee Strengthening Program

 Emphasis is to build muscle strength using BOTH legs. Progress according to the PRE principle 

Frequency: 2 to 3 times per week, 3 sets of 10-15 repetitions 

Basic Program Exercises (see illustrations at the back of the handout)

• Leg Press

• Hamstring Curl

• Knee Extension Machine

• Wall Slides (hold dumbbells for resistance)

• Roman Chair (hold dumbbells for resistance)

• Chair Squat

• Calf Raises

• Hip Abductor/Adductor machine

• Step Up/Down (see attachment for progression) 

If you do not have access to gym equipment, the following exercises can be substituted

using ankle weights (see illustrations and instructions attached):

• Straight leg raise

• Short-arc lift

• Side lying abduction

• Standing hamstring curl

• Toe raises 

In General, the Basic Knee Strengthening Program is good for most people who are active recreationally, but who do not participate in running and jumping sports. For people who will participate in running and jumping sports, the following Advanced Knee Strengthening Program can be used to develop a higher level of knee strength.  

Watch video on Medicine website: http://www.massgeneral.org/sports/protocols_therapy_videos.html

Advanced Knee Strengthening Program 

Emphasis is to continue to build muscle strength using both legs and progress to Advanced Exercises using the Single leg. These exercises are integrated with the exercises from the Basic Knee Strengthening Program. 

Frequency: 2 to 3 Times per week, 3 sets of 10 repetitions 

The following single leg drills are integrated into the workout on a rotating basis:

• Step Up/Down

• Single Leg Wall Slide

• Single Leg Squat (see attachment for progression of single leg drills)

 When starting the new single leg drills, start with 3 sets of 5, and add one repetition per set, per workout until you can do 3 sets of 10. When 3 sets of 10 are easy and pain free, then you can hold dumbbells to increase resistance and strength. So that the Advanced Knee Strengthening Program would be as follows: 

• Leg Press

• Hamstring Curl

• Knee Extension Machine

• Wall Slides (hold dumbbells for resistance)

• Roman Chair

• Chair Squat (hold dumbbells for resistance or barbells)

• Calf Raises

• Step up/down

• Alternate workouts with single leg wall slide and single leg squat

Precautions:

Knee extension machine (quadriceps extensions): while providing effective exercise for the quadriceps muscles, this exercise places high levels of stress on the kneecap joint. Please use caution and stop using this machine if you are experiencing any pain, clicking or grinding in the knee. 

Roman Chair: to avoid injury, proper technique with good abdominal and low back control is very important with this exercise. Do not perform this exercise if you have a history of low back injury or are experiencing any low back pain.

 

The following exercises can cause injury and should be performed with caution:

• Stairmaster or stair climber machines

• Lunges

• Squats beyond 90 degrees of knee flexion

• High impact and plyometric exercises

 

If you have any questions regarding the exercises contact us or your nearby physiotherapist.

             Leg Press                                             Hamstring Curl

           Knee Extension                               Abductor Adductor strengthening

 

                   

                     Calf Raise                                                 Roman chair

                  Straight leg lift                                           Short arc lift Hams

                        

           Hamstring Curl                                                        Side leg lift

 

Calf Stretch     Quadriceps stretch       Hamstring stretch       ITB stretch

 

 

 

 

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