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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