Saturday, 6 November 2010

Knee Prehab/Rehab

Knee injuries are a common complaint in several sports. As the knee joint is one of our weightbearing joints and takes a lot of out load when walking, running etc, it may not be difficult to understand why it is so vulnerable to injuries. I know a lot of people who have suffered severe knee injuries such as ACL rupture, PCL rupture and I know the rehab from these injuries can be tough and last for months. I will therefore explain some simple exercises that can help strengthen the knee and therefore reduce the chances of experience long lasting knee injuries. Before I go on and describe some basic knee exercises I will describe in an easy way the build up of the knee.
The knee joint is the articulation of the femur and tibia (tibial femoral joint) and the femur and patella (patella femoral joint). The kneejoint consist of several ligaments that are there to stabilise the knee: the Medial and the Lateral Collateral Ligament are on the inside and outside of the knee and they are there to prevent sideways movement of the knee. Inside the knee there are two cruciate ligament: the Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). The ACL is there to prevent hyperextension of the knee and the PCL is there to prevent hyperflexion of the knee. In the middle of the joint there are meniscus that acts as a shock absorber within the joint, these help to absorb some of the impact on the knee. The knee is a hinge joint which means it mainly allows for flexion and extension (bending and stretching), with limited sideways movement. As you can tell the knee joint is a complex joint with several structures that could get injured, which is why I wanted to explain some simple balance and strength exercises that can help you improve your knee stability and strength.

Please be aware that if you have sustained a knee injury you should get it checked and identified by a qualified therapist or doctor prior to starting these exercises.

Purpose: To improve knee stability and strength

Suitable for: Everyone who wants to improve their knee stability and strength
Equipment needed: A foam roller, balance pad, a box/chair, a gym ball, balance mat and a wall

Repetitions and sets:

3 sets per exercise

10 - 15 repetitions per exercise

120-180 seconds recovery between sets

Picture 1- Start
  The workout

1. Foam rolling for your quadriceps (front of thighs)

• Place the foam roller under your thighs, start just above your knees

• Place your hands in front of you to hold yourself off the floor (Picture 1)

• Now roll the front of your thighs on the foam roller, start above your knees to the top of your hips (Picture 2)

• If you find a tender spot, apply a bit more pressure and roll back and forwards over the tight spot
Picture 2- End

• To increase the pressure further, cross one leg on top of the other, which means you only have one thigh on the foam roller at the time

• Roll for 45 - 60 seconds on each thigh

2. Wall squats with gym ball

• Start by placing the gym ball between your back and the wall

• Place your feet about hip width apart with your toes pointing forward

• Place your arms onto your hips for support

• Squat down with the ball rolling down against your back by bending your knees till you reach 90° with your knees

• Make sure you keep your abdominals pulled in, your chin parallel to the floor and your back firmly against the gym ball

• Stand up to the starting position by squeezing you gluteus and extending your knees

• Focus on keeping the same distance between your knees all the way throughout the movement

• Repeat this 10-15 repetitions

 3. Hop and hold

• Imagine you have a square with 4 smaller squares in front of you on the floor (each square around ½ metre long)

 • Lift one leg of the floor so you are standing on one leg (have a slight bend in your knee) 
Picture 1- From the side

• Jump on one leg into the first square in front of you, you should bend in your knee to secure a smooth landing (Picture 1)

• Make sure your knees are pointing forward in line with your toes

• Hold this landing position for 2-3 seconds, then jump forwards into the square in front of you, and then sideways into the square next to you

Picture 2 - From the front
• Then jump backwards into the square behind you, then sideways into the square you started in

• Make sure you keep your chest out to avoid your upper body dropping too far forwards

• You can hold your hands in front of your body to counterbalance

• Go through this 3 rounds with each leg (this is one set). Repeat this 3 sets

4. Lunge on balance mat 

Picture 1- From the front
Picture 2- From the side
• Start by standing with your feet about hip width apart on the floor

• Pull your abdominals in and keep your chest out prior to starting

• Place your hands on your hips for support

• Step forward onto the mat in a lunge position by bending both knees. Your front knee should not cross the line of your toes and your back knee should just touch the floor gently (Picture 1)

• Push your legs back up and step back to the starting position, repeat with the other leg

• Repeat 10-15 steps on each leg

Picture 1- Starting position
 5. Single leg squat off a box

• Step onto a box/bench or a solid chair (that do not move!)

• Place one other leg over the edge of the side of the box whilst keeping the other leg planted solid on the box (Picture 1)

• Squat down with one leg to about 90° in your knee, keeping the leg outside the box straight

• It would be ideal to do this in front of a mirror to check that you knee is not moving inwards, but in a straight line

Picture 2- During the movement
• You can hold arms in front of you to counterbalance if necessarily

• Make sure you keep your abdominals pulled in and your chest out

• Do 8-10 repetitions on each leg

Picture 1
6. Balance on bosu ball/balance mat

• Start by standing on a bosu ball or and exercise mat with your feet hip width apart (ideally this should be done in socks or barefoot)

• Lift one leg of the floor so you are now standing on just one leg (Picture 1)

• Place your hands out to the side to balance if needed
• Have a bend in the knee on the leg you are standing on and keep your chest up

•  Hold your balance for 45- 60 seconds

• When you are done with one leg, change over to the other leg and repeat

Picture 1- Start
7. Hip clam

• Start in side laying on the mat, with your legs on top of each other

• Bend your legs to 45° with your heels in line with your bottom (Picture 1)

• Place your elbow on the floor and rest your head onto your hand for support

Picture 2- Hold Position

• Rotate the top leg backwards until you can feel the outside of your top glut working, hold this position for 5-10 seconds and lower back down

• Make sure your toes and heels are in contact throughout the exercise

• Do 8-10 repetitions and turn over to the other side and repeat with the other leg


Always warm up with 5- 10 minutes of easy mobility movements such as body weight squats, walking lunges, side lunges, spidermans, hamstring walkout etc (Look at previous blogpost on mobility exercises if you are unsure how to do these) Always cool down after the workout with 5-10 minutes of stretching for the main muscles used in the work out. In particular quadriceps, hamstrings, hip flexors and gluteus. Hold each stretch for 20-30 seconds and do 2-3 sets of each stretch (Look at previous blogpost for explanation of stretches if you are unsure how to perform the stretches)

Lets keep our knees strong and injuryfree as we need them for a long time!:)

Have a good weekend everyone!



Kine said...

I love this blog post about how to prevent and rehab a knee injury:) My instructor at the gym also just told me about how effective the foam roll is to your knee.. Continue the good work you are doing:)

Monica Torland said...

Thanks Kine, really appreciate that:) Let me know how your knee is doing and I would be more than happy to give you any help or advice if you need:)

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