Knee Rehab - Stabilize the Knee to Prevent Injury
The knee is one of the most utilized and injured joints in our body. If you are a professional athlete, fitness fanatic, or generally active individual, you need to read this knee rehab article. Working out with a proper stability and stretching program for the knee will help prevent injury and improve this vital joint’s function.
Knee Rehab – Help Prevent a Lax Joint
Everyone knows the importance of stretching after a workout, but is there ever too much of a good thing? Well, like all things, the answer is … that depends on a variety of factors. Flexibility is a very desirable and necessary thing, however, when people over do flexibility training the effect is joint laxity. Joint laxity can create a perfect storm for injury by causing instability.
It is important to remember to focus on dynamic stretches at the beginning of a workout such as leg swings, standing alternating knee raises (knee to chest), quick feet, leg swings, walking lunges, skaters and toe pointers; to name but a few. Actively warming up the knee joint is an essential part of an athletic knee rehab program. However, static stretches, where the joint is held in place for 20 to 60 seconds is meant to increase the muscle length and must be left to the end of the workout. Doing static stretches at the beginning of the workout activates the Golgi tendon organ which relaxes the muscle as opposed to warming it up, thus increasing the risk of injury during a workout due to instability.
What Needs to Be Strengthened?
The knee is a very complex joint and knee rehab needs to be specific. Comprised of a network of muscles, tendons and ligaments, the dynamic stabilizers of the knee include: the quadriceps femoris and extensor retinaculum, pes anserinus, popliteus, biceps femoris and semi-membranous.
The superficial medial collateral ligament (MCL) is the most important medial stabilizer of the knee (inner side); whereas the lateral collateral ligament’s importance is that it permits the attachment of the lateral meniscus to relax the supporting ligaments in flexion allowing rotation.
The anterior cruciate ligament (ACL) is to inhibit anterior instability with hyperextension and internal and external rotation. The posterior cruciate ligament (PCL) is to inhibit posterior instability in the flexed knee position.
Adductors of the Inner Thigh
The medial knee is more susceptible to injuries such as an ACL tear when there isn’t adequate adductor strength.
A knee rehab exercise for this muscle is a Side Lying Inner Leg Lift. Perform this exercise by starting on your side, stretch out your bottom leg, and bend your top knee 90 degrees placing the leg in front of you on the floor. Exhale, lift the bottom leg up until you feel a contraction in the adductors, then inhale as lower it back down but do not let it touch the floor. Repeat for 12 to 15 repetitions, add an ankle weight to create more resistance, complete 2 to 3 sets on each leg.
Balance Tension in the Knee with Hamstring Strength
A common knee problem is an imbalance between the quads and hamstrings; weakness of the hamstring is a primary cause of injury. The hamstrings create flexion of the knee and help prevent hyperextension. Therefore, if you fall and have an imbalance, it increases the risk of injury.
Stability ball curls are an excellent way to create strength and balance in the hamstrings while also activating the proprioceptors. The body’s inability to facilitate proprioception is a primary cause of injury.
Perform the knee rehab Ball Curl by lying on your back with your feet on a stability ball, hip width apart, and the knees slightly bent. Activate your lower pelvic floor muscles and then roll your hips off the floor one vertebra at a time, until your back is straight and the knees still have the gentle bend. Maintain the hips and spine in a neutral position elevated off the ground and bent your knees until they reach 90 degrees. Perform 8 to 12 repetitions for 2-3 sets.
Leg Abduction is an Indirect Influence of Knee Stability
The leg abductors are a group of four muscles located in the lateral hip and buttock areas. They are comprised of the Gluteus Maximus, Gluteus Medius, Gluteus Minimus and Tensor Fascia Lata. When there is an imbalance, it can change your gait which causes pain due to poor form.
To strengthen the abductors, one of the most powerful exercises is the robot walk (watch the video). Start off with circular tubing around your ankles. Start off with light tension; your legs should be shoulder width apart. Once you have a proper tension, shift your weight onto one foot and raise your other leg sideways in the air. When you shift from one foot to the other, make sure you keep the tension consistent. Pause for one second in this position, then move to the other side. Repeat this “pendulum-like” side step for 8-12 repetitions on each side for 2-3 sets.
The Vastus Medialis is Responsible for Leg Extension
The vastus medialis runs along the front of the medial or inner thigh. It is part of the quadricep muscle group and is frequently called the VMO, which is the portion that is just above the knee. The VMO helps to extend the knee and stabilizes the kneecap. When the vastus lateralis and rectus femoris are dominant or stronger, it can cause the kneecap to track to the side which causes pain and instability.
To strengthen the vastus medialis do single leg quarter squats. Perform this knee rehab exercise by standing on one leg and gently bend the knee until you are at a 45-degree angle or less, if you have pain. When dealing with pain stay in pain-free range of motion. Perform 12 repetitions on each leg and do 2 – 3 sets. Use a wobble board or Bosu to increase intensity and create more instability.
The Popliteus is Small Muscle that Bends Your Knee
The popliteus is a small, flat, triangular muscle in the posterior compartment (behind the knee) of the lower leg region. It resides in the lower part of the popliteal fossa or in the hollow located just behind the bone forming the knee joint.
The popliteus works when the knee flexes causing the femur to rotate on the tibia laterally. One of the functions of the popliteus is to stabilize the back of the knee. Another responsibility of the muscle is to pull the lateral meniscus dorsally, which prevents it from getting trapped.
To strengthen the popliteus, do a reverse heel tap. Perform this knee rehab exercise by using a resistance band, attach one end to a low, stable surface then attach the other end to your foot by wrapping the handle around the front of the foot around the toes. Stand with your feet together and hold onto something if you need help with stability. Bend you knee and bring your foot behind you and attempt to touch the heel to the opposite hip. This action flexes the knee and internally rotates the knee which strengthens the popliteus. Return to the starting position and repeat for 15 repetitions on each leg for 2 – 3 sets.
Expand Your Knowledge about the Hip, Knee and Ankle Rehab
Learn more about explaining and implementing the general exercise rehabilitation guidelines and exercise prescription for a variety of common conditions related to the hip, knee and ankle. Andre Noel Potvin, MSc., demonstrate and teaching corrective exercises for a variety of common conditions. You will leave this workshop with the ability to explain and implement the general exercise rehabilitation guidelines and exercise prescription for a variety of common conditions and know when to refer to other health professionals.
Cathie Glennon – BCRPA/SFL, Rehabilitation Specialist, Pharm Tech (Level 3)