Fremnt Knee Facts The knee lses strength and stability after an injury. Stretching, strengthening and stability exercises are recmmended nt nly fr peple wh have injured their knees, but als t prevent injury. Hw can this class help? The purpse f this class is t have yu begin a series f hme exercises. Please review the instructins and perfrm the exercises as prescribed (frequency, number f repetitins). These exercises shuld be perfrmed regularly fr three weeks. If yur symptms feel wrse with any exercise, stp ding the exercise until yu check with yur physical therapist r yur dctr r call the Fremnt Physical Therapy Department at 510-248-3200 t schedule an appintment with a physical therapist. Class Gals: Present a brief verview f the anatmy f yur knee Present an verview f the causes f yur knee pain Instruct yu in exercises fr recvery: stretches, strength and aerbic exercises Discuss hw yu will manage flare-ups Anatmy f yur knee Bnes: Femur, Tibia, patella, fibula Jints: Knee jint, Patell-femral jint Ligaments: Ligaments are strng bands that help hld the bnes tgether. Muscles: The muscles surrunding yur knee give it supprt and allw yu t mve. Eg: Hamstrings, Quadriceps, Calf What causes knee pain Knee Strain/Sprain - When muscles, ligaments r meniscus are injured due t trauma. Degenerative jint disease (Knee Ostearthritis) cartilage lss. 1
Fremnt Patellfemral Syndrme (PFS) cmpressin f the kneecap. STRETCHING EXERCISES Quadriceps stretch: Standing Hld n t a chair, cunter r wall. Bend yur ne knee back and grab yur ankle. Gently tighten yur buttcks until yu feel the stretch dwn the frnt f yur thigh. Hld fr 30 secnds. Repeat 2 times. Frequency: 1-2 times/day OR Quadriceps stretch lying n stmach: Place a strap arund the ankle f the leg yu want t stretch. Tighten yur buttcks. Bend yur knee and gently pull n the strap until yu feel a stretch n the frnt f yur thigh. Hld fr 30 secnds. Repeat 2 times. Frequency: 1-2 times/day Standing ITB stretch: Stand next t a chair r a wall, abut 1-2 feet away. Crss yur uter leg in frnt f yur inner leg. Lean away frm yur inner leg. If yu are standing next t a wall, yu can lean yur hip int the wall fr balance. Hld fr 30 secnds. Repeat 2 times. Frequency: 1-2 times/day 2
Fremnt Standing Hamstring Stretch: Place yur ft n a chair in frnt f yu. Slwly straighten yur knee until yu feel a stretch in the back f yur thigh. Stick yur buttcks ut backwards t increase the stretch. Hld fr 30 secnds. Repeat 2 times. Frequency: 1-2 times/day Calf Stretch: Stand facing a wall with yur hands n the wall at abut eye level. Place the leg yu want t stretch abut a step behind yur ther leg. Keeping yur back leg straight and yur back heel n the flr, bend yur frnt knee and gently bring yur hip and chest tward the wall until yu feel a stretch in the calf f yur back leg. Hld 30 secnds. Repeat 2 times. Perfrm 1-2/day. 3
Fremnt Sleus Stretch: Stand facing a wall with yur hands n the wall at abut eye level. Place the leg yu want t stretch abut a step behind yur ther leg. Keeping yur back knee bent and yur back heel n the flr, bend yur frnt knee and gently bring yur hip and chest tward the wall until yu feel a stretch in the calf f yur back leg. Hld fr 30 secnds. Repeat 2 times. Frequency: 1-2 times/day STRENGTHENING EXERCISES Quadriceps Set: Place a small twel rll under yur knee. Straighten yur knee by tightening yur thigh muscles. Press the back f yur knee int the flr r twel and hld fr 5-10 secnds. This may als be dne sitting. Repeat 3 sets f 10 repetitins, 3 times/week Shrt arc quadriceps set in supine: Lie n yur back with a large twel rll under yur knee. Tighten yur thigh muscles and lift yur heel ff the grund. Keep yur knee n the twel rll as yu hld yur leg as straight as pssible fr 5 secnds. Repeat 3 sets f 10 repetitins, 3 times/week 4
Fremnt Straight Leg Raise Supine: Lie n yur back with yur affected leg straight and yur ther leg bent. Tighten yur thigh muscle then lift yur straight leg n higher than the ther knee withut allwing yur knee t bend. Keep yur thigh muscles tight while yu lwer yur leg. Repeat 3 sets f 10 repetitins, 3 times/week Step up: Stand with ne ft n the step and ne ft placed behind yu n the flr. Raise yurself up n the step. Keep yur stmach and buttck muscles tight and yur pelvis level. Repeat 1 set f 10 repetitins, 3 times/week 5
Fremnt Step dwn t the side: Stand n ne leg clse t the edge n the step. Bend the knee f yur standing leg and tuch the tes f yur ther leg t the flr. Extend yur knee t return t standing. Keep yur stmach and buttck muscles tight and yur pelvis level thrughut the exercise. Repeat 1 set f 10 repetitins, 3 times/week Wall Squat: Stand with yur back t the wall and feet abut 12-18 inches away. Perfrm a small squat, making sure yur knees stay ver yur ankles. Hld the psitin fr 5-10 secnds. Return t standing and repeat. Repeat 1 set f 10 repetitins, 3 times/week Standing Calf Raises Prgressin Use bth feet t rise up nt yur tes and lwer the heels slwly. Assist with the unaffected side s that there is n pain in the affected side. The affected side may d mst f the wrk at this stage. Repeat 1 set f 10 repetitins, 3 times/week 6
Fremnt Balance Exercises with r withut supprt. Hld 30 secnds. Repeat 3 times. Yu can prgress this exercise by: Standing n ne ft Turning yur head left and right while yu maintain yur balance. Clsing yur eyes while yu maintain yur balance. Standing n a sft surface such as a fam pad, pillw. Hamstring Curls Stand n ne leg with yur knee slightly bent. Keep yur stmach and buttck muscles tight and yur pelvis level. Hld n t the back f a chair fr balance. Bend yur ther knee up and dwn, lifting yur heel tward yur buttcks. D nt let yur knee mve frward r backward as yu bend it. Repeat 1 set f 10 repetitins, 3 times/week 7
Fremnt Starting an Exercise Prgram Respect yur pain Yu will cntinue t have gd and bad days Back ff a little n bad days D nt increase exercises just because it is a gd day Success cmes frm being cnsistent Avid reacting t much t daily changes Mnitr the cumulative effects f ther daily activities Stressful activities Running: 6-11 times bdy weight Squatting: 5-8 Times bdy weight Climbing Stairs: 3.5 times bdy weight Jumping Leg extensin machines Less Stressful activities Biking n level surfaces r statinary bike Walking n level surfaces Swimming with flutter kick Exercise fr recvery Stretching Strengthening Aerbic exercise Begin an aerbic prgram Walking is an easy way t start D sme walking every day Start at a time and distance that yu can cmplete easily. Start with a 5-minute walk and add 5 minutes t yur time as tlerated. Yur gal is t reach 20-30 minutes f walking every day. This may be yur mst imprtant exercise. Strengthening guidelines Start withut weight. Perfrm 10 t 15 repetitins. Perfrm 3 sets f each exercise. Exercise 4 t 5 times per week. Add weights nce yu have achieved the exercise level abve. Avid pain r any discmfrt (during r after the strengthening exercises) D nt perfrm exercises which aggravate yur symptms. D nt hld yur breath during exercises. 8
Fremnt Next Steps: Begin yur exercise prgram tday Strengthening exercises. Aerbic exercises (walking, biking) If the exercises make yu wrse: Have yu dne the exercise crrectly? Have yu dne t many repetitins? Have yu exercised t vigrusly? Be patient. It is nt always realistic t expect t eliminate all f yur pain. It can take 2-3 mnths t create change. Tips fr managing flare-ups Place a cld r heat pack n yur knee fr 10-15 minutes t help with the pain. Place a thin clth layer between the skin and the cld r heat pack. Repeat this several times per day when it is flared up. Take yur medicatin as prescribed Wear supprtive shes: Gd arch supprt and supprtive shes decrease pain with activities by achieving gd alignment. Avid nn-supprtive shes like, flip flps, sandals and high heels. Mdify yur activities: Limit repetitive r excessive amunts f activities that increase pain. Cmpressive activities like squatting, stairs, running, and jumping put the mst pressure n yur knees. Replace these activities with less cmpressive activities such as biking, swimming, water aerbics and the elliptical trainer. Begin with 5 minutes, prgress t 20 minutes, as able. Use a pad under yur knees when kneeling. Change yur leg psitin ften when sitting. Take frequent breaks. Questins??? Thank yu!! Department, Kaiser Fremnt 9
(510) 248-3200 Knee Class Fremnt 10