Knee exercises. Having great knee control is when an individual is able to stabilise and maintain positioning of the knee joint during every day tasks and in demanding situations such as the gym environment or on the sporting field. When poor knee control is a concern a shearing force occurs on the knee, known as knee collapse or valgus, therefore increasing chance of injury and leading to degeneration of the passive structures of the knee such as the meniscus and ligaments.

The dynamic stablisers of the knee can be influenced through appropriate strength training and are of vital importance in normal knee joint function. These dynamic stabilisers include the muscles of the anterior compartment and the posterior compartment, such as:

  • Anterior
    • Vastus lateralis
    • Rectus femoris
    • Vastus medialis
    • Vastus intermedialis
  • Posterior
    • Biceps femoris
    • Semimembranosus
    • Semitendinosus
    • Gastrocnemius

During knee rehabilitation it is not enough to just strengthen the muscles by performing knee exercises. We also need to look at the body as a whole. The knee is essentially a slave to the hip and the ankle so it is important to identify muscle imbalances, blockages and leakages throughout the entire kinetic chain so that poor biomechanics does not occur. Two common weaknesses we see when an individual has poor knee control are weak gluteal muscles and poor foot mechanics such as a collapsed arch (excessive pronation).

 

“Lumbopelvic rhythm is important to learn early to introduce the correct bending movement pattern (hip hinge) and allow for utilisation of the appropriate hip musculature. This will stop the overloading of the lumbar spine and/or knees when lifting”

 

Knee exercises: How to regain control of your knee.

Body weight movement pattern.

  1. Vastus Medialis Oblique (VMO) activation

VMO activation is extremely important as this muscle often switches off or misfires after injury. This can cause the patella to not glide smoothly within the patella groove compromising its stability and leading to faulty biomechanics.

Exercise: Terminal Knee Extension with a theraband (see below)

 

  1. Gluteus medius/maximus activation

Gluteus activation is important as they play a vital role in controlling the hip and when weak, alter the positioning of the femur. Gluteal strength is vital in reducing the trendelenburg sign and contributing to knee valgus.

Knee exercises: Crab walks (see below) and Monster walks

 

  1. Foot control

Foot control is the ability to activate the muscles of the foot and hold an appropriate arch during all exercises.

If pronation occurs the biomechanics of the lower limb changes, the load going through the knee is increased and a valgus force is created putting more pressure on the medial structures of the knee.

Exercise: Short foot

 

  1. Lumbopelvic rhythm (LPR)

Lumbopelvic rhythm is important to learn early to introduce the correct bending movement pattern (hip hinge) and allow for utilisation of the appropriate hip musculature. This will stop the overloading of the lumbar spine or knees when lifting.

Exercise: Wall taps (see below)

  1. Single leg control

Single leg control is being able to master all bodyweight exercises with correct alignment between hip/knee/ankle and executing it with no energy leakages or blockages.

This is important to improve imbalances in strength and overall movement quality before progressing to loaded movements.

Exercise: T-slides (see below), Step down, single leg deadlift

Knee exercises continued: How to regain control of your knee.

Later stages.

  1. Loading the movements

Once the bodyweight movement pattern has been achieved and there are no longer alignment and technique concerns then it’s time to progressively load the pattern.

It is important to load these movement patterns to increase muscular strength and endurance, enhance control and improve coordination.

Exercise: Deadlift, Squat, Lunge, Step up

 

  1. Plyometric exercises

These are used in later stages for power development.

Plyometrics utilise the stretch shortening cycle by using a lengthening movement (eccentric) quickly followed by a shortening movement (concentric).

Knee exercises: Landings, depth jumps

 

  1. Return to running/sport

A return to running program is designed to slowly progress the individual back into running following injury. Once this is achieved agility based movements are incorporated to be able to withstand sport specific demands.

Example: 100m x 10 with a 300m recovery

 

An Accredited Exercise Physiologist can assess and create an individualised exercise program for you based on your specific needs and stage of knee rehabilitation, speak to the Longevity team for more information.

 

By Daniel Elias Arciuli
Master of Clinical Exercise Physiology (ACU)
Bachelor of Exercise and Sport Science (ACU)
Accredited Exercise Physiologist at Longevity Exercise Physiology

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