Early knee exercises videos

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Hi there.

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My name is Chris

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and I'm one of the physiotherapists here at Addenbrooke's Hospital.

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In this video series, we are going to go through some early knee exercises.

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You may have been directed here by a consultant

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or physiotherapist following a recent knee injury.

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This could have been a twisting injury that may have caused a ligament sprain

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or some irritation of the cartilage in the knee, otherwise known as the meniscus.

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Depending on the severity of the injury,

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you may have been given crutches to help with your walking.

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As the pain improves and provided you need feels stable.

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You can stop using the crutches

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under the guidance of your physiotherapist or consultant if needed.

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This may only be a few days or could be a few weeks

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as of course, all injuries are different.

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It's important to understand that the large majority of these injuries

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get better with time and a good rehabilitation program.

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With only very few small numbers requiring surgical intervention.

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In all

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cases, the first part of the process is to go through a course of physiotherapy

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as a large majority of people recover by doing this.

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In the very few cases where time and physiotherapy has not allowed someone

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to make a full recovery, this may be where they are referred for a scan

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and seen by an orthopedic consultant.

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Following a knee injury, it is important to keep the knee

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moving as pain allows, to prevent the joint becoming too stiff.

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It is also important to start a strengthening exercise program

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to allow you to maintain and regain quad,

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hamstring, glute and calf muscle strength.

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As you progress, look to return to your normal activities as pain allows,

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such as gradually increasing your walking and returning to activities like cycling.

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The timeframe of recovery varies considerably

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depending on the severity of the injury and the individual’s journey.

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Some people return to full function within 3 to 6 weeks.

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For others, it can take 2 to 3 months and for some cartilage related injuries,

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it is not unusual for these to take a little longer,

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with people still improving up to six months after the injury.

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Whatever stage of recovery you are at, there is always scope

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for an exercise program to improve your situation.

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We are breaking the exercises down into phases.

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Start with the easier exercises and as you improve,

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progress to the more challenging ones.

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It is worth noting that research supports a criteria based progression

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through the phases rather than a strict time based progression.

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This means that you may be able to progress to the next phase

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a little earlier than the weeks stated, or it may take a little longer.

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Progress when you feel ready and as pain allows.

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If you are unsure about any of the exercises in the videos

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or have any questions, please consult your physiotherapist.

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I hope these videos are helpful.

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Thanks for watching.

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Welcome back.

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Here, we’re going to go through some early knee exercises in phase one.

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We have classed phase one as the first two weeks following the injury.

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As I mentioned in the previous video, research supports

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a criteria based progression, through the phases

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rather than a strict time based progression.

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This means that you may be able to progress to the next phase

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a little earlier than the week stated, or that it may take a little longer.

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Progress when you feel ready and as the pain allows.

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As for how often and how many,

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this will vary from person to person and depend on your stage of recovery.

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In the early stages, we often recommend doing the exercise

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as little and often, perhaps 6 to 12

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repetitions, 3 to 4 times a day.

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As you progress, aim to increase

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the numbers gradually as pain allows.

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Aim to progress to 8 to 15 repetitions,

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2 to 3 sets in that little session, 4 to 5 times a week.

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As you

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improve, you should aim to do enough reps and sets to get to the point

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where your muscles feel fatigued.

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The first exercise is active

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or active assisted knee range of motion.

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Here we are going to use a towel or the rope of a dressing gown

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to bend and straighten the knee.

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Aim to straighten the knee as much as you can to ensure you regain

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full extension,

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as pain allows.

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As you are able, progress to not using the towel.

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The next exercise

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is the static quads exercise.

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In a long sitting position, either on the bed or on a sofa, it's fine.

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Tighten up your thigh muscles to fully straighten the knee,

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hold the contraction for 5 to 8 seconds and

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then relax.

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Then we have the inner range quads exercise.

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Roll up a pillow or a towel and place under the knee.

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So it is in a little flexion.

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Straighten the knee to lift the ankle up,

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hold in this position for 5 to 8 seconds

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and lower.

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The next exercise is the straight leg raise.

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Fully straighten your knee by tightening your thigh muscles

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like in the static quads exercise, then lift your leg off

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the bed and lower.

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We then have sitting knee extension.

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In a sitting position fully straighten the knee,

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hold for 5 to 8 seconds

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and lower.

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That’s the end of this Phase one video.

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These exercises can also be found on the physiotherapy section

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of the Addenbrooke's website under patient information leaflets

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where you can click on early knee exercises.

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Thanks for watching, see you at phase two.

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Hi.

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Welcome back.

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These are the exercises for phase two,

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which may be approximately

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2 to 6 weeks following the injury,

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as previously mentioned though,

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it might be

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that you are able to progress

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to some of these exercises

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a little earlier,

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or it may take a little longer, for you

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to manage something.

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Progress when you feel ready

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and as your knee stability

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and pain improves and allows.

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With regards to numbers at this stage

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you should be looking to progress

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from little and often

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to doing a more structured program,

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where you aim

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to progress to 8-15 repetitions, 2

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to 3 sets, around 4 to 5 times a week.

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As you improve,

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you should aim to do enough

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repetitions and sets to get to the point

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where your muscles feel fatigued.

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Gradually increase in numbers

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as pain allows.

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Low level discomfort that settles quickly

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following the exercise

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is absolutely fine,

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provided your direction of travel

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is improvement

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rather than having more difficulty.

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The first exercise is ‘sit to stand’.

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From a sitting position, stand up,

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then sit down again.

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You can vary the difficulty

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by changing the height of the seat.

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This exercise can also be made easier

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by moving the injured leg

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slightly forwards

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before standing, or harder

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by moving it slightly back

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to bias a certain leg.

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The next exercise is a squat.

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This can be done in a variety

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of different ways.

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You may want to start with your back

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against the wall

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for a little more support.

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Feet away from the wall, around

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shoulder width

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apart, bend and straighten the knees.

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Start with a smaller squat

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and gradually increase the depth as able.

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As you progress,

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move on to a squat away from the wall.

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Again, feet roughly shoulder width apart,

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you can have your feet facing forwards

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or slightly out

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whichever you find more comfortable.

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Simply bend and straighten the knees.

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Start with

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small squats

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and gradually progress the depth.

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If there is some

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cartilage-related irritation

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from the injury,

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then a deeper squat would irritate this,

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so we tend to advise against really deep

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squats beyond 90 degrees

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for this type of injury at this stage.

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Moving on to heel raises.

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Holding onto the wall

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or supportive surface,

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come up onto your toes

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and lower back down, progression

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would be moving onto one leg.

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The next exercise is the bridge.

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Working on hip

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strength is also important

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in the recovery of a knee injury.

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Either on the floor

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or on the bed, lie

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on your back

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with knees bent,

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feet about shoulder width apart.

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Lift your bottom off the bed

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as high as you are able and lower.

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To progress, lift one leg into the air,

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then lift the bottom of the bed

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to perform a single leg bridge.

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Moving on to the lunge,

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place the leg you're working on

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in front of the other leg,

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holding onto a supporting surface

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or the wall as needed, bend

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and straighten the front knee

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to perform a lunge.

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The back heel can come off the ground.

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Start with a small lunge,

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and gradually progress the depth.

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As you

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progress,

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you could move onto a stepping lunge.

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Start with feet together.

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Step forward to perform a lunge, then

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bring the foot back

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up to the starting position.

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The next exercise is single leg stand.

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Following a knee injury,

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there is usually

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a reduction in our balance.

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It is therefore important

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to include balance exercises

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into the rehabilitation program.

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This exercise involves

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simply standing on one leg,

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start at a supportive surface as needed,

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aiming to gradually increase the time

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you can stand on one leg.

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This exercise

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can be made more challenging

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by closing your eyes

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or by standing on an unstable surface,

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such as a cushion, a wobble cushion,

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or a balance board.

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The final exercise

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in this video is a single leg dip,

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standing on one leg,

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holding on to the wall

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or a supportive surface,

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bend and straighten the knee.

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Start with a smaller bend

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and gradually increase as able.

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That's all of the exercises

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in this early knee

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exercise, phase two video.

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The progression

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of some of these exercises,

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such as the squat

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and the lunge, would be to start

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adding weight using dumbbells, a barbell,

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kettle bells, or simply a backpack.

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If you're unsure about

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any of the exercises in these videos

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or have any questions,

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please consult your physiotherapist.

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I hope these videos have been helpful

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and you now have more confidence

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in your rehabilitation program,

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and are getting back to full function.

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All the best, cheers!