Tuesday, June 25, 2013

Stretches For Knee Pain


Stretches for knee pain is a very important part of returning back to function, after any debilitating episode in the knee joint. However, this necessitates that one consciously works towards achieving complete range of motion in not just the knee but in all the joints of the leg, i.e.: the hip and ankle as well. Statistics have shown that 90% of knee pain comes from tightness in the quadriceps, hamstrings and calf muscles. Hence complete flexibility of all the muscles that surround these three joints is key to recovery via:

1. Stretching for all the muscles and joints of the leg
2. Strengthening of all the muscles that offer the leg support

Stretches are very important because tight muscles are easily injured. They can also pull a joint out of alignment. Both these factors would further increase your pain, if you are already symptomatic. Stretching over two joints at a time is more effective, as is working with two muscle groups at the same time. Always stretch the uninvolved leg as well. To be effective, each stretch is held for 30 seconds with 5 repetitions.

The main muscles that effect knee stability are:

1. The quadriceps and hamstrings. These are muscles in the front and back of your thigh respectively.
2. The hip flexors made up mainly of the iliopsoas and rectus femoris. These are located in front of your hip
3. The hip extensors (the buttocks) mainly comprise the gluteus maximus and the hamstrings
4. The hip abductors which include the gluteus medius and IT band (by virtue of the muscles attaching to it). These are on the outer side of your hip.
5. The hip adductors that are located on the inner side of your thigh, beginning in the groin
6. The calf muscles

Stretches for knee pain are carried out slowly.The exercises below are for pain in the right knee, no matter what the cause is.

Stretching the hip flexors and quadriceps together, stretches out the muscles in front of the hip and thigh:

1. Start in half kneeling position, i.e. bear weight on the right leg, by kneeling on the right(R) knee, while you support yourself on the left(L) leg by bending it at 90 degrees at the hip and knee. (Place a cushion under your (R) knee, for comfort, if necessary).
2. The foot of the (R) leg is placed up on a chair behind you, while you continue to stay in half-kneeling.
3. Arch your back backward gently, to stretch out the(R) hip flexors and (R) quadriceps. You can reach back to hold the chair if you wish. Hold/ repeat as suggested above
4. Next, placing both hands over your (L) knee, lean forward over (L) leg, so that your (L) hip is well flexed beyond the position of the ankle of the same leg. The (R) knee does not move out of position. The (R) foot continues to stay up on the chair behind you. This will stretch the (R) hip flexors. Hold/repeat as is required.

Stretching the hamstrings and calf muscles together, stretches out the back of the knee:

1. Place the toes of your right foot on a roll that is 4-6" in diameter while standing on your (R) heel. Place your (L) leg comfortably behind you.
2. Tighten your (R) quadriceps to relax your(R) hamstrings(by the muscle law of reciprocal relaxation)
3. Gently drop down towards the floor by bending forward at both hips (without bending your knees) till your fingers reach the floor. Hold/repeat as suggested above.

Along with stretches for knee pain, strengthening of all the muscles around the hip, knee and ankle is also very important. Strength is built up gradually.But for the first and last two exercises, all the rest (exercises 2-6) are started at 5 counts and increased by 1 every other day till 15-20 counts are reached. Weights can slowly be introduced as a progression. Again we are discussing the right knee.

1. Lie on your back, after placing a small towel roll under your (R) knee. Gently press your knee down toward the surface using your quadriceps, while lifting the heel of the same leg off the surface. Hold the position for 10 seconds. Move your foot back and forth during those 10 seconds. Repeat both steps 10 times. This is one set. Perform 5 sets. These are known as "knee isometrics".
2. Still lying on your back with your legs out straight, bend your (R) leg up toward your chest. Return back to starting position. Repeat. Stay mindful of the counts.
3. Next, lift your (R) leg up towards the ceiling without bending your knee. Stop when your leg is at a 45 degree angle with the surface you are lying on. Return to starting point. Repeat. Count as above.
4. Turn on to your left side. Bend your left knee to provide support. Lift your (R) leg sideways, while keeping your knee straight. Return to base. Repeat. Stay with your counts.
5. Now lie on your stomach. Bend your (R) knee, then lift that leg upward off the surface. Return. Repeat. Count.
6. Continuing to lie on your stomach, lift your (R) leg off the surface, this time with your knee straight. Return back and repeat. Keep your counts.
7. Wall Slides: Stand against a wall. Place a 9" diameter ball in the small of your back. Bend your knees 30 degrees. Slide down, then return back up the wall. Place your hands on the wall for support. Keep your feet parallel. Never let your knees go out over your toes. Repeat 10 times.
8. Stand on your toes while holding on to the back of a chair for support. Bring your heels back down. Repeat 10 times.This strengthens your calf muscles.

This completes your hip, knee and ankle strengthening program.

Pain is your body's signal for help. Doing a regular exercise routine will ensure the health and stability of your knee joints and decrease or prevent pain as the case may be. Since strengthening shortens muscles, it is advisable to start with "knee isometrics" to warm up, continue with the strengthening routine and finish with the stretches for knee pain.

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