The knee joint is the largest and most complex joint in the human body. Because of its special structure and the fact that it carries the weight of the entire body and needs to adapt to the various activities that people do on a daily basis, it is prone to a variety of problems. Nearly half of the patients in the orthopedic department come to the outpatient clinic for reasons such as knee pain and swelling.
Problems with the knee joint often significantly affect the patient’s quality of life due to pain and other symptoms. To make matters worse, the knee joint can also suffer from minor or major functional deficits, such as lack of strength, deformed gait, and decreased athletic ability, which can cause serious health problems. Many patients do not have the conditions to go to professional rehabilitation institutions for rehabilitation, so Dr. Lee summarized the key points of knee rehabilitation and recommended some exercise programs that can be done at home for patients’ reference.
Indications: Various acute and chronic injuries of the knee joint, such as patellar chondromalacia, infrapatellar fat pad inflammation, acute and chronic synovitis, patellar tendonitis, etc.; patients after knee arthroscopic surgery, such as meniscus surgery, cruciate ligament surgery, etc.; patients after knee prosthesis replacement; patients after other knee surgeries.
1. Control inflammation, suppress pain and eliminate joint swelling.
During the time of acute knee injury, or within 1 month after knee surgery, the main purpose of rehabilitation is to control sterile inflammation in the joint, suppress pain, and eliminate joint swelling. Patients can take the lower extremity elevation to reduce edema, or they can use some non-steroidal anti-inflammatory and analgesic drugs, physical therapy, cold and hot compresses, etc.
2. Restoration of full knee extension mobility.
The ability to achieve full knee extension is important to the normal gait of the patient and the ability of the muscles to perform at maximum performance. Therefore, patients should take the initiative to straighten the knee. You can use a towel roll to raise the ankle in the supine position, so that the knee joint is suspended behind, using the gravity of the lower limbs to help straighten the knee joint, and if necessary, you can also use an appropriate weight of sandbags on the knee joint to assist in leg compression.
3, patellar mobility exercise.
The patella is the staging area for the quadriceps to perform, and its mobility is crucial. After knee injury or surgery, the mobility of the patella will be reduced to a certain extent due to inflammation or trauma scarring, and active exercise is needed to assist in recovery. During exercise, the patient’s thigh muscles need to be completely relaxed and the patella pushed medially and laterally, up and down. Daily massage of the soft tissues around the knee joint is also required. In the case of surgical patients, massage of the wound is required to improve adhesions and to improve the ductility of the tissues after the wound has healed.
4. Range of motion of the knee joint throughout.
The flexion angle of the knee joint is important for walking, walking up and down stairs and squatting. Flexion angle exercises need to be done daily during the rehabilitation process. Patients can bend on their own or ask family members to help. Stay in flexion for a few moments at the maximum angle they can reach and repeat the exercises until they can reach the level of the healthy side.
5. Re-establish voluntary control of the quadriceps.
Almost all of the knee extension function is carried out by the quadriceps in front of the thigh, so the strength and control exercises of the quadriceps are essential.
Recommended exercises.
(1) Isometric contraction exercises for the quadriceps (lying flat on the back with the lower limbs squared on the bed, the muscles in front of the thigh tightened with full force but without generating any activity, tightened for 15 seconds and then relaxed for 3-4 seconds, tightened again and repeated).
(2) straight leg raise exercise (lying down, tighten the abdomen, raise the anus, after the affected side of the thigh muscle is fully tightened, the whole leg will be raised from the bed 20cm, pay attention to the knee joint should be completely straight can not be bent, keep raised for 15 seconds, and then slowly lower the lower limb as much as possible, when it will touch the bed again raised, the whole process of thigh muscle does not relax. (This exercise can be a good practice of hip and knee flexion and extension of muscle groups)
(3) bending knee straightening exercise (can sit on a chair or bedside, bend the knee 90 ° to start, the front of the thigh muscles tighten the calf straight, the process should be slow, straighten and stay 3-4 seconds, then slowly bend, repeat the exercise)
6, restore neuromuscular control function.
The neuromuscular control function of the limb, also known as proprioception, is a very important but highly neglected part of the patient’s rehabilitation process. In fact, the static perception of joint position, the dynamic perception of joint movement and the regulation of muscle contraction reflex and muscle tension are all reduced to varying degrees after injury and surgery, and need to be reshaped through various exercises.
Recommended exercises: balance training, etc.
7.Restoring weight-bearing ability.
After knee injury or surgery, the weight-bearing capacity of the affected limb will also be reduced. However, because patients are often worried about re-injuring the knee, they will habitually put their weight on the side of the healthy leg, making the affected limb even more lacking in weight-bearing training. Patients need to make a conscious effort to exercise the weight-bearing capacity of the affected leg and try to maintain even weight-bearing on both sides when walking, which is also positive for gait correction.
You can do alternating weight exercises (standing position, feet apart, shoulder-width apart, alternating weight on each side of the foot), lateral striding exercises, single-leg standing exercises, etc.
8.Gait exercises
Due to the decline of strength and proprioception after injury or surgery, patients’ gait will be abnormal, and abnormal gait will also play a negative role in rehabilitation training. Therefore, walking, stairs and squatting gait need to be trained consciously. Patients who need to use crutches and walkers should master the use of assistive devices to avoid unnecessary limping gait. When walking, avoid the appearance of outwardly or inwardly eight feet, pay attention to restoring the activities of the first metatarsophalangeal joint and ankle joint, and pay attention to the balanced mobilization of all muscle groups to coordinate the force.
9. Exercises to improve athletic performance.
The ultimate goal of rehabilitation is to make the limb function as close as possible to or even completely restore to the level of the previous health, so on the basis of all the above training, patients need some exercises suitable for themselves. In addition to meeting the basic requirements of daily life, these exercises should also take into account the needs of athletic competition for limb function, especially for professional athletes.
This part of the exercises includes: jumping exercises, lateral jumping exercises, acceleration and deceleration running exercises, etc.