Knee flexion exercises, together with knee extension exercises, are collectively referred to as knee mobility exercises.
The knee joint is the site of most injuries and bone and joint diseases, and is the basis for functions essential to daily life such as standing and walking. Therefore, whether or not the mobility of the knee joint, i.e., the ability to bend and straighten, is restored to normal after injury or surgery is one of the determining factors in our ability to resume our lives.
There is no need to repeat the importance of returning the knee to a normal bending angle. It is important to remember that you should not just look at the angle values in books or rehabilitation programs. Those values are statistically calculated by measuring many people and are normal values for a “population”, but may not be suitable for a particular person.
So when practicing knee flexion, the most important thing is to see what the maximum angle of flexion is for the leg that is not injured. Some people are able to press their heel against the hip, while others are still much worse than the normal angle of leg flexion. So practice before you must take a good look at their maximum angle of flexion is how much before you start to have control of the exercise. You can refer to the previous article, which describes in detail how to measure your knee flexion angle.
Specific exercises for knee flexion.
Patellar Release.
The patella, commonly referred to as the kneecap, is a nearly circular “seed bone” directly in front of the knee joint. When the joint is not swollen, the outline of the patella can be seen when the leg is naturally stretched out on the bed. After injury or surgery, the outline of the patella may not be easy to find due to swelling of the knee joint. The trick is to place both legs side by side at the same angle and compare the position of the healthy leg to easily find the patella of the affected leg. (This method does not work well if both legs are injured or operated on at the same time)
The role of the patella is very important for the knee joint, and the movement of the patella is very complex when the joint is moving, so I won’t go into more detail here, but I will talk about it later. It is important to mention that the mobility of the patella determines to a large extent the angle of flexion and extension of the knee joint, and if the patella does not move freely, the angle of the knee joint will be greatly restricted and affected!
Therefore, before practicing knee mobility, it is common to do patellar release so that the knee can be flexed and extended with better results. The pain and danger will also be lower.
The specific method is as follows.
Push on the edge of the patella with the fingertips (pushing with the fingertips will pinch the flesh and is not good for force) and push slowly and forcefully in each of the four directions up, down, left, and right to the limit of where you can push the patella. Push in each direction 5-10 times and hold for 3-5 seconds when pushing to the maximum range of motion. Do this before knee flexion exercises to facilitate patella sliding during knee flexion.
Bedside leg drops.
The so-called bedside is because the early exercises in the hospital were either practiced at the hospital bedside or at the treatment bedside. In fact, when you practice at home, the bed at home is relatively short, so your legs hang down and your feet touch the ground, so you can’t practice at the edge of the bed. So you can switch to table side leg draping, that is, you should sit on the table and let your feet off the ground, in order to facilitate the practice.
The specific method is.
Sitting on the edge of a table or a bed that is high enough. With the healthy leg under the injured or operated leg, hook your foot underneath the ankle of the affected leg, that is, hold the affected leg with the healthy leg. The muscles of the affected leg are completely relaxed and the entire weight of the leg is placed on the healthy leg. Then, slowly lower the leg with the strength of the healthy leg, the lower the leg, the greater the angle of knee flexion of the affected leg. After feeling significant pain, stop and hold still for 1-2 minutes as the tissues adapt and the pain may disappear or decrease, then lower the leg again.
This method is suitable for flexion exercises within 0-90°. Because of the protection of the healthy leg underneath, it will not be very nervous and afraid, especially suitable for the early exercise of flexion angle after injury or surgery, and the warm-up exercise before the larger angle bending.
The point is that the affected leg must be completely relaxed, the more afraid to relax, the more obvious the pain will be, the more difficult it will be to bend.
Sitting position “against the wall”.
Place the chair directly against the wall. The person sits in the chair with the toes of the affected leg against the wall or other fixture to prevent sliding.
Once the body is seated properly, slowly move the body forward, and as the body moves forward, the bending angle increases. After 1-2 minutes, the pain may disappear or decrease as the tissues adapt, and then move the body forward to the limit. You can indirectly measure the knee flexion angle by the distance of the knee joint from the wall. The smaller the distance between the knee and the wall, the greater the angle of flexion, provided that the height of the chair remains constant.
This method is suitable for flexion exercises in the range of 90-100°. If the chair is relatively short, the knee joint top to the wall, you can also reach an angle of about 110 °. This method is very safe, because people sitting on the chair, feet on the ground, very stable, as long as they are not suddenly forcefully forward to the top, the angle will not change too much, there is basically no danger. (Except for the chair suddenly broken!)
The point is that the body to sit upright, not because of pain on the crooked body or lift the hips. Otherwise, it will not be possible to increase the angle and control the progress of the angle.
A word of caution: you cannot use this method to practice flexion angle after a tibial plateau fracture, meniscus suture or other surgery where the affected leg cannot bear weight!
Supine leg drop.
Lie on your back with your hands on the back of the knee joint of the thigh, so that the thigh is perpendicular to the bed, and if necessary, you can also have someone else help to fix the thigh to keep it stable.
You can have someone else hold the ankle joint of the affected leg for protection, or you can separate one hand to hold your heel. After this protection, completely relax the muscles of the thigh and let the lower leg drop naturally by gravity, gradually increasing the angle of knee flexion. After feeling significant pain stop and hold still for 1-2 minutes as the tissues adapt, the pain may disappear or decrease, at which point it is placed at a greater angle.
This method is suitable for a flexion range of 100-120°, and some flexion angles are more flexible and can be practiced to about 130° by this method.
If the joint adhesions and other conditions, the weight of the leg can not increase the angle. Then you can add a load at the ankle joint, but the load should never be too heavy, otherwise the muscles can not relax, but also prone to danger.
It is important to find the right weight for you by trying. It is best not to feel significant pain in the beginning 3-5 minutes, and the calf dares to relax and sag naturally. 3-5 minutes later the pain starts. The last 3-5 minutes of pain reaches the level of need to insist on endurance, can barely hold on to 10-15 minutes as appropriate.
The main point is to fix the thighs and not to move. At the same time, learn to relax the muscles and do not extend the knee to fight the pain. Also master the weight of the load. The trick is not to use a sandbag, use a bag tied to the ankle, add something to the bag, a little more if it’s light, a little if it’s heavy, you can very easily adjust the weight at any time!
Sitting knee hold.
Sit on the bed, first actively bend the knee to the maximum angle. Afterwards, hold your ankles with both hands and pull hard towards your body, so that the heel slowly and gradually approach the buttocks to increase the angle of knee flexion. After feeling significant pain, stop and hold still for 1-2 minutes as the tissues adapt, the pain may disappear or decrease, and then hold the leg at a greater angle.
This method is suitable for 110-130 ° flexion range, some flexion angle is more flexible, can also rely on this method to practice to about 130-140 ° angle, or even reach normal.
The advantage of this exercise method is that the degree of knee flexion angle can be indirectly measured by measuring the distance between the heel and the hip.
Prone pulling knee flexion.
Prone, that is, face down on the bed, the affected leg first straight, then active force bending, after flexion to the maximum angle, by someone else’s help or their own grip on the affected ankle, after pulling closer to the direction of the hip, so as to passively make the knee joint to increase the flexion angle. If the angle does not reach the point where you can grip your ankle, you can find a non-elastic band or your own pants to put around your ankle to facilitate pulling harder at a greater angle. After feeling significant pain, stop and hold still for 1-2 minutes to allow the tissues to adapt, the pain may disappear or decrease, and then pull at a greater angle.
This method is suitable for 120-135 ° flexion range, some flexion angle is more flexible, can also rely on this method of practice to about 140-150 ° angle. Even to the heel next to the hip, to achieve the full range of flexion angle.
The advantage of this method is that when practicing knee flexion you will feel a significant pull on the muscles of the front of the thigh, which is very good for increasing the extension and elasticity of the antagonist muscles of the knee, the quadriceps, and can help improve the flexibility of knee flexion.
The point is that violence should never be used to suddenly increase the angle, especially when others are helping!
Protected kneeling sitting.
The angle is close to normal at this time. You can increase the angle of knee flexion by holding on to something for protection and gradually kneeling down with your weight. After feeling significant pain, stop and hold still for 1-2 minutes as the tissues adapt, the pain may disappear or decrease, and then kneel at a greater angle.
Be careful to keep your body square and distribute your weight equally between your legs. A crooked body may result in knee flexion with rotation or inversion, which may be dangerous!
The point is also never to use violence to suddenly increase the angle, and must be a large angle as a basis to start this exercise, otherwise it may be very dangerous!
Full squat under protection.
After the knee flexion angle is basically close to normal. You can hold on to something to protect the squat and use your weight to gradually squat down to increase the angle of knee flexion. After feeling significant pain stop and keep still, 1-2 minutes after the tissue has adapted, the pain may disappear or reduce, then squat to a greater angle.
Squatting, who understands what it means, there is no need to draw a diagram to explain.
The important thing to note is that the body should be square and the legs should distribute the weight equally. The body skew may cause the knee joint flexion accompanied by rotation or inward and outward, may occur dangerous!
The point is also that you should never use violence to suddenly increase the angle, and you must have a large angle as a basis before you start this exercise, otherwise it can be very dangerous!
Summarize.
These are the methods of practicing knee flexion at different angles and in different situations. Generally speaking, no matter which method you use to bend your leg, the whole process should be limited to 30 minutes. Too much time and repeated flexion can overstimulate the joint, causing increased swelling and inflammation in the knee joint, which is detrimental to the recovery of joint function!
When practicing knee flexion, it is important to stick to the end of each exercise and not to relax in the middle. In other words, do not “repeat” the whole process. Do not relax and rest when you feel pain, and then practice and bend again. You should slowly advance the angle and hold it for 1-2 minutes after the pain starts, so that the pain is relieved after the tissues adapt, and then hold it in a little bit to gradually increase the angle. Otherwise it is repeating the knee flexion and extension movements, which will likewise stimulate the joint and cause an increase in swelling and inflammation of the knee joint.
The most important point: although the above-mentioned are methods that can be practiced at home without special equipment, due to the different injuries and surgeries and different tissue conditions of each person, the exercises must still be evaluated and guided by a professional physician therapist who thinks you are suitable for a certain exercise before you can do it. Blindly practicing on your own in one-sided pursuit of angle will only cause danger! Remember! Remember!
It is also important to remind that the joint release treatment done by a professional therapist in a regular hospital is, on the surface, similar to the methods described above in some positions, but in fact it is a very operational treatment technique that cannot be learned just by looking at it. If the situation requires, after practicing by yourself the angle is not or is difficult to progress, or even regress, you must go to a regular hospital by a professional therapist to do arthroplasty treatment!