knee stabilising exercises

[badbadger]

Hi,

I have just been through a course of physio to help with knee pain I have been having. It appears I have a stretched ACL which isn't supporting the knee properly when I try to exert maximum effort (like when I play rugby!).

The exercises the physio suggested helped a little, but were elastic band based and limited in number and my progress has stalled.

I have read about some rugby players who have surgery so many times on damaged ligaments that they have had to work to develop the knee stabilising muscles to help give additional support to more or less unrepairable knee ligaments.

So, basically I am wondering what sort of exercises would really target the knee stabilising muscles to help support a weak ACL?

Many thanks for any help...

 

[Marat]

Basically your standard lower body exercises...squats,deadlifts,lunges,good morning etc.

My ACL has been about 75% torn for the last few years and as my lower body got stronger, my knee felt more stable.

 

[DIVINITUS]

I have a rebuilt/repaired ACL in my right leg and my surgeon told me the stronger my quads were the better and faster my recovery would be. He did tell me NOT to do seated leg extentions for at least a year after my surgery. I would also say the exercises that m11 suggested be a staple of your routine.

 

[haziron]

I had ACL surgery, rode a stationary bike a ton to strengthen the leg.

 

[bigback51]

I torn my ACL playing football for Ohio State. At that time our orthopaedic surgeon , and we had some of the best, as an initial core rehab exercise, insisted that we perform seated leg extensions, but with the focus on the top 5 degrees, by that I mean contracting your quad/ raising your lower leg, and holding it in the straight/ locked position for 2 seconds, no bouncing at the top, we did about 4 sets of 10 reps, every day. Once you start bringing back that lower portion of the quad, above the knee, the tear drop, we eventually went on to squats etc.
This exercise seems to be contrary to what post#3 is saying, but thats what we did to begin the rehab process, of tightening that knee joint up.
Big Back 51

 

[P-funk]

Doing knee extensions for an ACL issue is great.....if you were doing physical therapy in 1983. Any therapist doing that still today is way off base and probably doesn't understand what the hell they are doing.

patrick

 

[Built]

Now that's interesting, because I had a knee tracking problem years ago and my doc told me to do this same thing, the top third of the movement actually. Low weight, 20-rep sets, pausing a moment at the top so as not to bounce.

It worked too.

Is this a different situation, or would you still say the movement is contraindicated, Patrick?

 

[P-funk]

I don't see any benefit in that. That is the old school VMO strengthening bullshit.

 

[Built]

I understand, but it worked. Fast too.

What might have worked better?

 

[Yanick]

Interesting study, I've only read the abstract so far though (I have a reading list that just keeps getting bigger lol), and it is in runners, but might bring some illumination to this subject.

http://www.medscape.com/viewarticle/584086

 

[P-funk]

I understand, but it worked. Fast too.

What might have worked better?

Strengthening in the hips.

Lots of things work for people.....It doesn't meant that they are right.

Why do some people succeed on low-fat diets? Why do some people get great results with High Intensity 1-set to failure training?

It could be total placebo effect. Sometimes we automatically see improvements because the doctor "told us" that it would work, which psychologically makes us feel better. It is the same reason why people with knee problems can go in and be told they are getting a surgery, be put under anesthesia, and just get the little scars that would be present with arthroscopic surgery - even though the surgeon does nothing to the knee at all (a sham surgery) - and they automatically feel better, because they "think" something happened to allow them to heal.

n = 1


Yan, I have that paper if you want it.

patrick

 

[Built]

I had swelling in the knee. Doc told me what to do. I did it, and the pain and swelling went away. It came back, I did the movements again, this time religiously. The problem never returned.

<shrug>

I don't think I was n=1. The doc didn't invent it just for me.

Is there nothing therapeutic about that movement?

 

[P-funk]

I had swelling in the knee. Doc told me what to do. I did it, and the pain and swelling went away. It came back, I did the movements again, this time religiously. The problem never returned.

<shrug>

I don't think I was n=1. The doc didn't invent it just for me.

Is there nothing therapeutic about that movement?

What was the injury?

I don't see anything therapeutic about an open chain knee extension exercise (especially not in an ACL specific situation).

patrick

 

[Built]

As I mentioned, this for me was not ACL. It was a tracking problem. It's gone now.

 

[P-funk]

Yea, even for a tracking problem, I just don't see the point. Especially since some people now talk about the fact that it isn't the patella that moves out of place, but the femur that moves, causing the patella to track improperly. The idea that it is a "knee issue" is extremely myopic. It is a movement problem and should be treated as such.

patrick

 

[Dale Mabry]

I had swelling in the knee. Doc told me what to do. I did it, and the pain and swelling went away. It came back, I did the movements again, this time religiously. The problem never returned.

<shrug>

I don't think I was n=1. The doc didn't invent it just for me.

Is there nothing therapeutic about that movement?

Think about it this way, if it worked, why did you need to do it again? If you had corrected the actual problem, which could be a number of things, you wouldn't need do go back to doing the exercise. Those single joint exercises are just like meds that only moderate the symptoms, they don't actually cure the problem. You would be doing yourself a favor figuring out the actual problem, if you find it and it's something as simple as a tight hip, you could avoid all of that pain just by incorporating specific stretches in your warm-up.

 

[Built]

Dale,

When I did it the first time, it was sporadic.

When it happened again, I knew exactly what to do, I did it religiously, and it went away.

 

[Dale Mabry]

Dale,

When I did it the first time, it was sporadic.

When it happened again, I knew exactly what to do, I did it religiously, and it went away.

I hear ya, Built, but my contention is that something else is causing the problem, and those exercises just mask it. For example, every now and again I would get a tweak in my neck. Traditional PT would have me stretch certain muscles and strengthen others, and completely ignore the fact that I sleep with my shoulders protracted and do a lot of computer work that causes the same. Simply working on retracting them in both situations fixes the problem, whereas doing those stretches only helped with the pain while I was doing them.

 

[Built]

I'm willing to entertain the possibility that it got better on its own and it was just a series of coincidences that lead me to believe that it was the prescribed treatment that induced the cure.

That being said, I haven't had the problem since. And it's been years.

 

[Dale Mabry]

I'm willing to entertain the possibility that it got better on its own and it was just a series of coincidences that lead me to believe that it was the prescribed treatment that induced the cure.

That being said, I haven't had the problem since. And it's been years.

That's not what I'm saying. I'm saying the exercises helped, but that it will come back because it's a deeper issue.

 

[Built]

Well, it's been six years.

 

[Dale Mabry]

I could certianly be wrong, though.

 

[P-funk]

That's not what I'm saying. I'm saying the exercises helped, but that it will come back because it's a deeper issue.

I wouldn't say that. I am sure it worked for her. Lots of things are aren't optimal work.

I have noticed this while working in various physical therapy settings. The poor therapists who do not do good work or who use lots of old school ideas/principles may get results with some people as what they are doing HAS TO WORK for someone. However, they are terribly inconsistent with their results, so they may get 1/15 people really better and then others just sort of suffer.

patrick

 

[Built]

Well that's reassuring. I just happened to have something that just happened to respond to what I was told to do. I can live with that.

What should I have done, just in case it comes back?

 

[P-funk]

Well that's reassuring. I just happened to have something that just happened to respond to what I was told to do. I can live with that.

What should I have done, just in case it comes back?

I look at the hip for the answers - and probably the ankle.

If the hip isn't controlling femoral movement properly, we can develop knee pain. If the ankle isn't allowing proper mobility to take place - we can get knee pain.

I guess that is sort of simplistic and stupid sounding...lol

patrick

 

[emilyfulton]

just do a warm up before you go on an exercise.