The four abilities your knees should have are:
- Good muscular strength
- Adequate flexibility
- Intact working proprioception
- Ample endurance- enough endurance to allow us to perform movements over and over again
When trauma, accidents or aging changes occur, the knee loses one or more of the above abilities. This leads to loss of function. This results in pain.
To become pain-free, you have to regain function by doing specific exercises to restore the four abilities.
Exercise to develop good muscular strength
Knee problems tend to cause isolated muscle wasting and weakness, specifically in the quadriceps group. The easiest and simplest way to strengthen the quadriceps is to do isometric exercise.
Isometric exercise involves applying a force to an immovable object. The muscles build up tension, but there is no actual movement. Multiple randomized controlled trials have proven that isometrics can increase both the size and the strength of the quadriceps muscle in men and women.
The isometric exercise to develop quadriceps strength is shown below:
Exercise to develop flexibility
Your knee has three basic motions. It can bend backwards(flexion), straighten out(extension), and rotate. Stretching exercises can help restore all of these motions. Many problems, like swelling, tight muscles, mechanical problems, pain and tight joint capsule can lead to limit knee motion and lead to loss of flexibility. Stretching can help restore flexibility in many cases.
One thirty-second stretch done once a day, five days a week, is sufficient to cause a muscle to lengthen over a period of weeks.
The two groups of muscle you need to stretch are the hamstrings and quadriceps.
The quadriceps stretch is shown below:
The hamstring stretch is shown below:
Exercise to develop proprioception
Proprioception helps to protect your knee from injury and damage. There are two simple exercises to develop proprioception- one with eyes open and the other with eyes closed. They are shown below:
Exercise to develop endurance
There are two types of endurance: muscular endurance and cardiovascular endurance. Knee pain can affect both. There are three types of energy systems that provide energy to the body:
- Phosphagen system: supplies energy for the first 8-10 seconds of an activity
- Glycogen-lactic acid system: Supplies energy from 10 seconds to 2 minutes of an activity
- Aerobic system: Supplies energy from 2 minutes onwards.
Since the knee is often used for more than 2 minutes at a time, it is important to develop the aerobic system to develop knee endurance.
The simplest exercise for endurance is walking. This is shown below:
Other things to remember
- Imaging findings of the knee are not related to knee symptoms in many cases.
- The relaxation response is also useful to decrease knee pain. This involves doing two things:
- Repeating a word, sound, prayer, phrase or muscular activity. Do this for ten to twenty minutes daily.
- Passively disregarding everyday thoughts that come to mind and returning to the repetition
- Using heat for five to ten minutes can relax the knee and may be useful to do before the exercises.
- Massage also helps. When doing massage, do the massage transversely across the muscles of the thigh in the front and the back. You can use any lotion.
The weekly plan is shown in the figure below:
So that’s it.
You can use this simple program to become free of knee pain.