by Dr. Anupama Soness
This article deals with physical therapy which is the mainstay of management of knee Arthritis, whatever be the other modes of treatment. Physical therapy intervention includes exercises for strength, flexibility, range of motion and the use of devices designed to provide rest or support to the joint, such as orthotics (knee cap, knee brace) or splints. Regular exercise is essential to restore joint movement & strengthen the knee. Weight should be optimized. Once symptoms are noted, excessive loading of knee joint such as from climbing stairs & sitting on the floor should be avoided. Some useful exercises for knee are given below. Each exercise should be performed at 10 times for first 2 weeks and can increase thereafter.
If my knee Hurts, why exercise?
Having strong, flexible muscle is the best way to keep knee healthy and prevent further injury.
Strength – strengthening the muscles that support your knee will reduce stress on your knee joint. Strong muscles in the front of your thigh (quadriceps) and back of your thigh (hamstrings) help your knee joint to absorb shock. The less strain on your knee, the better the chances are for pain relief and preventing further injuries.
Flexibility – Stretching the muscles that you strengthen is an important part of preventing injury. Gentle stretching after strengthening exercise reduces muscle soreness and will keep your muscles long and flexible.
How do I start exercising?
Start slowly, building muscle strength takes time. As you get stronger, gradually increase the number of exercise repetitions or add weight to an exercise.
Do not ignore pain – You should not feel serious pain during an exercise. You might feel discomfort because you are challenging your muscle, but not pain. If exercise hurts, then stop the exercise.
Do not overdo it – You should not feel serious pain after exercise. If you feel so sore that it is difficult to move then you have overdone your exercise. Rest is the best thing for sore muscles.
Talk to your doctor/therapist if you have pain.
EXERCISES
- Lie on your back with a rolled up towel under your knee and a weight around your ankle. Start with your knee bent (pressing down). Finish with your knee straight. (Fig. 1) Repeat the same with the other leg.
- Standing with your feet together. Start with your heels on the ground. Finish with your heels off the ground (Fig.2) Hold for 10 seconds and slowly return to standing position.
- You have to lie on your right side on floor or table, shoulder and hips aligned. Use your right hand to prop up your head. Place the left hand on floor or any other surface eg. table top in front of you to help balance yourself. Bend (L) leg and bring leg about 10 inches off the floor, hold for one second, and then slowly lower leg to ground. Lift 10 times on each side (Fig.3)
- You have to sit on a chair. Extend leg parallel to floor. Keep knees straight (or as straight as possible if you have arthritis). Tighten thigh muscles. Hold for count of 10. Relax for count of 3. Do 10 repetitions. You can do this several times throughout the day. You can build up to 2 or 3 sets of 10 repetitions at a time (Fig. 5)
- You have to lie on your back with legs straight, hands on your sides. Press the knees hard towards the ground and pull the toes upwards towards yourself. Hold for 5-10 seconds & slowly return to starting position.
- Lie on your back, without bending knees, lift your right leg at about 45 degrees from the ground. Hold for about 5-10 seconds and slowly return to the starting position. Do this 4-5 times. Repeat the same with the left leg.
- You have to lie on your back, pull the toes of your right leg towards your body, press knees towards the ground, lift the leg and cross it over the left leg. Slowly return to the starting position. Repeat the same with the left leg.
- You have to lie on your stomach. Bend your right knee at 90 degree, hold for a few seconds and return to the starting position. Repeat the same exercise with left knee.
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