Eliminating Anterior Knee Pain through Exercise (At home)

knee_painThere are millions of people who suffer from anterior knee pain, or as it is sometimes called Patellofemoral Syndrome (PFS).
Sufferers usually struggle with movements such as squatting down, or climbing stairs. Quite often, this pain is often made worse when going down. For many people, these movements are part of their daily routine and the pain that is experienced places a large strain on their quality of life.

Often, this pain is completely unnecessary and can be eliminated if the right diagnosis is made and the right treatment strategy is put into motion.
Listed below are 10 great exercises that will help PFS sufferers by strengthening the vastus medialis obliquus (VMO); the muscle which helps controls the way the knee cap moves when we bend and straighten our knees

vmoVMO – incredibly important for patellar control during knee flexion and extension. This muscle is incredibly important, therefore maintaining the optimal recruitment levels are essential to keeping our knees happy. If you are a PFS sufferer, and have been given a rehab programme, there is no reason why you can’t say bye to your knee pain very quickly; especially if the programme is performed consistently and with good technique.

From experience, I wouldn’t bet against you noticing a massive decrease in your pain levels within the first week. Little decreases in the pain your feel when you’re walking downstairs make a huge increase in your quality of life.

Pain is a hardship. It bogs you down, prevents you doing what you would normally do. It has not only physical implications, but psychological ones too.
It tells our brains that we can’t do that particular movement or we’ll feel pain. So we adapt to do the movements differently and cause further compensations which leads to other problems and pain.

However, if you use the combination of foam rolling (SMR), Static Stretching, and rehabilitative exercise, I can guarantee that you will reduce or fix your PFS pain.

Exercise
Guidelines

  • Make sure that an appropriate physical specialist such as a physio, osteo or sports rehab therapist has diagnosed, and advised you to begin treatment for PFS
  • Always perform each exercise with perfect technique
  • Perform the exercises in the order they are presented. Once the exercise has become too easy, slightly increase the repetitions or the time held for the contraction before moving on to the next exercise.
  • Stop if your knee starts to feel worse and contact your physio, osteo or sports rehab therapist for advice and to discuss future treatment

Sitting Isometric Contractions (Toes Facing Slightly Out)

  • Sit on the ground with your legs out in front of you.
  • Place your first 2 fingers on your VMO. ( Refer to the image above if you don’t know where that is)
  • Tighten your quad muscles and imagine pulling your knee cap upward towards your hip
  • Hold the contraction for up to 10 seconds and make sure you feel VMO working (aim to contract that muscle first)
Note: For those doing this exercise for the first time, try to perform 10 repetitions for 5 second holds. Once this becomes easy, increase the length of the hold to 10 seconds and decrease the reps by 5. Once that becomes easy, start to increase the reps until you’re up to performing 10 repetitions for 10 seconds holds.
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Seated isometric VMO and adduction contractions

  • Sit on the ground with your legs out in front of you.
  • Place a pillow, cushion, or a foam roller under your thigh
  • Place your first 2 fingers on your VMO. (Refer to the image above if you don’t know where that is)
  • Tighten your quad muscles and imagine pulling your knee cap upward towards your hip
  • At the same time, squeeze the pillow, cushion or foam roller between your thighs
  • Hold the contraction for up to 10 seconds and make sure you feel VMO working (aim to contract that muscle first)
Note: For those doing this exercise for the first time, try to perform 10 repetitions for 5 second holds. Once this becomes easy, increase the length of the hold to 10 seconds and decrease the reps by 5. Once that becomes easy, start to increase the reps until you’re up to performing 10 repetitions for 10 seconds holds.
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Foam roller leg extensions

This one is very handy, especially if were smart enough to get a foam roller to release the tension in the outside structures of the thigh. Foam Rollers have many purposes!

  • Sit on the ground with your legs out in front of you
  • Place the foam roller under your knee
  • Place your first 2 fingers into VMO and tighten your quad muscles, lifting your foot off the ground and contracting your thigh
  • Hold the contraction for up to 10 seconds and make sure you feel VMO working (keep trying to feel it if you can’t at the start!!)
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Plie knee bends

For those who don’t know what a ‘Plie’ is, it is similar to a ballet move where you do a 1/4 squat with your knees going out slightly to the sides.

  • Stand with your knees hip width apart and your toes pointing slightly out. Imagine them at 12 o’clock at the start and pull them to roughly 2 o’
  • Squat down slightly and let your knees follow your toes
  • Concentrate on VMO and ‘pull’ your legs back up mostly using VMO
  • Gradually build the amount of reps up to 15, making sure that they are all done with perfect technique
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Ball Squats

This is one of the first exercises I would do with a client if they had difficulty performing a body weight squat. Once you build up the strength in your legs, remove the ball and concentrate on using only your body weight.

  • Place a Swiss Ball against a wall and lean into it with your lower back supported
  • Gradually lower yourself into a seated position, pushing your hips backward (as if you were trying to touch your bum against the wall, but be conscious to push your knees forward at the same time)
  • Lower yourself until your thighs are roughly parallel with the floor
  • Push through the heels and squeeze your thighs until you are standing vertical again
  • It would be better to put a small ball between your legs while you are doing this exercise.

Ball Squatsball_squats

Split Squats (Stationary Lunge)

This is an exercise I refer to as a stationary lunge that is performed at the mid-way point

  • Start with your feet hip width apart and take a slightly longer than normal step out with one leg
  • Keep most of your body-weight through the front leg, but particularly through the heel of the front leg
  • Slowly start to lower your self down, pushing back through the hips and maintaining a fairly upright position
  • Make sure that your knee is also being pushed forwards, but the heel remains in contact with the floor
  • Once you are in the bottom position, push through the heel of the front foot to return to the starting position
  • Concentrate on VMO through both the raising and the lowering of the movement
  • Start off with lower reps such as 6-8 and build them up until you reach 12-15
  • Hold onto a railing, wall, or broom handle for support if balance is an issue
  • Gradually add more weight through the use of dumbbells, a barbell or even a knapsack on your back

Split Squats

Single 1/4 leg squats

This can be a difficult exercise for some people. Make sure you are well balanced and use a railing, wall or broom handle for support if needed

  • Stand with your feet hip width apart
  • Slowly raise one of your legs off the ground (bring your heel towards your bum)
  • Slightly point your toes out to the side (5-10 degrees)
  • Slowly push the knee out over the toes, concentrating on holding VMO
  • When you reach the bottom of the movement, pull the leg back up using VMO
  • Maintain good hip alignment throughout and use a railing, wall or broom handle for support if balance is an issue
  • Start off with lower reps (6-8) making sure that you can feel VMO, and gradually increase the reps up to 12-15 as your strength improves
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Step-Ups

  • Stand in front of a step, or a stair
  • Step up onto the step, ensuring that your knee is in line with your toes and hip
  • Pull through the heel and contract VMO to pull yourself upward into a straightened position
  • Maintain the contraction in VMO, keep your heel on the step and knee over the toes on the lowering phase
  • Start off with lower reps (6-8) making sure that your balance is good and you are using VMO
  • Increase the height of the step as you improve and up the reps to 12-15
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Step-Downs

  • Stand on top of a step or chair
  • Make sure your weight is through your heels and slowly lower yourself down to the floor
  • Concentrate on maintaining a contraction into VMO and keep an upright posture
  • Keep your hips level
  • Start off with lower reps (6-8) making sure your balance is good and you are using VMO
  • Increase the height of the step as you improve and up the reps to 12-15
Were hoping to have a library full of pictures to help you through these exercise descriptions very soon! Watch this space.

Running and sport specific activities

  • begin by performing straight runs on a flat surface
  • increase the challenge by incorporating sport specific motions. For example, side to side movements, hops, twists and jumps are all movements that are specific to many different sports
terminal-knee-extension

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