Restoring full knee extension can be difficult in some patients after an ACL surgery , a Total Knee replacement or any other knee surgery or procedure.
Full knee extension is mandatory for normal walking and daily activities.
If the knee is not completely straight, putting weight through the knee will affect the normal quadriceps / hamstring relationship and increase the load at the joint causing cartilage problems as well.
From day one after a knee surgery or injury the goal should be restoring knee extension as soon as possible with patellar mobilizations , quadriceps activation and straight leg raises to reinforce Knee extension.
The following videos show different ways to improve Knee extension in order of complexity and aggressiveness
1. Patellar mobilizations
One of the most effective ways to improve knee extension is moving the patella all over but especially up . Here is a picture of the different directions of patellar mobilizations
2. Roll and Stretch
Then you can continue with prompting the heel over a towel roll or foam roller and push the knee down into the table, and you can further stretch the posterior capsule / tissues by using a strap or band to add ankle dorsiflexion and knee extension , all in one movement.
3. Prone Knee Extensions and Planks
Once you restored some extension with the two previous exercises it's time to use it this improvement. Prone Knee extensions are great for this tapping into full extension by pushing on your toes and activating the quads . Planking is another way to achieve the same quadriceps activation.
4. Standing Knee Extension and Single Leg Balance
All the previous exercises are great but the real challenge is for the client to be able to extend the fully in standing and walking.
This exercise works exactly on that: full extension and load the joint in standing.
5. Low Load Long Duration ( LLLD) Stretch
There are times when the knee is really stiff and it needs a more aggressive way of improving extension. There are different ways to do this and in this video I show my preferred version. The goal is to get at least 45 minutes to 1 hour of this stretch spread out in the day, for example 4 times of 15 minutes: early morning, late morning , early afternoon and evening.
Lionel Pannunzio is a Physical Therapist Certified in Sports Injuries.
With more than 20 years of experience helping athletes return to their sports after an injury. He is the Owner of White Bay Sports Physical Therapy and Fitness, conveniently located in the beautiful City of Weston, where he treats Soccer Player, Runners and Athletes of all ages
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Board-Certified Sports Specialist
Owner of White Bay Physical Therapy