Getting Back on Your Feet
Performance Building Rehab Exercises
It's more that just your knee function. Getting back on your feet takes physical, emotional and mental determination. Did you know your spine houses 120 muscles, 220 ligaments, 33 bones all working together to give you strength, range of motion, and support needed for daily activities. To have a strong knee you need a strong core stength. Building a strong core is as much about your diet and mental focus to show up and train, as it is about exercising.
These exercises will provide you with the stength and agility needed to not only return to the sport you love, but also kick ###!. ONLY embark on these moves when your health professional has cleared you to start to exercise. Remember to ice your knee regularly to prevent post exercise swelling. Bathing with Epsom salts will help to pull out toxins from your body and speed your healing process.
Stabalize Your Knee - Pre-Surgery
Whether your knee injury requires surgery or not, the first steps to recovery require stabalisation. Follow all steps outlined for diagnosis. Once your swelling has subsided and you are ready to rehab, the first steps of exercise should be focused to very carefully rebuild knee stability. Start with exercises that always maintain your knee alignment and build muscle strength. The stronger your knee stability, the quicker you can return to the sport you love and recover from surgery, should you need it.
Regaining strong body alignment post injury is key. This exercise trains your body to properly stack your hips, knees and ankles, whilst building strength in your quads, gluts and leg muscles. Use a ball that allows your knees to bend at 90° when you sit on it. Stand with your feet forwards, shoulder width apart and place the ball behind your lower back against a wall. Engage your core and slowly perform a squat, keeping your back straight. Your knees should be in line with your middle toes and should not move forward past your toes. Perform 3 sets of 10.
1 Knee Stability - Exercise ball Squats
Just Out of Surgery
The first days to a week post surgery involve the same regime as just after your initial injury. You will focus on reducing swelling and managing pain. Using a cryo-cuff is the easiest way to reduce swelling. A cryo-cuff is a knee wrap attached to cooler, which pumps iced water through the wrap, providing consistent cooling and compression to your knee. It eliminates the need to repeatedly improvise and renew ice wraps. Cryo-cuffs are one of the most valuable tools for rehab and continue to be useful when you get back to exercise. Once iced, keep your leg elevated above your heart and rest.
Immediately post surgery is a good time to use tapping exercises, meditation and sound healing, supported by a diet high in anti-flammatory foods to speed up the healing of your whole body. Aim to flush out toxins caused by anesthesia and pain medications. As soon as your bandages are off, gently rub oil from a vitamin E capsual onto the site of your surgery can help to speed up healing of the wound and reduce the appearance of scaring.
2 Range of Motion - Single leg Cycling
Cycling is the optimal exercise to regain full range of motion in your knee, because your knees are kept in line, preventing any tension from twisting as you exercise. Set up your Bike using a Bike traininer. Use pedal cages to anchor your foot. Pedal clips may cause issues due to need to twist in and out of the pedal. Adjust the seat height to change the angle of motion depending upon where your are in your healing process. You should never feel pain. Set the gearing resistance to minimum. Start to pedal only using your injured leg. The purpose of this exercise is to complete lots of revolutions to build motion, not build stength. Investing in a bike trainer so that you can exercise at home is a great way to manage your own rehab between visits to health professionals. Start with 10 minutes per session, then ice your knee afterwards. Slowly build up the cycle time and change the seat height and resistance as your range of motion improves.
First Steps Post Surgery - Week 1-6
First reducing swelling before walking is vital, because swelling limits range of motion. Your first steps will also depend on the type of surgery you have had. When your swelling is reduced you can start to place some weight on your leg and move around with support. This may be with the use of crutches. The amount of time and frequency of your first steps should be determined by your health professional. Everyone is different and will have varying levels of muscle strength around the knee, which will also determine the speed at which you can start to bear weight.
Steps will be very stiff to begin with, which is why a strong focus on physio to establish full range of motion is highly valuable. Establishing full leg extension is key to achieve the proper gait without limping. As you start to walk, your brain has to resetablish the motor skills associated with your newly built knee. This process should not be rushed. As soon as your knee starts to throb or ache apply ice and rest.
Once you build up enough stamina to move around, typically around week 2, you can start to gently exercise to gain range of motion. These exercises will include the basics used pre-surgery, to build the muscles aroung your knee and then build to more intensive exercises as indicated opposite.
This period can be the most challenging emotionally and mentally. You have to cope with immobility whilst getting back to normal life/work habits. Frustration about not being able to exercise as you are used to, unexpected anger and even symptoms of depression can commonly show up. Acknowledging these feelings and actively seeking to use tools such as tapping to calm the nervous system are highly powerful.
A big part of rehab is retraining the brain to trust your injured knee and not favour your other side. This exercise builds strength and trust. Stand with legs hip width apart, knees soft and aligned over toes. Engage core and raise knee, standing on one leg. Repeat on both sides and try to hold for 1 minute. Once this exercise is too easy, close your eyes. Then move to stand on a wobble board eyes open and eventually eyes closed.
3 Balance - Eyes closed Single leg Standing
4 Core Strength - Jefferson Curl
This curl tackles strength and range of motion all in one exercise by targetting the cervical, thurastic and lumbar parts of the spine. It is often overlooked, but provides excellent core stengthening to prevent shoulder, hip, back and knee injuries. Stand with legs hip width apart, fold over to touch toes (you can hold a bar bell for added weight and stand on a box to achieve a deeper curl), engage your core and legs and start to roll up to standing position, one vertebrae at a time. When standing, roll your shoulders up, back and down to finish in a strong tall standing position.
Building Strength - Week 6-12
Weeks 6-12 continue to be about building your strength and range of motion. This period can be quite tricky to balance doing too much versus not enough. It is the period where you are at greatest risk of doing further injury.
Being able to intuitively read your body is key, along with following a consistent focused rehab plan. Adding a little more to stretch yourself daily is the best way to build strength. Eating a diet that is rich in nutrients is highly beneficial to promote new cell growth.
Drinking a mixture of hot water with 2 tablespoons of organic apple cider vinegar and honey to taste is a great way to flush lactic acid out of your system. Organic Apple Cider Vinigar contains amino acids, potassium and enzymes which help break down the lactic acid, which cause muscle fatigue and soreness. Adding supplements can also provide that extra boost.
Most importantly remember to continuously ice post exercise, or a heavy day on your feet to keep swelling to a minimum.
Add this ninja exercise to your peak perfomance training. A series of squats, planks and crunches are required to deliver the same results as this one exercise. The Hollow-Body Hold is a powerful foundational position that builds your abs, allowing transferance of force from your upper body to your lower body without any energy leaks. Strength in this position delivers power when squatting, throwing, pushing, pulling, jumping, hitting, kicking, or sprinting. Lie on a mat on your back, with your arms by your side and legs bent. Engage your core to press your lower back into the floor. Lift your shoulders and arms off the floor a few inches by elongating your spine and actively contracting your abs. Also lift your legs a few inches off of the floor keeping your knees bent. (Keep your elbows locked, legs together, toes pointed and lower back glued to the floor with tight abs). Hold in strong form for 1 minute without any wobble. As you gain strength, straighten your legs to hover a few inches from the floor and raise your arms to stretch out in line with your ears (shoulders off the floor).
5 Core Strength - Hollow Body Hold
One of the biggest frustrations of a knee injury is the impact on your cardio stamina. Swimming is the easiest and quickest exercise to regain cardio performance. The water supports your body, taking the pressure off of the injured joint. You can begin by running in water to rebuild knee strength and motion, then build to free style or back stroke where your knee is exercised in line with your body. Swimming in the sea has double the benefits from being emersed in healing salt.
6 Flexibility - Yoga & Pilates
Peak performance requires flexibility as much as stength. Yoga and Pilates are some of the best forms of exercise to increase flexibility in your joints whilst building strength. Learning to practice the following poses at home on a mat is an easy way to build your sporting stamina and protect against future injury by targeting you vastus medialis to keep your hip, knee ankles aligned: Staff poses, Warrior poses, Eagle balancing poses. Learn More >>
Back to Sports
The million dollar question - when can I get back to sports? Timing will vary for everyone, because each situation is unique. From the type of injury to the level of rehab support, diet followed and emotional / mental state, are all factors playing into the timing and results experienced. Focused athletes are able to return to sports faster than most sporting enthusiasts simply because of the level of rehab programes that they are able to engage in.
One key to returning to sport is your ability to work on balance, but to also improve agility, jumping and landing skills to prevent re-injury. Many sports health professionals will allow patients to start running at 3 months, going very short distances for a few minutes, with equal rest intervals, and then slowly building up.
It doesn't all have to be physical. Active visualisation is a great tool to employ during rehab to not only heal effectively but also improve your game.
9-12 months is the most common period for return to sports, but in many cases, neuromuscular control deficits have been noted to persist past 11 months. It takes the brain longer to reprogram to your adjusted knee. Many patients will find that they can engage back in sporting activities, yet feel strange sensations in their knee when walking down stairs.
Getting your brain to catch up with your rehabed knee can be significantly aided by practicing Yoga or Pilates. Both of these forms of exercise build stronger neurological connections through the linkage of breath with body movement. Yoga and Pilates also significantly aid endurance and flexibility, two key aspects to elevate your overall sporting performance.
Most people are at full participation enjoying the sport they love by 12 months!
7 Cardio - Swimming
Useful Knee Rehab Exercise Equipment
1 Exercise Ball
An exercise ball is a relatively cheap but highly valuable rehab tool. It is versatile, supporting a range of exercises, but specifically helps to build core strength by working your abs and back muscles, without putting stress on your knee. An exercise ball provides a seat for a range of balancing and weight lifting exercises, to support your knee for ground work and as a tool for wall squats. When choosing an exercise ball you need a size that enables you to sit with your knees at 90° angles. See Exercise Ball options >>
2 Exercise Bands for Stretching
Exercise bands are a key rehab tool to slowly build up your knee strength and range of motion. Exercise bands come in different tensile strengths (usually colour coded). By selecting lower tensiles and then gradually moving up, you can safely exercise without placing undue tension on your knee joint. A length of band is used, with one end tied to a chair, bed, or piece of furniture and a loop created in the other end for your foot. Exercise bands can be used anywhere, following the key rehab exercises defined by your physio. See Exercise Band options >>
Most knee rehab exercises can be done in your own home. A yoga mat provides your body with protection and cushioning against hard floor surfaces. A mat is highly valuable investment to incorporate the Hollow-Body Hold and Yoga poses into your rehab routine. See Exercise Mat options >>
3 Exercise Mat
4 Bike Trainer & Bike
A bike trainer turns your bike into a stationary unit so that you can exercise indoors. Bike trainers hold the back axel in a fixed frame and provide resistence against the wheel to allow training through all your gears. This simulates normal riding. Bike trainers are available in a range of types and prices, from wind trainers, to mag trainers to fluid trainers. This might be one of your most expensive rehab investments but will be one of the most valuable to build long term performance. Raise your front wheel with a bike block, piece of wood or thick book! See Bike Trainer options >>
5 Balance Disc / Wobble Boards
A balance disc is an inflatable round cushion with a platform that is strong enough to sit or stand on. Balance Discs or wobble boards are great for rehab to build proprioception. This is the feedback loop between the body telling the brain what position the joints are in and the brain making rapid adjustments to the joints' position depending on it's situation. See Balance Disc options >>
6 Foam rollers
Foam rollers are relatively inexpensive and not only valuable for rehab but also as an ongoing exercise warm up and cool down tool for your muscles. Foam rollers are used by placing them under your leg whilst lying on your side or sitting up and slowly moving your body up and down the foam roll. Rolling breaks down muscle knots and speeds up blood flow. You can use a foam roller to stretch the myofacial (connective tissue around the muscle), instead of relying on a physiotherapist. Foam Roller options >>