Updated Jan 2021 - Knee exercises

The knee - simple anatomical view

KNEE EXERCISES

I originally published this on October 26, 2015

Edited May 15, 2020 for readability and to refresh the information as people are asking.

Some context and background -- 

DISCLAIMER:

First of all I am not a doctor nor physician and I am only sharing the lessons learned.  If you come across this, be advised that this is for informational purposes only and medical advice should be sought by a practicing and license Physical Therapist or Doctor. 

What I am, I am an endurance sports hobbyist that is reasonably intelligent and sharing info that would have beneficial to me - I didn't know that I needed this info until I encountered the problems.

Analogy and helpful information

The Dr. put it like this, the knee is like a lonely violinist or flutist when expecting a full orchestra/symphony - what he said is the violinist or flutist is well-positioned and can play the music and the pieces all by themselves, but the fullness of the orchestra is lost.  In the case of the knee, it often leads to over stress, and injury....the knee can meet over 23 angular planes...but who goes to the gym to work on a great hip abductor....because of this understanding the supporting instruments in the orchestra, in this case, the muscles and tendons of the knees, hips, hamstrings, glutes, soleus etc are all vital to a masterful and safe performance.

What were my symptoms?

I went from no activity to well - see my post on Transformation Tuesday (click here)!

My knee was OFTEN warm to the touch during training and I went to the Dr. X-rays and other tests validated that there was no structural or muscle damage (the repairing enzymes in the knee, cartilage and muscles cause the heat sensation - this is similar too, but not caused by infection).  During my 70.3 Ironman in St. George in 2015, my knee rendered me walking and locked up a bunch on course (Click Here to see post).  About half way through my event, I was having binding and aching and clicking and well, it was a nightmare.  There were multiple times in training i just pushed through what I thought was discomfort and tightness.  In retrospect, the analogy above was spot on, I was bringing a single instrument to the symphony and not doing anything else.  I learned a lot about biomechanics and the interoperability of muscular skeletal systems.  I'm not an expert but I do get asked to recount my story and experiences a lot, so I thought I would share here for reference.

What was my recommended action plan?

• I was strongly recommended to rest for 3-4 weeks -- NO running and minimize all other activity (not possible for all athletes but may be helpful) 
• In retrospect - I would recommend Pull buoy only swimming while resting - this assures an athlete doesn't go crazy.  With the PB, no kicking.  Did you hear that, NO KICKING, do not cheat this one!!!
• Dr recommended the following minimum supplements (6 weeks) -- This was based off my weight at the time and should be adjusted to a given persons physical makeup:
• Naproxen/aleve - at least 200 MG a dose - take in the morning and the evening before bed for swelling and inflammation management
• Osteo Bi Flex (I used the generic from Sam's club brand) -- 3500 mg a day - which is two pills 3 times a day for 4 weeks, then to maintenance dosing - 4 pills total a day for two weeks, and normal 2 pills a day on non-activity days (honestly I just normally take 2 morning and 2 before bed); fast forward to April 2020 - I take for a week normal dosing when I feel any stress or aches or pains. UPDATE: 2021 - I have a shellfish allergy and when I took the 3500/3600 mg I started to see an inner thigh rash, so where I am not in crisis injury mode, I am taking 1 tablet of Osteo a day for now and I will report back if things go sideways.
  
  
                                  

• PT exercises (see photos below)
  
  
  

What was my outcome form doing the exercises?  

I have not needed a PT, where I do think some will -- please understand that I run and bike anywhere from 6 -12 hours weekly in 2020/2021 in my Ironman training.  IN Jan 2021 after a significant break from October 2020 from running, I felt my hip flexors acting up and began to follow this again.  So far, for me, no knee pain following the information received from tense hip flexors.   Thought I'd update so folks have valid and current information.

So, to the Knee exercises - Right?

The following exercises were recommended and I was to IMMEDIATELY seek the advice of a Physical Therapist if these exercises didn't resolve the issues or if the problem recurred in the future.

So, while resting and after recovery the exercises are listed in pictures below. The Doctor also gave me about 10 more exercises - which I lost and are not a part of this posting.  Once I began the exercises, I did start pedaling (cycling) after about 10 days of complete no activity, but I DID NOT run for 4 weeks.... 

Follow the pictures, do each 2 or 3 times a day...

Do the following exercises after noonish - the reasoning is waiting this long to allow for the blood in your body to be readily ciurculating from the other activities in the day.

Directions

• Complete 3 sets of each exercise (6 pictured below) 
• Do 12 - 18 reps each
• Frequency - do multiple times a day at first
• At First I did 4 times a day first 2 weeks
• Then 3 times a day the following 2 weeks
•  Over time you can taper down. 

Currently in May 2020 I do these exercises maybe one time a week and 2 sets of each exercise doing 15 reps each. The Hip Abductor exercise I also do in the pool almost every time I swim.

STRETCH - Quadriceps, Prone



FLEXIBILITY - Hamstrings



STRENGTH - Hip Abduction in Quadraped



STRENGTH - Hip Abduction



STRENGTH - Hip Abduction



STRENGTH - Quadriceps VMO