Knee rehabilitation- late stage
The aim at the late stage of rehab is to start some early impact exercises, return to running and progress to sport specific training.
Once the range of movement, strength and control of the knee joint has been restored we can now start to look at a progressive return to your chosen sport or hobby. Your physiotherapist will have been through some physical tests with you which will help to make a decision as to when someone is ready to start running or playing sport again.
Early impact and return to running drills
Before starting to run it is beneficial to prepare the knee for the forces that are imposed on the knee during impact activities. The emphasis should be on good knee stabilisation during landing encouraging a light/soft but stable landing. Running can be introduced gradually once the person is demonstrating good technique and there is no significant increase in pain or swelling related to the increase in activity.
Examples of exercises:
- A-walk
- A-skips
- High knees run
- Plus sign jump drill
- Drop and land
- Squat jump
- Mini box jumps
Return to running video drills
Progressive impact exercises
At this stage you will be working towards improving your landing control on one leg. Some of the exercises will start to introduce deceleration forces in diagonal or lateral planes of movement. During these exercises ensure a soft and controlled landing.
Examples of exercises:
- Plus sign hop drill
- Broad jump
- Ski Hops
- Lateral hop and land
- Lateral jump and land
- Depth jumps for height and distance
Early agility and plyometric exercises
At this stage we bring in some higher level plyometric exercises and start to incorporate rotational single leg landing and deceleration. There may be a gradual increase in pace with these exercises which may introduce an element of fatigue. It is therefore important to maintain good control throughout these movements.
Examples of exercises:
- Lateral plyometrics – jump laterally on/off 2 boxes landing on 1 leg
- Box jump variations
- Lateral hops over a marker increasing tempo and distance
- Rebounding jumps on and off a step
- Squat jump into lunge
- Modified T-drill, increasing to 50% effort at first
Early agility and plyometric exercises
Sport specific training
At this stage we start to implement training that is more specific to your chosen sport. These exercises aim to increase the rotational forces on the knee whilst progressing the intensity of direction change, cutting and pivoting. When starting these drills initially it is advisable to perform them at 50% effort and gradually building this up over time.
Examples of exercises:
- Sport Specific Compass Drills- responding to verbal cues
- Bottom kicks
- Crossover hop drills
- Rotational Hops
- Modified Hexagon Drill
- Number Hop Drills
- Jump with perturbations
Advancing sport specific drills
Advanced strengthening and control exercises
Below are some advanced strength and control exercises for the legs. Continuing with these exercises whilst working on the impact part of your rehabilitation is very important as this will help conditioning the muscles around the knee. You may experience some discomfort whilst performing some of the exercises and this may persist for some time after finishing them. The pain you may experience after the exercises does not mean you are damaging anything. How much and how long the pain lasts for is something you will discuss with your physiotherapist, but usually if the pain and the length of the time the pain lasts for is acceptable to you, then it’s fine.