Knee injuries are a common cause of pain and often take surgery, long term rest and moderate movement to recover. I know this because I suffered an ACL (Anterior Cruciate Ligament) tear to my right knee back in 1989. This was a life changing experience for me and helped me learn from an early age to listen to my body, use the technology available and to focus on my own self care at home.
One of biggest the challenges for people recovering from knee injury is lack of range of motion due to two things: atrophy and scar tissue both of which can cause pain.
Atrophy - When an injury happens the muscles in the injured leg are inflamed and need rest and therefore suffer from the lack of use which leads to reduction in strength of those muscles. This is very common after surgery as well while the leg is healing. Here are some treatments you may see after surgery to help with atrophy:
Continuous Passive Motion (CPM) machines which moves the leg which has undergone surgery while the person is lying down.
Electric Stimulation often called a TENS (Transcutaneous Electrical Nerve Stimulation) Unit can also be used to keep the muscles working by stimulating the nerves. This electrical charge moving the muscles around the knee can help keep the muscles engaged. At home this can be done with very moderate exercise and massage.
Scar tissue - Once an injury has happened whether there is a surgery or not, there is often scar tissue in the knee area. When this happens the fascia (the translucent tissue that surrounds the muscles) can build up as a protective barrier which can be painful and limit motion as the strands of fascia become tighter and remain very tender. Here are some treatments to help:
Therapeutic Ultrasound may be used by your healthcare provider to help break up scar tissue. Additionally they will use massage to help break up tight scar tissue.
These breakthrough technologies help people recover from knee injury faster than ever before, however the more you are able to work on your self care at home the more likely you will recover faster and gain more range of motion.
Range of Motion is tested with a goniometer which measures the angle of the knee during flexion and extension. The flexion point is centered on the bend in the knee and aligns with the bones in the leg.
Normal Range of motion is between zero degrees of extension (a completely straight leg) to 135 degrees of flexion for a bent knee. Some people have knees that hyperextend which would lead to a negative number for extension and some have an even deeper range of flexion to 155 or so degrees.
Here are some secrets to improve your range of motion, reduce pain and keep your joints flexible. The exercises below are meant to gain strength and range of motion. If any of the movements cause sharp or shooting pain, reduce the amount of motion or discontinue the motion altogether.
Before you stretch take ten minutes to warm up. Either walk or get on the stationary bike to get the circulation flowing and the tissues warm. This will help with your range of motion and reduce pain.
Lying prone (on stomach) with straight legs bend the knee and bring the heel to toward the buttock pause at the top and then lower. You can use a strap or elastic band to provide more tension to bend the knee even further as you progress. A band can be used to add tension as you progress.
Leg Raise (Front & Back)
Lying supine (on back) with straight legs lift leg as high as comfortable, pause and then lower. Use an elastic band to provide more resistance as you grow stronger.
Calf Smash With Lacrosse Ball
This move allows you to work out tension in both your calf and your hamstring. Sit on the ground and pull your right foot close to your buttock muscle so your knee is bent. Wedge a lacrosse ball (or yoga/massage ball) below your right knee, sandwiching it between your calf and hamstring. Create a “compression force” by pulling your shin toward you, then rotate your foot in alternating circular movements to help create space in your knee joint. Continue until you feel tightness in these areas being relieved, then switch legs. Your range of motion will may prevent you from being able to hold the ball at all - so work toward that goal first.
Figure Four Stretch
Stretching your hips out can positively effects the knees! Lie on your back with your feet on the floor, then cross your right ankle over your left knee and clasp your hands behind your left thigh. Slowly and gently pull your left knee toward your chest. Repeat on the other side.
The most important thing you can do to regain range of motion is to move your knee. The recumbent and stationary bike are great options for this goal, as you are able to achieve motion without putting additional weight on the muscles. The recumbent may be a good place to start, as the angle for your knee will have less range of motion at the start.
As you progress you will find that your range of motion improves and you are able to use the upright stationary bike and your knee will be able to bend quite a bit more. At some point you may be strong enough to do a spin class and even put weight on the pedals.
Contraindications & Knee Stretches
There may be times that stretches are not comfortable due to your level of pain and or range of motion. In these instances, you may need to modify the stretch to fit your comfort. This is often true in yoga classes. For more information on some yoga poses and stretches that you can modify for knee injuries, visit this website! There are some great modifications to popular poses that will help strengthen the knee.