Knee Exercise Prescription

Question 1

Explain the phases in a typical rehabilitation program.

Answer 1

Phase I: 0-4 weeks, control swelling, build ROM, 4/5 MMT
Phase II: 4-6 weeks, full weight bearing, eliminate swelling
Phase III: 6-10 weeks: full ROM, full strength, full squat, return to light jogging
Phase IV: 8-12 weeks: full strength, ROM and endurance of limb, high sport specific

Question 2

What does typical isolated grade III medial knee injuries focus on?

Answer 2

Restoring quadriceps function, improving knee ROM and controlling knee edema

Question 3

What tissue takes the longest to heal?

Answer 3

• Ligament (grade III and intra-articular)

- Tendon (chronic and rupture or surgically repaired)

Question 4

What deficits exist in patellofemoral joint pain?

Answer 4

Hip abduction strength, knee extensor strength, foot pronation, femoral rotation

Question 5

List the following movements from least to most patellofemoral joint loading: Level walking, squatting, jumping, stair climbing, jogging, stair descent

Answer 5

• Level walking
• Stair climbing
• Stair descent
• Jogging
• Squatting
• Jumping

Question 6

State the activity ladder

Answer 6

1. Easy walking/ cycling
2. Fast walking/ medium to hard cycling
3. Slow running
4. Stair climbing
5. Running and jumping at medium speed
6. Running and jumping at high speed

Question 7

What are the 6 phases of tendinopathy progression?

Answer 7

1. Reduce pain (isometrics in mid range, reduce compressive load)
2. Improve strength (heavy slow resistance training in non-compressive position)
3. Build functional strength (progress strength work into more functional)
4. Increase power (reduce reps, increase speed)
5. Develop stretch-shortening cycle (plyometrics)
6. Sport specific

Question 8

What is a good set/ rep scheme for isometrics?

Answer 8

4-5 sets of 40-60 seconds @25-50% MVC

Question 9

What are PRE-ACL surgery goals?

Answer 9

• Aim to achieve full knee extension ROM
• Maximise quad and hamstring strength and hypertrophy
• Maximise general lower limb strength and function

Question 10

What are POST-ACL surgery goals?

Answer 10

• Regain knee joint ROM
• Restore quad activity, hypertrophy and strength
• Consider graft type in exercise
• Progressively introduce plyometrics, running and change of direction

Question 11

What weakness is associated with knee osteoarthritis?

Answer 11

Quadriceps weakness

Question 12

What are some pre-surgical management strategies for total knee replacement?

Answer 12

• Build knee extensor and flexor strength

- Reduce weight for weight bearing

Question 13

What are some post-surgical management strategies for total knee replacement?

Answer 13

-Basic range of motion and strengthening