Category Archives for "Knee Injuries, Pain, acl"

Knee Ligament Injuries ACL

Mark: Hi, it's Mark from TLR. I'm here with Wil Seto of Insync Physio in Vancouver, multiple time winners, their whole crew of best physiotherapists in Vancouver and in North Burnaby, they have two offices. And we're going to talk about things that break in your body. How are you doing Wil?  

Wil: I'm doing great. 

Mark: This isn't so much a break, this is more of a tear kind of a thing. The knee ligament injuries. What kind of symptoms that people have when they come in with knee ligament problems? 

Wil: Well, what I wanted to actually discuss a little bit more today was major ligament in the knee, called the ACL. Now the ACL stands for anterior cruciate ligament, and the whole purpose of the ACL is that it's actually the main stabilizer in terms of ligament in the knee.

So you have several ligaments in the knee. You have your ACL, your PCL, and your LCL and you MCL. And so with the ACL quite often you also injure it in conjunction with a couple of other structures in the knee. So with your MCL, which is your medial collateral ligament, and then also your medial meniscus.

So quite often with the three injury, they call it the evil triad, so to speak. So quite often with sports, it's very, very common, you know, when you have like a sport that involves running with cutting and a lot of fast changing directions.

Particularly hockey, any kind of field sports, like football, soccer, ultimate Frisbee and rugby. Even like, believe it or not like tennis and squash. Anything that involves like fast changes in movement, but particularly the other ones that I mentioned because they involve contact. So you can kind of add that factor into it. 

Quite often, what happens is if you have contact, then you have sort of this initiation of force on the knee, and so this is where it involves all three parts. Like I called the evil triad. Where you can injure the ACL, MCL and the meniscus where you get this blunt force on the outside of the knee where it causes it to buckle and also hyperextend. And that's where you get the injury to all three. 

Now in another case where you can get just the ACL isolated, it could just be like a hyperextension type of injury, because the main function of the ACL is it actually stops like, so your knee, if you think of your knee is a hinge joint. And so the purpose of that ligament is, so say this is your lower leg and then this is your femur or your thighbone, so when you go to extend your lower leg or your knee, it actually prevents it from hyperextending or straightening out beyond what should be. And that's the protective, normal check and balance for protecting the knee.

 And so what ends up happening too is you've got a lot of nerve endings in that ligament, that basically when that happens, muscles will kick in and stop, like your hamstring is the biggest one. And so when you hyperextend it, and especially if you have your foot planted, then that can cause a tear in that ACL. 

And there's different degrees of tearing. So there's basically three classifications. So they have a grade one, grade two and grade three, and those are the three classifications.

And in grade one, it's a very mild injury to the ACL where basically you still have a good portion of the ACL, but it's either been slightly torn or stretched. And when you assess it and you diagnose it and you feel for it, and there's a battery of different tests that you want to do to kind of test it. But a couple of main ones and you can still feel that there's still ligament there intact. 

And a second degree, that's where you feel like a lot more give and it feels, it definitely has more of this like unstable kind of feeling, but it still has a little bit of that ligament left where, you know, it's still kind of holding it in place.

Whereas a grade three tear classification is that, that ligament is completely torn. And when you do specific tests on it, then that's not holding at all. And it's just basically, you know, pretty unhinged.

Mark: So how would, other than pain, swelling, what other symptoms would people have? Is it more about how it feels, whether how stable that knee feels for certain actions or you're just not capable of doing those actions anymore? What am I going to notice if I have a tear? 

Wil: So well, first off, if it's an acute injury or a trauma, there's going to be swelling right off the bat. Particularly because there's the way the blood supply is and how it connects and everything like that, then you're going to know right away that you've injured most likely your ACL, if you've done those sort of directions of movement that may cause the injury. The swelling happens automatic, like pretty instant.

And so the other thing to also consider too, is like, what I was talking about in terms of the movement is that you're going to have this feeling unstable. So your knee will feel like it gives up because it's just basically, especially with a grade three tear, you know, like I said before now it's like unhinged. I mean, it's got a bit of a weird term, but like the stability in your knee is no longer as good.

And so when you walk, you're going to feel like it gives out. And so that's a big problem. Like your knee will literally give up. Like it'll feel like it sort of just like glides out of joint and out of place. So that that's another thing to look for.

Now is you have other things that are happening, like if it locks, then it could be a meniscal injury as well. So when I talked a little bit earlier about how it could be this triad, this evil triad, and you have a bit of meniscal stuff going on, then that could be a part of it too. So you want to get it properly diagnosed to see if it's just the ACL, if it's possibly, you know, two or all three of them.

Mark: So where's the line between rehab and the knife? 

Wil: That's a really great question. Now it's kind of interesting because prior to 2019 and 2018 if you were a very active individual and especially if you were involved in athletics and sports and you had a complete tear, then the rule of thumb was to get that reconstruction and get that repaired.

But they have done a lot of research and they came out with a consensus and a study. Some studies done in 2019 and they presented it at sport physiotherapy in the sports medicine conference, world congress in 2019, showing that it's actually 50-50. And so in other words, with a complete rupture of your ACL, there've been people that have had athletes, so this is going back to the athletic population, and were very active and depending on that stability. That if they've gone under the knife and they had the reconstruction done, they've done really well in terms of rehab. But then they've also seen half of that study group not do well. 

But then they took another group where they had individuals not do any surgery. And they did really well. They just did very specific rehab that was geared towards what they needed to get back to playing sport. And they were actually back playing competitive sports at the level that they could play with the full rehab, with a fully torn ACL.

So this has been interesting. So that's kind of where we stand now more recently in the last couple of years and that's kind of the direction that we're going. But either way, the rehab component of strengthening and really being sport-specific or activity specific dependent is a huge factor. So you always want to make sure that you're addressing whatever deficits are needed. Because that's ultimately the key to successfully return to sport or a successfully returned activity, whatever that is. 

Mark: Okay. I really don't want this ever. How do I prevent it? What are the actions I can take to help prevent other than a blunt force to the front of the knee kind of thing, that hyperextends it, what could I do to strengthen it? 

Wil: There's some specific things that you can do. Like you want to strengthen up your quadriceps. You want to strengthen up the hams, like all those muscles around the knee. And there's some specific exercises that you can do. We actually have a YouTube channel with a specific list of ACL prevention exercises.

So there's about seven to 10 exercises that you can do, but there's more. But those are the basics that you can start with. And then obviously as you get into like specific sports, like if its Ultimate Frisbee, even rock climbing, you want to do some specific things to work on strengthening the knee.

So that is very important because what you're doing is you're developing the what's called the muscle activation pattern, that will stop your knee from going beyond the range that it should be. Because I mentioned before that your ACL has nerve receptors. And so when it goes to the end range of extension, as it goes just even a little bit past that end range, your nerve receptors kick in right away. Now, if your muscles are trained and strong and you've been, and you've been really focusing on having a good sort of sense of muscle activation patterns with respect to also your balance and all that stuff and how everything activates properly, then that's a really great way of preventing injury.

Mark: Depends on the grade of injury, but what's a typical course of treatment? 

Wil: Yeah. So it can take anywhere from up to six to eight weeks for really, really mild someone that's just sprained it very, very gently. Where they're back on track and they're doing their sports to as long as a year. And the other interesting thing about that is that you're asking, you know, your actions, I never want this injury. Well I didn't mention that this injury can be something that can happen that you might not even be aware of. And then maybe because you're very active, I'll give you an example. 

One of our therapists is treating someone else right now who does not do any contact sports or running sports or whatever, but he is an avid golfer. Like super avid golfer. And he was complaining of like weakness and loss of range in like his hip and other areas. And he's like complaining about his golf game. And so the physiotherapists on our team assessed his knee and found that, well, this is the cause of your hip tightness and why you're compensating because you have, you have this deficient ACL and the best way to actually ascertain that is to compare that knee in question with the other knee. So you always want to do what's called a bilateral comparison. And so she found out that he had a total grade three ACL tear. And so they'd been doing rehab, working on it, and he's been doing simple things and he's like a very avid golfer. 

He's been really getting out there on the greens, but he's been like hitting balls and playing all summer long and his and his hip just started getting tight. So these compensation patterns started happening. His knee started feeling weird. But he didn't know why. And for life of our physio, who's been working with him you know, like there has been no trauma. So that's really interesting. So we think that it's his compensation pattern and he's been over stretching and over stretching and over stretching. 

So his timeframe for rehab you know, let's go back to your question, might take a little longer, because he's developed all these muscle patterns in his hip, in his back because of that ACL. And he didn't even know he had an ACL injury. 

Mark: Yeah, complicated. If you want help with your knees, the guys to see are Insync Physio. You can reach them at their website to book, insyncphysio.com. Both offices you can book there. It's really easy to use, or you can call them in Vancouver 604-566-9716. Or in North Burnaby, 604-298-4878. Get professional help. Keep going with your sports. Thanks. Wil.

Wil: You're welcome Mark.

Knee Osteoarthritis with Simon Kelly

Mark: Hi, it's Mark from Top Local. I'm here with Simon Kelly of Insync Physio in Vancouver. We're going to talk about osteoarthritis. Something that's probably rampant in the population. Something that has, I get more grey hairs, I start to wonder about things around this particular subject. So Simon, tell me what's the deal with osteoarthritis.

Simon: Thanks for having me. Absolutely, like osteoarthritis, a lot of people are well aware or have heard the term arthritis any way for sure and osteoarthritis is more, to be honest, it's sometimes healthy, not healthy, but we all get a bit older and sort of, we do develop some wash terminology can be like degenerative, osteoarthritis, wear and tear. They all kind of mean the same thing, but I think sometimes our terminology can get a bit out of hand as well. So it is just wear and tear and break down of cartilage. 

Now, one thing I like to let people know is that once the cartilage is worn out, they know physio can really get it back, which you can really increase the longevity of your joint by increasing the muscles around that joint and maybe the joint evolve. I'll speak about the knee in this video just for simplistic reasons. So like the real hard part about osteo, so that's osteoarthritis sorry. And it's not to be confused with rheumatoid arthritis, which are autoimmune diseases and that's kind of the body attacking instead of a little bit. So it's  a little bit different from that. 

Osteoarthritis generally, you know, it usually affects the older population. It's rare that, you know,  it would present gradually. People will come in and say, Oh, I just suddenly have pain in my knee. And generally they're pointing to the inside of their knee because that compartment gets loaded more than the outside compartment of the knee. Some people do complain about pain behind the knee cap as well. That can be put in with patellofemoral pain syndrome, but usually it's a bit of wear to the cartilage behind a knee cap as well. And some people would present with the three different components. The inside of the knee, the outside and  behind the kneecap. 

But anyway, it would be gradual in onset. People would be like I can't remember doing anything, no specific event. And it usually points to the inside of the knee. So usually what we do is when they come into clinic, first of all, we do take a history. We look at the age of the person. Could be mid fifties sometimes, maybe late fifties and onwards. What's important to know osteoarthritis is it is painful. But not all the pain is bad in that it's okay what I said to have 2 out of 10 pain are 3 out of 10 pain when you're doing your activities. 

I had a guy in recently, actually, I kind of link it to this case study. He was a 58 year old man loves his tennis and obviously quite worried about like is his joint degenerating? What can he do moving forward and wanted to be proactive. So I told him, look, it has a bit of wear on the joint, not to be worried about the terminology. But you can also settle, pain isn't always linked to the where prior to the joint, it can be linked to just a bit of over activity. He was doing a bit of tennis in his case, so maybe more higher impact then just normal squats or when your foot is fixed on the floor.

So, and, but he was also doing like, again, it's nice weather now at the moment here in Vancouver. And he went from like zero to like hero of like five days in a row of tennis and Vancouverites love the outdoors. Just like a woman in the previous videos. So they love to run a lot and get out a lot and I don't blame them in the pandemic.

Like if he came in with a very swollen knee in his case, I asked him what he was doing. And he told me he was playing tennis five times a week and cycling two or three times a week. So really had to address the load his knee was on. Obviously he was 58 years old. He had a previous MCL injury, which is the ligament on the inside your knee. So he was wearing a big brace with two metal bars down, either side of his knee, which is good for MCL strain or injury. It prevents the knee from kind of going from side to side. But Ironically, he thought it was still an MCL injury, but I tested him in clinic, we do a few tests and his MCL was pretty good.

So it was really just early onset osteoarthritis that we were dealing with. So he just had to, the plan for him was just to offload. Maybe again, don't play a tennis five days in a row. Even if the weather is good. I know you like the weather and we'll probably get some rain next week here. Well, like if you just went to like Monday and again, every Wednesday or Thursday, and they'll be cycled on the alternate days, his knee might not have swelled up at all.

So the real trick osteoarthritis, even if you are feeling a bit of pain with your activities like 3 out of 10 is okay, but like, I don't want his knee ballooning up swollen like he presented to me in clinic. That's just too much and that can really progress the disease that much quicker actually. So like, he'd be looking at a knee replacement like, I dunno exactly maybe three or five years, as opposed to maybe 10, 15 years. If he's to play tennis at that level, where his knee is swelling up, which is just not ideal.

However, too little load is also detrimental because I used the analogy like astronauts in space. You go up into space, like you just lose all your bone density. So like gravity and weight is actually quite important for new bone growth. Every 10 years, our body makes new bone growth until we die. You stop growing between the ages of 17 and 25, but they keep regenerating every 10 years.

So it's also not going to like, not load the joint at all. So the real trick is to load the joint pain, 2 or 3 out of 10 on a pain scale, 10 being excruciating pain and zero being no pain. And it's kind of what we're seeing in the research is okay without obviously ballooning up of the knee and obviously like not giving it kind of time to rest. So it really is getting that  happy medium again. 

No w in clinic obviously you have to assess all of that. And then we do a lot of exercises. A lot of the time it's actually the hip muscles that become weak that cause the knee to kind of turn inwards. That puts the load down through that kind of inside compartment of the knee.

That's why they point their finger to the inside of the knee. It's in your glute medius, it's the name of the muscle, we've all heard of the glutes and glute minimus. That keeps the pelvis level in single leg stance. It also pushes the knee back into neutral. Prevents a kind of caving inwards. So a lot of the exercises are geared towards the joint above because it's mostly weakness in the hip. And a little bit in the knee, but mostly in the hip that we need to kind of correct. 

So when someone comes in, we'll look at the biomechanics of the body. We'll sort of get the load more neutrally distributed down through the lower limb, and then we'd obviously allow the person, I like to get the person to do their activities. In his case, it is tennis. It was high impact. You know, he's only 58. I want him to have enjoyment out of tennis. So I'm not going to cut it out completely because I don't believe he needs to cut it out completely. He just needs to cut it down and drastically for a while initially. Like maybe once a week he could go twice a week and then his knee could last him 15, 20 years.

Mark: And what's the typical treatment protocol for him to get to a place where the pain is minimized, maybe not gone, but just minimized.

Simon:  Absolutely Mark. So, and you're right with the minimize there. A timeline, rough timeline it's not as long as the tendinopathy, mostly four to six weeks. All depends on how would a patient adheres to like the knowledge that you kind of pass on as well. If they really like in his case, actually, I saw him just during the week. He'd cut down his tennis. He'd done what I told him. And he had no swelling at all on the next visit. He'd stop wearing his knee brace because he doesn't need it to, because of the old ligament injury he thought he had. And he understood like, you know, a little bit of calm weight is important, but not to be ballooning up.

So you know, that was almost like a magic trick he felt, I felt it as well. It's almost like a magic trick, but just because he was loading it in such a different manner to like doing the weekend warrior stuff on it, you know? So I usually just treat that like four to six weeks, you could argue it is a bit of a lifestyle. He will need to monitor his knee from this point onwards. With or without me, you know, it has kind of reared its head. If he keeps continuing at that point, his knee will decline much quicker. But if you kind of just alters those few bits, his knee could last him like 10, 15, more years, maybe even longer. Obviously it depends on his activities and whether he wants to play a tennis in two or three years. And at that point you might want to look at maybe lower impact activities, more like biking. Also depending on how we would present maybe in three or four years time. 

Mark: And what would be the kind of typical hip exercises that you would prescribe? 

Simon: So yeah, we do a bit of single leg bridging again. I kind of spoke about it before. A lot of glute medius exercise, kind of like single leg stance. We call them hip hikes. So you're kind of standing on the edge of step and let your hip drop down and then you pull it back up. So this glute medius pulls this hip back into neutral. That's kind of what happens.

We call it a trendelenburg gait. Usually it's hard to see though the early stages of osteoarthritis, but you know, you're 80 year old women, you know, you really notice it.  They try to step on their pelvis, but their pelvis is dropping because it can't keep it level in order to take a step. If that makes sense, but we really want to prevent getting to that stage.

And obviously if it does get to that stage, you do have to get, like it's usually pain that people get a hip replacement for eventually. But that's maybe a conversation for another day, but at times, like it depends on your age. You probably don't want to get a hip replacement at 90, just because you might get an infection or something in clinic, so it's better to kind of choose. Usually have a 20 year life span. So a lot of people might get a knee or hip replacement around 65, 70, and that would probably do them their lifespan. As opposed to like maybe 88 and then, you know, because there's a bit more comorbidities. People are kind of struggling at that moment in time. So that's just something that you'd have to discuss with the individual, depending on how it presents.

 Mark: If you're noticing some pain in your knee, could it be osteoarthritis? Come and see Simon Kelly at Insync Physio. You can book an appointment at insyncphysio.com. Easy one click, boom, boom. You can find the opening and where works for you get in there. Get to see him.  Get some treatment. Get the pain minimized or you can call to book at (604) 566-9716. Thanks Simon. 

Simon: Thank you Mark.

Knee ligament Injuries – Big Ball Curls

When you injure your knee ligaments an important part of the recovery process is to begin to strengthen it properly. Big Ball Curls do just that!

Lie down on the ground with your lower legs and the back of your calves and heels on a big ball. Keep your arms on the ground, knees straight and the inner core muscles for your lower back engaged so that your back stays in neutral.

Then lift your butt up off the ground while maintaining your balance and then curl the ball in towards your butt with your heels activating your hamstrings and posterior hip muscles. Hold this for a good second with the knees fully flexed and then slowly straighten the knees push the ball away from you.

Keep your butt off the ground the whole time for ten reps and then come down for a rest after one set of 10 reps. Do 3 sets of 10 in total.

This is a great exercise to build more functional core and knee strength after injuring it. If you have any problems or questions with this exercise consult your local Physiotherapist before continuing. 

Knee Pain – Heather Camenzind

Mark: Hi, it's Mark from Top Local. I'm here with Heather Camenzind and she's a physiotherapist at Insync Physio in Vancouver in the Cambie Street area. And we're going to talk about knee pain while running. How are you doing Heather? 

Heather: I'm good. Thanks for having me Mark. 

Mark: So knee pain from running. This is a new thing, or there's been an increase in it because of something. 

Heather: Yeah, it's not a new thing, treated a lot of it before. But I'm seeing an increase in the past year. I think with the current status of our globe and with the pandemic, we're seeing a lot of people that have taken up running as their form of exercise with the gym schedules being modified and closed. So I'm seeing an uptake in the clinic with knee pain. 

Mark: So is there specific things that cause knee pain from running? 

Heather: There's many different causes. But a lot of them that we're seeing is a breakdown for the underside of the knee cap. So it's basically, it's a rubbing on the underside of the kneecap on the end of the femur bone. And there can be different causes to why that breakdown is happening. And so that's why a physiotherapist can help with that. 

Mark: So what's the protocol. What does treatment look like when you're faced with a client coming in? 

Heather: Yeah, a typical treatment will start with a history of how long that they had the pain. Where does the pain, can they describe it? And you just have a good chat about that. And what are some factors that may be contributing to that? So changes in current training schedule, have they significantly increased how much they're running or the terrain that they're running on? 

Other things that can affect it are their footwear? Have they made a change to their shoes? Or lifestyle changes. So that's what we're seeing a lot of right now is the lifestyle changes. I think people are trying to be active, but we're also told to stay at home a lot right now. And so I think people are sitting more than they typically would in the past.

Mark: So give us a couple example things of how you would treat this. Couple of causes, a couple of treatments. 

Heather: Yeah, so different ways that we can treat it is sometimes it's just that the hip flexors and the quads are more tight. And so we have to release the tension through there. So the physio might work with some manual therapy on that, and then give you some exercises such as foam rolling, and some stretches to open up the quad and the hip flexors.

Another common thing that we're seeing is that people are weak in their glute muscles. So, especially their glute medius muscle. That's the muscle on the side of your hip that helps control the alignment of your knee. And a lot of just like leg lifts out to the side. Or like your figure four stretch is a very common stretch that people know, are ones that can help with that hip tightness that will help with the alignment of the knee.

Mark: And what's I know it's case dependent, of course, but what would be a more typical treatment program and what might it affect how effective it is? 

Heather: Yeah, so different things that can affect like how much progress you see is a, I counsel people on is kind of like, the more often you do your exercises and how frequent you do them, you'll get a better bang for your buck so to speak. If you're consistent with them, you'll notice progress sooner and faster. If you're maybe do them once a week, yeah, you may get there. It will improve. It'll probably just take a lot longer. So the more consistent that you are at home the better it is. You only really see your physio probably once a week maybe for maybe half an hour, 45 minutes an hour, if you're lucky. So there's so many more hours in the day that you can be working on things yourself. 

The other thing is just, can the physio diagnose and figure out what is the major contributing factor for you? Is it just a modification that needs to be done to your training program? Have you increased things too quickly? Or can they narrow in on the specific weaknesses that are contributing to your knee pain. Such as glute weakness, or maybe it's your running shoe? So it's proper diagnosis of what is the main cause. And then you'll start to see progress. Typically we see progress within six to eight weeks that you're seeing significant progress with it.

Mark: And I guess depends on how much the pain is and the cause whether somebody has to totally stop their running program in order to let the healing happen. How does that work? 

Heather: Exactly. So some people come in and they're, they're very flared up. Everything is hurting, just walking and it's very sore. Those people benefit from just allowing their nervous system, allowing their body, the inflammation that's there to calm down.

So we have to say, I'm sorry, you have to stop running right now. Others it's maybe their knee pain only comes in 45 minutes into their run or something. It comes on later and then their body tolerates it quite well. They don't really get too aggravated after. So those people we're able to work with them and just modify their running program and get them doing the right exercises. And then we're able to maintain their running. So it depends on the person. And sort of a case-by-case basis on what I typically recommend for them. 

Mark: So if you put the work in and you listen to your physio and have the right shoes and don't crank it up too much, within six weeks, eight weeks, you're probably back running as hard as ever and all the things you want to do without pain.

Heather: That's the hope. Yeah, definitely. 

Mark: So there you go. If you want some expert advice on how to deal with your knee pain while running, or any kind of knee pain or any kind of shoulder problems or neck or back, or you name it basically toes to the top of your head, this is a person to call. Heather Camenzind. You can reach her at Insync Physio to book an appointment. Insyncphysio.com book online. You can see there, they've got both the Vancouver and Burnaby booking systems are hooked up. Very easy to use. Or call the office at 604-566-9716. Thanks Heather. 

Heather: Thank you very much. Bye.

Knee Ligament Sprain Injuries – Airplane Transitions

Start with one lower leg length away from the wall. Plant the foot on the ground with the standing leg. Hip hinge into the wall and make sure you hinge at the hip and not bending through the knee.

Keeping your pelvis, navel, and the centre of your chest in a straight line and pivot through the hip, turning your pelvis over the standing leg. You should be feeling it through the side of your hip, back of your gluteal muscles, and the upper part of your hamstring. 

This is a great exercise to build more core strength to help with the rehab of your knee ligament injuries. 

Knee Ligament Injuries – One-Legged Squats

This is a great exercise to rehab & strengthen your knee injury after you have sprained it. It works the muscles of the lower quadrant to help provide more dynamic stability.

Keep both sides of the pelvis level and squat down on one leg pushing your butt back like in a chair. Keep the knee over the ankle and aligned with your hip and second toe and prevent it from moving past the toes as you squat. You also want to reach both arms out in front of you to keep balanced and bend your hips so your chest comes forward. Your weight is on your entire foot as you come straight back up. Place the emphasis on pushing through the heel while squeezing your butt all the way back up. Repeat this for 10 repetitions doing 3 sets on each side.

Knee Ligament sprain injuries affect the optimal activation of what’s called proprioceptive strengthening, or rather the balancing muscles of the leg and hip. The gluteus medius is a muscle that is important in this function.

If you have any pain or problems doing this exercise consult a local physiotherapist before continuing. 

Knee Ligament Injuries – One Leg Balance with Dumbbell

Stand on one leg holding a 5-10 pound dumbbell. Keep the opposite foot hiked up off the ground by engaging your gluteus medius muscles of your butt. Maintain your balance on that leg while transferring the dumbbell between your hands in a circular direction around your body.

Keep squeezing your glutes and activate your core muscles to maintain your balance. Pass the dumbbell in the opposite direction at the halfway mark while performing this exercise for 60 seconds in total. Do this for 60 seconds for 3 repetitions on each side.

This is a great exercise to gain more strength, balance and proprioception in your knee and hip and core stability after a knee ligament injury. If you have pain or are unsure about the exercise, consult your local physiotherapist before continuing. 

Knee Pain Overuse Patellar Tendinopathy – Spanish Squats

Place a strap over your leg at just below knee level. Keeping your knee in line with your second toe, sit back into a squat position, ensuring your knee stays back behind your toes. Hold this position for 10 seconds. Slowly return back to starting position. Repeat this exercise for 3 sets of 10 repetitions This exercise is useful for patellar tendinopathy, a condition that involves overuse of the patellar tendon.

Knee Pain Ligament Injuries – One Leg Bridge

Start out lying on your back with your knees bent. Hug one knee to your chest. With the opposite leg, squeeze your bottom and push through your heel to raise the hips up towards the ceiling. Hold at the top for 10 seconds. Slowly lower down. Repeat 3 sets of 10 repetitions. 

This exercise is great for knee pain to strengthen the gluteal muscles while offloading the knee. 

Knee Ligament Injuries – 2 Leg Lateral Block Hops

Stand beside a 20 inch high block that is about 20 inches wide as well. With your inner core engaged, perform a lateral hop onto the block and then hop down onto the ground to the other side. Then do a lateral hop back to the start position to complete the repetition.

Do 3 sets of 10 reps 3 times x/week.

This will help you develop more progressive strengthening so you can more readily return to your functional sports or activities that require dynamic knee strength.

If you’re unsure about the exercise or have any uncertainty about where you’re at with the recovery of your knee injury, consult your local Physiotherapist before continuing. 

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