Physical therapy is essential to the treatment, rehabilitation, and prevention of many of the conditions that affect the knee joint and its surrounding supporting structures. Physical therapy for knee pain often includes ice, elevation, and muscle-toning exercises.
Activity limitations — To speed recovery and protect against future knee damage, activities that cause pain should be avoided temporarily.
The following positions and activities place excessive pressure on the knee joint and should be limited until knee pain and swelling resolve:
- Squatting
- Kneeling
- Twisting and pivoting
- Repetitive bending (multiple flights of stairs, getting out of a seated position, clutch and pedal pushing, etc.)
- Jogging
- Aerobics, dancing
- Playing stop and go sports (basketball, sports that use racquets)
- Swimming using the frog or whip kick
The following types of exercise equipment also place excessive pressure on the knee joint and should be limited until knee pain and swelling resolve:
- Stair stepper
- Stationary bicycle
- Rowing machine
- Universal gym utilizing leg extensions
The preferred exercise equipment for the knee should provide smooth motion of the knee, maximal toning of the front and back thigh muscles (quadriceps and hamstring muscles), minimal jarring and impact to the joint, and the least amount of bending to accomplish toning. These activities are acceptable alternatives to the above:
- Fast Walking
- Water aerobics
- Swimming using the crawl stroke
- Cross country ski machines
- Soft platform treadmill
Ice and elevation — Ice is useful for the control of pain and swelling. It can be applied to the knee for 15 to 20 minutes as often as every 2 to 4 hours, particularly after physical activity. A bag of ice, frozen vegetables, or a frozen towel work well. The swollen knee should be elevated above the level of the heart while icing.
Pain relief — If needed, a non-prescription pain medication such as acetaminophen (Tylenol®), ibuprofen (eg, Advil®, Motrin®) or naproxen (eg, Aleve®) can be taken. No more than 4000 mg of acetaminophen is recommended per day. Anyone with liver disease or who drinks alcohol regularly should speak with his or her healthcare provider before taking acetaminophen.
Strengthening exercises — Rehabilitation of the knee begins with gentle strengthening exercises. These exercises are performed without bending the affected knee.
Straight leg raises — Sit on the edge of a chair or lie down on the back. Bend the opposite leg. Keep the affected leg perfectly straight and raise it 3 to 4 inches off the ground. Hold for 5 seconds. Repeat 10 to 15 times (one set). Perform a total of three sets.
As your condition improves, perform straight leg raises with weights at the ankle; begin with a 2 pound weight and gradually increase to a 5 to 10 pound weight (pennies or fishing weights in an old sock, 2 cans in a purse, or Velcro ankle weights).
Hip abduction — Lie on your side on the bed or floor. The affected leg should be on top and should be held straight. The bottom leg should be bent. Hold the top leg straight and raise it 3 to 4 inches towards the ceiling. Hold for 5 seconds then slowly release. Repeat 10 to 15 times (one set). Perform a total of three sets.
Be sure to avoid rolling forwards or backwards while lifting the leg.
Hip adduction — Lie on your side on the bed or floor. The affected leg should be on bottom and should be held straight. The top leg should be bent with the foot placed in front of the bottom leg. Lift the bottom leg 3 to 4 inches. Hold for 5 seconds then slowly release. Repeat 10 to 15 times (one set). Perform a total of three sets.
Quarter squats — Stand 18 to 24 inches from a wall. Lean back against the wall. Bend both knees slightly (the buttocks should not be lower than the knees), keeping the back straight. Hold for five seconds then slowly stand up straight. Rest as needed. Repeat 10 to 15 times (one set). Perform a total of three sets. To increase the difficulty, bend the knees more deeply, hold for a longer time, and increase the speed.
Alternately, use an exercise ball to perform squats. Stand up straight, holding the ball between your back and the wall. Slowly bend the knees and lower the back (roll the ball down the wall). Hold for a count of five. Stand up. Repeat 10 to 15 times.
Stretching exercises
Hamstring stretch — Sit on the floor or bed with the affected leg extended straight out in front of you. The opposite leg may be bent or may hang off the bed. Keeping the affected leg straight, lean forward and reach for the ankle. Hold for 30 seconds but do not bounce. Sit up straight. Repeat 10 to 15 times.
Quad stretch — Stand behind a chair, holding the top of the chair with one hand. Bend the knee and grab the foot with the hand on the same side of the body. Stand up straight. Gently pull the foot towards the body. Hold for 30 seconds, holding constant pressure on the foot (do not pull-release-pull). Release the foot. Repeat 10 to 15 times.
Runner's stretch — Face a wall and stand 18 to 24 inches away. Place hands at head height and lean into the wall, keeping legs and back straight. You can rest your head on your hands, against the wall. You should feel a stretch in the muscles in the back of the calf. Hold for 30 seconds. Repeat 10 to 15 times.
The information here is to give you an example of what to expect in therapy for your knee. It is not meant to replace a physical therapist. The Information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies.