Health Society of South Africa

THE FIT KNEE WORKOUT
Stretching
Strengthening
Charting your progress

Knees That are Fit for Life

Are you recovering from a knee injury? Or perhaps you want to strengthen a weak knee. Maybe you are getting in shape for sports like skiing or running Whatever the reason, a simple workout can help improve your knees' flexibility and strength if you follow an exercise programme as directed by your health care provider, you should be able to be as active as you want. You can also keep your knees in good shape.

A Joint That's Easily Injured
Your knee is a complex joint. It can bend and rotate slightly. If you put a lot of stress on your knee, you may injure it. Once your knee has been injured, it can easily be injured again - unless you build up surrounding muscles. These muscles provide strength for movement. They also stabilise your knee and act as "shock absorbers" to relieve it of stress and strain.

How to Use This Book
When done the right way, the exercises in this book are safe for most people. Your health care provider may add special instructions so that you can get the most from each exercise.

Stretching and strengthening exercises can be done at home. Exercises that require gym machines may be done at home with your own machine, at a physiotherapy facility or at a fitness centre.
You can't expect quick results. Follow the programme on a regular basis.
Over time, increase the number of times (repetitions) you do each exercise. Or, use an elastic band or tubing or weights. Increase resistance as your knee becomes stronger.

Calf Stretch
The calf stretch makes the muscles in your lower legs more flexible. It helps your legs handle walking, bending and pushing more easily.

1. Place the palms of your hands flat against a wall. Put one foot several centimetres behind the other. Point both feet straight ahead.
2. Bend your front leg. Keep both heels on the floor and your back leg straight. Hold for 10 seconds, then relax. Repeat 10 times. Then switch sides.
Caution: Don't lift your back heal; don't arch your back.

Thigh Stretch
Thigh stretches make your quadriceps and hamstrings more flexible. These muscles can then straighten and bend your knee more easily.

Quadriceps:
1. Stand an arm's length away from a wall. Keep your eyes facing straight ahead.
2. Place your left hand flat against the wall. Hold your right ankle with your right hand. Pull your thigh straight back. Don't arch or twist your back. When you feel the stretch in your thigh, hold for 10 seconds. Then relax. Repeat 10 times. Then switch sides.

Hamstrings:
1. Sit on the floor. Extend one leg out straight, flat against the floor. Bend the other leg, bringing that foot near the straight leg's knee.
2. Lean forward, keeping your back straight. Do not bend the knee of your straight leg. Feel the stretch in the back of your thigh. Hold for at least 10 seconds. Then relax. Repeat 10 times. Then switch sides.

Leg Raises
The straight leg raise and short arc quad strengthen the quadriceps. This helps you with activities like walking and stepping off curbs more safely.

Straight leg raise:
1. Sit on the floor. Bend one leg. Point the toes of your straight leg toward you as far as you can comfortably. Press the back of your knee down while tightening the muscles on the top of your thigh.
2. Raise your leg 15 to 20 cm. Lower it slowly and smoothly back to the floor. Relax. Repeat 10 times. Then do the other leg.

Short arc quad:
1. Sit on the floor with one leg bent. Roll up a towel. Place it under your straight leg just above your knee. It should raise your knee to a height of 15 cm.
2. Straighten your knee, lifting your lower leg off the ground. Hold for 5 seconds. Relax. Repeat 10 times. Then do the other leg.

Challenge yourself - for greater resistance, use weights around your ankles.

3-Way Leg Exercises
These exercises strengthen front and back thigh muscles. They help with moves such as getting out of a chair.

1. Lie on one side. Raise your top leg as high as you can comfortably. Keep your legs and hips straight. Hold 5 seconds, then lower. Repeat 10 times; switch legs.
2. Lie on your stomach. Raise one leg as high as you can comfortably. Keep your back and both legs straight. Hold 5 seconds, then lower. Repeat 10 times; switch legs.
3. Lie on one side with your top leg bent behind the other. Raise your straight leg as high as you can comfortably. Hold 5 seconds, then lower. Repeat 10 times; switch legs.

Caution: when lying on your side, don't roll onto your hip.

Challenge yourself: place an elastic band or tubing around both ankles. Hold it down with your bottom ankle. Be careful to raise and lower your top leg slowly and steadily.

Wall Slide
The wall slide helps to increase knee stability and strength. This exercise also makes it easier to get in and out of cars.

1. Stand with your back and head against a wall. Look straight ahead. Keep your shoulders relaxed and your feet at least 30 cm away from the wall - shoulder-width apart.
2. Keep your head against the wall. Slowly slide straight down to a near-sitting position. Try to hold for at least 10 seconds. Then slowly slide back up. Repeat 10 times.

Leg Lunge
The leg lunge, like the wall slide, builds quadriceps, hamstring and buttock muscles. This give you a greater ability to squat down.

1. Stand with your feet 3 to 5 centimetres apart.
2. Step out as far as you can comfortably. Keep your back straight. As you step, the heel of the foot in back comes off the floor. Return smoothly to your starting position. Repeat 10 times. Switch legs.

Caution: Don't bend forward; don't step out so far that your rear knee touches the floor.

Step Ups
Step-ups strengthen your quadriceps. Stronger quadriceps take some of the strain off your knees during high-stress activities like climbing stairs.

1. Stand with your left foot raised on an 8 to 12 centimetre support (such as a block of wood). Keep your right foot flat on the floor.
2. Shift your weight onto the left leg. As your right leg comes off the floor, straighten your left knee. Then lower your right leg back down to the floor slowly. Repeat 10 times. Switch legs.

Caution: Don't lock the knee of the raised leg; don't push off with the foot that's on the floor.

Toe Raises
Toe raises strengthen your calf muscles. Your knees are then better able to withstand strain while walking or running.

1. Stand with both feet flat on the floor, shoulder-width apart. If you need a support, steady yourself with your hands on a counter, wall or table.
2. Raise both heels so you're standing on your toes. Hold for 5 seconds. Then lower your heels to the floor slowly. Repeat in times. As you become stronger, stand on one leg at a time. Raise that leg's heel off the floor.

Challenge yourself: Sit on the floor with one leg bent. Put an elastic band or tubing around the foot of your straight leg. Support yourself with one hand and slowly point and relax your toes. Switch legs.

Step Machine
A step machine strengthens all your leg muscles for climbing stairs or hills. It also builds endurance by exercising your heart.

1. Position yourself with your hips over your knees. Keep your back straight. Don't put weight on your hands. Use railings for balance only.
2. Take short steps. Exercise for 5 to 10 minutes to start. Gradually increase the amount of time you use the machine.

Caution: Check with your doctor before using endurance-building machines.

Bike and Ski Machines
Stationary bikes and ski machines exercise your entire leg. They're helpful for walking, running and building endurance.

Bicycle
1. Adjust the seat so your knee is fully extended.
2. Use a setting with low resistance. Exercise for about 5 minutes to start. Then slowly increase the amount of time you use the machine.

Ski machine
1. Adjust the machine to fit your height. Place your hips against the front pad and keep your back straight. At first, use only your legs. Add your arms later.
2. Push backward with one leg while sliding forward with the other. Exercise for about 5 minutes to start. Gradually increase the amount of time you use the machine.

Caution: Check with your doctor before using endurance-building machines.

Leg Press Machine
A leg press machine strengthens quadriceps and hamstrings. This helps you to walk, run and do your daily activities.

1. Use the footplate without weights to start. Position yourself so your head is tilted slightly back and legs and back are straight.
2. Bend your knees. Then press your legs until they're almost straight. Repeat 10 times.

Caution: Don't lock your knees; press and release slowly.

Knee Machine
Knee machines exercise different muscles. Some machines help build quadriceps, others build hamstrings.

Quadriceps
1. Use the lightest weight to start. Begin with your leg bent against the quad machine.
2. Extend your leg slowly. Don't lock your knee or arch your back. Hold briefly. Then lower your leg slowly and steadily. Repeat 10 times. Switch legs.

Caution: Check with your doctor before using a quad machine if you have knee problems.

Hamstrings
1. Start with the lightest weight. Lie down on the machine. Keep your hips and stomach pressed against the pad. Don't arch your back.
2. Move your leg slowly up and down. Repeat 10 times. Switch legs.

Chart Your Progress

The key to a fit knee is a personal workout programme tailored to your needs by your health car provider. Exercise each day and you'll be rewarded with results that can last a lifetime.

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