I have a client that has advanced osteoarthritis of the knee, she wants to postpone surgery as much as possible and concluded with her doctor that strength training will be optimal. I want her to stretch her quads a few time a day, however prone and side lying quad stretch is hard to reach and causes pain, the same for standing traditional quad stretch. What stretch would you recommend? P.S Hip Flexor Lunge stretch is hard for her to get off then floor
With her condition, the amount of cartilage she likely has is zero. Before any stretching is attempted be sure to increase joint temp and circulation via upright bike or alternative low weight bearing modality. Otherwise, stretching will do nothing for her if you don’t prep for it.
For individuals in this stage of OA I’d look to increase ROM through active flexibility activity. For example, swimming and low intensity, higher volume weight bearing exercise with increasing ROM. Passive stretching will be useless. With the right practitioner, PNF stretching could help, but only after adequate joint temp achieved.
A very simple quad stretch can be performed in most bedrooms. Usually the bed is about knee high and near a wall. The person stands between the bed and the wall, facing the wall. Place the lower leg up on the bed with the hands on the wall for support. That knee will be at about 90 degrees or so. Then you posteriorly tilt the pelvis and slowly extend the torso back till the stretch is felt.
I would incorporate some ROM dynamic movements in their program.
The quad stretch I use most often is done seated. Sit towards the front of a straight chair. Turn sideways, extend front leg backwards until knee is under hip, or slightly behind, “shoelaces down”. Enhance by contracting pelvis (tucking under), pressing foot down, and/or twisting upper body towards back of chair.