a client facing a knee replacement surgery has usually very limited abilities, and many exercises may be painful for this person. My go-to exercise for knee problems, including pre-op and post-rehab knee replacements, is the terminal knee extension. There are several examples on Youtube, and here is a link to one of them http://www.youtube.com/watch?v=_E3gCSdkEz0
Good luck with your client.
core muscles all the way down to the muscles of the foot should be trained. THE MUSCLES OF THE KNEE ITSELF SHOULD BE TRAINED. HOWEVER THE QUADRICEP SHOULD BE TRAINED IN A FASHION THAT DOES NOT REQUIRE KNEE FLEXION. SUCH AS STRAIGHT LEG LIFTS IN A SEATED POSITION. LEG CURLS FOR THE HAMSTRINGS USUALLY DO NOT DAMAGE THE KNEE AND CAN BE USED IF THE CLIENT FEELS NO PAIN. THE CALFS SHOULD BE CONDITIONED IN A SEATED POSITION SUCH AS SEATED CALF LIFTS, THE ANTERIOR TIB. SHOULD ALSO BE TRAINED. ADDUCTORS SHOULD BE TRAINED AS THE PLAY A BIG ROLE IN KNEE STABILITY. I USUALLY TRAIN CLIIENT IN SEATED POSITION WITH A BALL TO SQUEEZE BETWEEN LEGS. HIP EXERCISES SHOULD BE DONE SUCH AS LATERAL RAISES WITH THE LEG AND SO ON. AFTER WORK WITH REHAB FIRST. THEN SAME EXERCISES CAN BE STARTED FROM THERE. AFTER SURGERY A CLIENTS GAIT CAN BE ALTERED SO IT IS IMPORTANT TO CONDITION ALL MUSCLES INVOLVED. ALSO INCLUDE LOWER BACK EXERCISES SUCH AS PELVIC TILTS. PLEASE EXCUSE MY SPELLING AS I AM RUSHING RIGHT NOW. HOW THIS HELPS.
Hi Debbie. Every client/patient is different, and much of how we approach their pre-op training depends on their condition when they come to us. That being said, without knowing much of the specifics of your client, I like using isometric leg lifts (seated on the floor) as a good quad strengthener that does NOT involve bending the knees.
I hope that this helps.
My answer is….I dont know. Give me a second and I will explain how you may be able to tell me what you need to do. Rather than give you exercises to do, I will try to give you a more of a systematic way to look at the leg and its functions. In general, I would say myofascial release, stretch and strengthen areas that will influence dysfunction, but please allow me to elaborate.
First of all, your knee itself is kind of like a series of caves that allow ligaments and tendons to connect the muscles bones of the upper and lower leg. The knee is positioned to act as fulcrum, so that the muscles and fascia can create or resist forces. So there really isnt a “knee” exercise, technically speaking. With that being said the knee is subjected (in this case very dramatically and determintally) to the many muscles that attach above and below at either the hip or foot and ankle.
Now to answer your question of what to do. For me, I would look for clues. Knowing that the hip and foot/ankle are culprits for knee problems, I would look there for some visual evidence. Maybe start at the foot and assess for neutral for position and arch type. If your client can’t bear weight, tale a look the foot for any abnormalities such as bunions or lesser toes deviations. This can be used as clue as for how the foot is striking the ground and you could make a link between type ankle and how the pelvis is shaped. You may even look to see if there is a discrepancy between the lengths of the two legs. Looking at the feet, the hips, and the leg lengths you will be able to come up with a plan to release tight fascia, increase the length of tightened muscles, and increase the communication between muscles.
So let’s say you follow my advice, and inspect to determine a flattened foot and anterior pelvic. You could try rolling out the foot, the tibialis anterior and posterior, stretching the soleus and hip flexor. I say that I cant what you should do though, because I think if is important you see for yourself what doesnt look right on their leg and go from there.
hope this helps,