In ligament injuries, mobility in the knee joint is initially restricted by reflex muscle tension, but later on, instability in the knee joint can occur, particularly in the case of torn ligaments. Untreated torn ligaments increase the risk of subsequent knee joint wear and tear – arthrosis in the knee joint. Once the injury has healed, the focus of therapy is on strengthening the surrounding muscles and especially on improving coordination to secure the joint muscularly. Leg axes should be checked to avoid overloading the ligamentous apparatus.
5 simple exercises to imitate
1. exercise – “Mobilization in closed chain” 2. exercise – “Mobilization in open chain” 3. exercise – “Stretching hamstring” 4. exercise – “Knee bend” 5. exercise – “Lunge” Injuries to the inner and outer ligaments of the knee joint are common sports injuries. By falls, twists or even blows against the knee the collateral ligaments can be overstretched or even tear. The inner ligament is affected more often than the outer ligament.
Ligament injuries cause pain in the area of the affected ligament and swelling, the joint may be reddened and warmed. In the case of inner or outer ligament injuries, the knee is often initially spared and little movement is made, and in the case of severe trauma and torn ligaments it may even be immobilized for a certain period of time. The next step is to restore the mobility of the knee joint.
It is important to move the knee to its full range of motion, as long as it has been released by the doctor (possibly restricted after an operation). In the early stages, mobilization exercises should only be performed in a pain-adapted manner in order not to disturb the healing process of the traumatized structures and to protect them from further overloading. Later, it is also possible to work around the pain threshold.
In addition to isolated exercises for mobilizing the knee, cycling is particularly suitable for mobilization, since this is where the body weight is removed. There is a variety of exercises, for example from the functional movement theory. A distinction is made between mobilization exercises in an open chain, in which the knee is moved freely without the body weight, and exercises in a closed chain, which are more physiological, but also more strenuous.
Closed chain In closed chain exercises, the patient stands on his leg and puts the weight of his body on the knee. This can be made more difficult with an unstable surface (balance pad, therapy spinning top, gymnastics mat…). The exercises range from tiptoeing over a slight knee bend to standing scales.
There are no limits to the imagination. Open chain For easy mobilization in an open chain, practice with a gymnastic ball is ideal. The patient sits elevated or on a chair and places the leg with the heel or lower leg on the ball.
The heel is now pulled towards the buttocks, the knee is lifted and bent. When the heel moves away from the body again, the stretching is trained. The back of the knee should be pushed through to achieve maximum extension.
The exercise can be performed 20 times in 3 sets. If you do not have a gym ball at your disposal, you can use another rollable object (e.g. a lying bottle or bucket). More exercises can be found in the article Physiotherapy Mobilisation exercises.
Stretching exercises for ligament injuries of the inner or outer ligament play an increasing role in muscular imbalances which can be the cause of injuries. In case of deviations of the leg axes, a specific stretching program should also be considered. Usually the lateral (outer) capsular ligament apparatus is tighter than the inner one.
The stretching of the lateral muscle groups can result in a relief of the inner ligamentous apparatus. Training with a fascial roller is suitable for this. In certain sports there is often a strong shortening of the knee-bending muscles, this can also favour injury mechanisms and should be prevented by stretching the back of the thigh.
Back of the thigh Place one leg stretched on a raised surface. The supporting leg is also stretched. Now tilt your upper body forwards towards the leg you are standing on.
Try to touch the foot with your hands. Another exercise is done in a wide standing position. Push your buttocks backwards and try to touch the floor with your hands.The knee joint is part of the lower extremity.
In the case of ligament injuries in the knee joint, the entire lower extremity should also be examined in order to uncover any causes for chronic overloading of the ligament apparatus. It can also be useful to integrate hip stretches into your exercise program for injuries to the inner or outer ligaments of the knee. Further exercises can be found in the article Stretching exercises.
In the case of injuries to the inner or outer ligaments, the strengthening of the knee muscles is the focus of the therapy, not least to stabilize the joint and prevent arthritic changes. Due to an unstable joint, the joint cartilage is more heavily loaded and tends to degenerate. The joint can be secured muscularly through targeted strengthening training.
It is particularly important to strengthen the quadriceps (knee extensors) and the muscles that bend the knee (ischiocrural muscles). Isolated exercises are suitable for this – knee extension from the seat, knee flexion in prone position, e.g. with Theraband. Physiological exercises in the closed chain such as knee bends or lunges are also particularly effective here.
Knee bendsWhen bending the knees, the feet are about hip-wide, the knee joints are above the ankle joints during the entire exercise. The buttocks are stretched far back so that the back remains straight, the weight is shifted to the heels. The lower legs and knees remain straight and do not look outwards or inwards.
Through the strength of the thigh muscles you straighten up again. Lunge When doing a lunge, one leg is placed far forward from the upright position, the rear knee is lowered to the floor, the upper body forms a straight line with the pelvis. The front knee does not look over the toes and does not deviate either inwards or outwards.
From this position, either small pulsating movements can be performed, or one pushes back into the upright position and changes sides. Both exercises can be performed about 15 times in 3 sets. For one-sided exercises always train with the right and left side.
Later weights can be added to increase the requirements. The exercises should be done regularly and on a long-term basis. For ligament injuries in the knee joint, coordination training is essential in addition to strengthening.
The ligaments of our joints are not only stabilizers, but also have receptors to report the joint position to our brain. This function (proprioception) can be limited by injuries. The joint feels unstable and unsafe (“giving-way”).
The strengthened musculature should now be prepared by coordination exercises to react quickly and effectively to different requirements in order to stabilize the joint adequately. The leg in the closed chain will be exposed to different resistances while the patient tries to keep it stable. At home, the changing resistances normally set by the therapist can be replaced by therapy bands.
In the following the exercises can be made more difficult by different yielding surfaces, or distraction – e.g. catching a ball. Jumping exercises have the highest difficulty. They require a high degree of coordination.
For example, cushioning the impact of a jump on a trampoline in such a way that the patient immediately stands firm again without rebounding is a very demanding exercise. Coordination training should make up a large part of the training and is particularly important to restore and permanently guarantee joint function after ligament injuries. Massage exercises can round off the treatment of ligament injuries.
Tendons and ligaments are less well supplied with blood than the muscles and therefore heal more slowly. Gentle massages – in the case of ligaments also transverse friction – can specifically promote blood circulation and thus support healing. Especially in early stages after ligament injuries, the muscles tend to tense up reflexively.
Gentle massages can then have a pain-relieving and relaxing effect. If there is swelling in the joint and surrounding tissue, massage techniques from the lymphatic drainage can also be used to remove the tissue fluid and support healing. Later, massages can be useful to loosen stuck tissue and thus increase mobility. Massage units can be combined very well with heat application. However, the focus is on active strengthening and coordinative exercises.The massage should only be used as a supplement to the actual exercise and treatment plan.
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