Knee Pain: Four Phase Rehabilitation and Strengthening Program: Phase 3

Phase 3:

• This week will add a new strength circuit to be completed every other day following the guidelines below. Look for updates below in bold
  • Light movements that I call “Daily Sequence”
    • This is a sequence that is all about light movement and muscle activation
    • It is meant to improve mobility and possibly serve as a warm up, cool down, or a light sequence in the morning or at night to improve mobility
    • I will continue to give you some alternative options over the next few weeks to include in this sequence
    • The goal is to isolate 4-5 movements that you feel are most effective in moving parts of your body that are stiff/painful and feel that they improve mobility/stiffness
    • You will do one set of 10-20reps for each movement so this sequence should be very quick and user friendly
    • There is something called the “5 Tibetan Rites” that had a great impact on me
      • Basically, these monks for thousands of years did this sequence, some calling it “The Fountain of Youth”
      • I do not necessarily hand out the 5 rites, but I do believe that everyone should have their own personalized version of 5 movements that are not incredibly challenging, that move areas of their body that they do no move enough in their daily life
      • This sequence should be brief and take only 5-10 minutes at the most
      • I do my own 5 rite sequence before bed each night and I do it as a warm up pre workout/wrestling practice/jujitsu
  • Strength Circuits
    • These are meant to challenge you with the goal of creating fatigue or tension in muscle without overloading painful structures
    • Your goal with this is to feel muscle tension and hopefully fatigue
    • Each movement will have a time goal or a rep goal, once you achieve that goal with no negative side effects, you are ready for a new challenge
    • When your body fatigues, you may start to get pain and that is your cue to stop
    • Pay attention to what you feel later that day and the next day
      • Mild pain is alright as long as it goes back to baseline within 24 hours
      • If pain is more severe you have a couple options
        • 1) Ice right after to minimize inflammation
        • 2) Try to decrease the intensity of the exercise by not going through as much range of motion or not pushing so hard
          • In my mind, most exercises can be made painful or not painful by the way that you go about it
          • Example: If I give you a squat variation, there are many ways to decrease risk of pain
            • Don’t go as deep into the motion, do it slower, keep weight more on the heels, hold an isometric position squat without moving in whatever range is least painful, do only 2-5 reps
          • Have the mind set of getting through new exercises making it super easy just to find a safe zone…you can always increase the challenge from there
• Daily Sequence: Complete everyday
  • Self Myofascial Release Options, press on any area that feels tender, especially if it is worse on the painful side
    • Focus on areas that feel more sensitive on the problem side
    • spend 30sec to 2 minutes on each tender spot as discussed in the video
    • Self MFR Quad/Hip Flexor VIDEO
    • Side Lying IT Band VIDEO 
    • 38) Self MFR Ball Glute/Piriformis VIDEO
  • 113.1) Ball Hamstring Curl to Knee Extension VIDEO
    • Full active knee motion with very little pressure on the knee
  • 29.1) Prone to Supine Quad Stretch, Isometric, Active Motion VIDEO
    • One of my favorite quad mobilizations
    • This one has 3 parts so shoot for 10-15 for each part
  • Bridge Band Around Knees Progression VIDEO
    • Only bend the knees as much as comfortable
    • Goal is to feel pulling in the thigh with no significant pain
    • band is an option to reduce tension in lateral quad/knee
• Strength Sequence: Complete every other day, if sore, wait until soreness completely goes back to baseline prior to completing it again which may require 2 day rest
  • First time through, try for just one set, if that goes well you can go through it 2x on strength day
  • Circuit #1
    • Bridge Progression Physio Ball Progression (Choose 1)
      • 113) Isometric Co-activation Abdominal/Glute Phase 1 VIDEO
      • 114) Abdominal Control With Hamstring Curl Phase 2 VIDEO
      • 114.1) Straight Leg Bridge Gradual Integration of Bent Knee Phase 3 VIDEO
      • 115) Double Leg Bridge Phase 4 VIDEO
      • 117) Double Leg Bridge With Hamstring Curl Phase 5 VIDEO
      • 118) Single Leg Bridge Phase 6 VIDEO
      • 119) Single Leg Bridge With Hamstring Curl Phase 7 VIDEO
      • Goal is 8-20 reps…if you achieve 20 slowly then progress to next level and start at 8
    • Heel Raise Progression at Wall (Choose 1)
      • 124) Double Leg Heel Raise Phase 1 VIDEO
      • 125) Double Concentric/Single Leg Eccentric Phase 2 VIDEO
      • 126) Single Leg Concentric/Eccentric Phase 3 VIDEO
      • Goal 8-20 reps
    • Sidelying Leg Raise Progression to a Stretch VIDEO
      • Make sure you feel this in the right place
      • Goal 8-20 reps
  • Circuit #2
    • Hip Extension/Glute Max Progression(Choose 1)
      • Quadruped with Physio Ball Hip Extension VIDEO
      • Hip Extension Over Table/Bed VIDEO
      • Goal 8-20 reps
    • 81) Basics of Bear with Leg Lift VIDEO
      • Begin with holding bear position for 30-90sec then progress to leg lifts for 5 sec holds
      • If this causes knee pain, try the alternative below with straight legs
        • 72) Push Up Plank Hip Ext VIDEO
        • OR the Option Below
          • 70) Chair/Step Height Phase 3 VIDEO
    • Hip Thrust Progression
      • 99) Double Leg VIDEO
      • 100) Single Leg VIDEO
        • Can be done with back on a weight bench
        • 8-20 reps