DD: Bilateral Knee Pain and Right Ankle PTTD and Tibiotalar OA: Weeks 4-6

Phase 3: Progress into further into functional strengthening positions. Variations will be given to challenge coordination of hip, ankle and trunk strength
- With your history of knee pain
  - Be careful not to progress too quickly with standing activities and remain in a range of motion that minimizes knee pain
- Goals:
  - set up strengthening circuits that alternate weight and non weight bearing movements
  - Progress loading of quad inot a stretch position but short of knee pain
- Do each sequence 1-2x/day, 1 set of 5-20 reps for each movement
- The sequences below will include a progression from the previous movements to move onto once the movements from weeks 2-4 have gotten easier. If any movement is painful, attempt to stay in a range short of pain. If that is not possible do not do that movement. Fatigue is good, but as soon as that fatigue turns to pain that is your body telling you to stop
- It is once again good idea to ice after each session
- Day 1
  - Calf Strengthening Progression (Pick one that is challenging but not painful
    - Phase 1 Seated Heelraise Isometric VIDEO
    - PHASE 2: Double Leg Heel Raise VIDEO
    - Phase 3: Double Concentric/Single Leg Eccentric VIDEO
    - Phase 4: Single Leg Concentric/Eccentric VIDEO
  - Bridge Progression (Choose 1)
    - Phase 1: Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
      - Decrease the amount of knee bend of you have pain
      - If this goes alright you may progress to the movement below
    - Phase 2: Band Around Knees Progression VIDEO
    - Phase 3: Heels to Butt on Floor Marching Phase 2 VIDEO
    - Phase 4: Heels to Butt on Floor Single Leg Phase 3 VIDEO
  - Single Leg balance Progression (Choose 1)
  - Progressive Loading of Quad (Choose 1)
    - Stay in a painfree range with the progression below, try to minimize knee pain and keep the majority of feeling in the thigh
    - Phase 1: Standing Quad isometric in a Stretch VIDEO
    - Phase 2: Kneeling Quadricep Activation Butt to Heels VIDEO
    - Phase 3: Tall Kneel Lean Back VIDEO
- Day 2
  - Seated Ankle Inversion VIDEO
  - Tibialis Posterior Seated Sweep VIDEO
  - Lunge Progression (Choose 1)
    - Phase 1:Step Knee Flexion Intro VIDEO
    - Phase 2: Sprinter Lunge VIDEO
      - may add weight, preferably in one hand so you have unilateral load which will make balance more challenging
    - Phase 3:Lunge with Band Around Knee Glute Med Activation VIDEO
  - Hamstring activation progression (Choose 1)
- Day 3
  - Calf Strengthening Progression (Pick one that is challenging but not painful
    - Phase 1 Seated Heelraise Isometric VIDEO
    - PHASE 2: Double Leg Heel Raise VIDEO
    - Phase 3: Double Concentric/Single Leg Eccentric VIDEO
    - Phase 4: Single Leg Concentric/Eccentric VIDEO
  - Bridge Progression (Choose 1)
    - Phase 1: Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
      - Decrease the amount of knee bend of you have pain
      - If this goes alright you may progress to the movement below
    - Phase 2: Band Around Knees Progression VIDEO
    - Phase 3: Heels to Butt on Floor Marching Phase 2 VIDEO
    - Phase 4: Heels to Butt on Floor Single Leg Phase 3 VIDEO
  - Single Leg balance Progression (Choose 1)
  - Progressive Loading of Quad (Choose 1)
    - Stay in a painfree range with the progression below, try to minimize knee pain and keep the majority of feeling in the thigh
    - Phase 1: Standing Quad isometric in a Stretch VIDEO
    - Phase 2: Kneeling Quadricep Activation Butt to Heels VIDEO
    - Phase 3: Tall Kneel Lean Back VIDEO
- Day 4
  - Seated Ankle Inversion VIDEO
  - Tibialis Posterior Seated Sweep VIDEO
  - Lunge Progression (Choose 1)
  - Hamstring activation progression (Choose 1)
- Day 5
  - Calf Strengthening Progression (Pick one that is challenging but not painful
    - Phase 1 Seated Heelraise Isometric VIDEO
    - PHASE 2: Double Leg Heel Raise VIDEO
    - Phase 3: Double Concentric/Single Leg Eccentric VIDEO
    - Phase 4: Single Leg Concentric/Eccentric VIDEO
  - Bridge Progression (Choose 1)
    - Phase 1: Glute/Abdominal Isometric Supine Max Knee Flexion VIDEO
      - Decrease the amount of knee bend of you have pain
      - If this goes alright you may progress to the movement below
    - Phase 2: Band Around Knees Progression VIDEO
    - Phase 3: Heels to Butt on Floor Marching Phase 2 VIDEO
    - Phase 4: Heels to Butt on Floor Single Leg Phase 3 VIDEO
  - Single Leg balance Progression (Choose 1)
  - Progressive Loading of Quad (Choose 1)
    - Stay in a painfree range with the progression below, try to minimize knee pain and keep the majority of feeling in the thigh
    - Phase 1: Standing Quad isometric in a Stretch VIDEO
    - Phase 2: Kneeling Quadricep Activation Butt to Heels VIDEO
    - Phase 3: Tall Kneel Lean Back VIDEO
- Day 6
  - Seated Ankle Inversion VIDEO
  - Tibialis Posterior Seated Sweep VIDEO
  - Lunge Progression (Choose 1)
  - Hamstring activation progression (Choose 1)
- Repeat this for week 6
- The third phase is more challenging and includes a variety of options, choose the one that feels like it is most beneficial in that it is difficult but not significantly painful