MGN: Medial Knee Pain/OA (11-5-17) Week 4

Week 4 Summary
- This week will continue to build on the program from week 3 with the addition of a new strength sequence
- Both strength circuits should be completed every other day with the daily sequence completed every day
- Once again, you will want to adjust the amount of motion you are going through to remain short of knee pain
- I recommend icing after the strengthen movements just to reduce the risk of increased inflammation and pain
Daily Sequence
- Self Myofascial Release Options
  - I do not expect you to do all of the movements below
  - I want you each day to inspect each area and try to pick up on a difference in the more painful side compared to the non-painful side
  - If it feels the same i both legs then it may not be an area you need to press on
  - 24.2) Standing Glute max/lumbar VIDEO
  - 25) Supine Hooklying Quad/Psoas VIDEO
  - 26) Self MFR Quad/Hip Flexor VIDEO
  - 26.1) Self MFR Calf VIDEO
  - 27) Side Lying IT Band VIDEO
  - 28) Self MFR Hamstring VIDEO
- Seated Slide Hamstring and Quad Stretch VIDEO
  - Light self mobilization into knee flexion and extension
  - This can be done lightly and frequently with emphasis on lightly
  - I would rather you do this alot throughout the day light rather then do it too aggressively and make yourself sore…then you don’t really want to do it again
  - 8-20 reps
- Double Leg Heel Raise VIDEO
  - Activates calf through full range while engaging some trunk control and shoulder stability
  - 8-20 reps
- Bridge Band Around Knees Progression VIDEO
  - make sure you keep knee bend short of knee pain
  - goals is to feel tightness in the front of the thigh
  - 8-20 reps
- Step with Ankle Dorsiflexion VIDEO
  - This position exaggerates the running/walking stride position
  - Make sure you stay short of knee pain or hold off altogether if you have pain
  - 8-20 reps each leg
Strength Circuit#1
- Complete this sequence every other day
- Go through the circuit one set, 2nd set try for half as many reps as the first set
- Ice after for 10-15minutes to minimize the risk of increased pain
- Double Leg Bridge Phase 3 VIDEO
  - Keep knees bent to about 90deg
  - 8-20 reps slow
  - Can use the edge of couch or chair in place of a ball
- Quadruped with Physio Ball Hip Extension VIDEO OR Hip Extension Over Table/Bed VIDEO
  - 8-20 reps
- Supine Straight Leg Raise VIDEO
  - slow and controlled while maintaining abdominal control
  - 8-20 reps slow
Strength Circuit #2
- Plank Knee to Chest and Hip Extension Progression(Choose 1)
  - Goal is 30-90sec
  - Once you are able to complete 90sec on each leg progress to the next phase down the list
  - Do each leg separately for 30-90sec
  - Counter Push Phase 1 VIDEO
  - Table Height Phase 2 VIDEO
  - Chair/Step Height Phase 3 VIDEO
  - Floor Phase 4 VIDEO
- Squat Pulses In Short Range VIDEO
  - Really important to stay short of knee pain with this one and keep the weight on the heels
  - This can be more harmful then helpful if you push too deep into the squat and get more knee pain
  - Goal 30-90sec
- Standing Foot on Chair/Step VIDEO
  - Good idea to throw in a quad stretch after the squat
  - hold each 5 sec repeat 10-15x each leg
- Lying Down Weighted Pullover Feet Elevated VIDEO
  - Start with light weight (5lb) dumbbell
  - Goal is 8-20 reps
  - If you get to 20reps, then you are probably ready to increase the weight and start back at 8-10 reps