Knee Prehab

Categories

Patella Tendon
Shallow Range Control
Rotational Control

-These movements are dependent on the type of injury or history of injury you have at the knee.
-Pain & some stiffness is OK and to be expected, particularly when starting out with these exercises.
-Should you have sharp, persistent pain that is accompanied by swelling you need to consult with the medical/S&C staff.
-Discuss with JP or Marshy which ones you should do and how often.

Patella tendon

-You should aim to progress through these phases as soon as you are able to
-When testing you should always aim for the highest level possible
-If you can’t tolerate that level (due to pain or coordination being compromised) then stay at the level below and use that as your training/rehab strategy
-If you are using phase one & two (for pain relief), you can use the movements as frequently as you like, pre & post-training/games if necessary

 

Phase One

Isometrics: pain-relief & high frequency

Phase Two

Isotonics: heavy, slow resistance & pain-relief

Phase Three

RFD: with an extended knee

Phase Four

RFD: with flexed knee

Phase Five

Jumps/Plyometrics

Phase One

Bulgarian split squat hold

Holds

Variations

-Loaded

Coaching points

-Comfortable bend with load but no pain
-Hinge at the hip is allowed to disperse stress away from tendon

Volume

4-5 sets
30-60s holds each side

Phase One

Spanish squat

Variations

-Double-leg
-Single-leg
-Loaded

Coaching points

-Upright trunk position
-Knees between 30-60 degrees bend
-No pain during just mild load felt through tendon

Volume

4-5 sets
30-60s holds (each side)

Phase One

Split squat

Holds

Variations

-Loaded

Coaching points

-Comfortable bend with load but no pain
-Hinge at the hip is allowed to disperse stress away from tendon

Volume

4-5 sets
30-60s holds each side

Phase Two

Step-off (counterbalance weight)

Variations

-Kettlebell/dumbbell
-Back loaded

Coaching points

-Keep arms straight, lift weight out in front as you bring rear leg toward the ground
-Lift toes on stance leg, shift weight into heel
-Tap rear toe on the ground then return to start position
-Don’t bring weight too high up > will force extra load onto back extensors

Volume

3-4 sets
5-8 reps each leg

Phase Three

Fast step-up

Unstable load

(Easy)

Variations

-Aquabag
-Dangling weights

Coaching points

-Hit the step hard
-Straighten knee explosively
-Hold in top position for 2s

Volume

3-4 sets
6 reps each side

Phase Three

Swing step to box

W aquabag

(Moderate)

Variations

-More hip hinge

Coaching points

-Swing your free leg through fast
-Explosively straighten the knee
-Hold for as long as you can before planting foot on the box

Volume

3-4 sets
6 reps each side

Phase Three

1-2-3-4 hold

W stick

(Hard)

Variations

-Stick on back
-Aquabag on back
-Moving forwards

Coaching points

-Knee must be straight before striking the ground
-Hold must be for ~2s

Volume

3-4 sets
4-6 reps each leg holding

Phase Four

Rear foot elevated bend & punch

W aquabag

(Easy)

Variations

-Rear foot elevated higher
-With plate punches
-Punches in different directions

Coaching points

-Bend and stop the knee rapidly
-Stiff punch with arms

Volume

3-4 sets
6 reps each side

Phase Four

Step & hinge

W pertubations

(Moderate)

Variations

-Step & punch

Coaching points

-Bend at the hip
-Step and push back as fast as you can
-Should feel tension through hamstrings/glutes as opposed to all at the knee

Volume

3-4 sets
6 reps each side

Phase Four

Lateral bound

W aquabag

(Hard)

Variations

-Without aquabag
-With arms across chest
-On grass, soft floor, off boxes

Coaching points

-Push off ground fast as possible

Volume

3-4 sets
4-6 reps each leg holding

Phase Five

Scissor & cycle jumps

From bounce

(Easy)

Variations

-Over hurdles
-Over stick/noodle

Coaching points

-Must split knees apart explosively at top of the jump
-Spring off with stiff ankles and get as high as you can
-Spend as little time on the ground as possible

Volume

4-6 sets
4-5 reps each side

Phase Five

Hurdle jumps

Continuous

(Moderate)

Variations

-Alternating hurdle heights
-Mixed hurdles & boxes

Coaching points

-Spend as little time on the ground as possible

Volume

4-6 sets
6-8 reps

Phase Five

Hurdle hops

Continuous, hurdles & boxes

(Hard)

Variations

-Alternating hurdle heights
-Mixed hurdles & boxes
-Rotations in between hops

Coaching points

-Spend as little time on the ground as possible

-Spend as little time on the ground as possible

Volume

Shallow Range Control

-You should aim to progress through these phases as soon as you are able to
-Focus: pelvic control, hip lock, terminal knee extension control, pain-free muscle bulk maintenance
-0-40 degrees knee flexion range of movement (no deeper)
-Examples: meniscal, patellofemoral joint and cartilage injuries
-The markers of difficulty are labelled in the top left corner of the exercise videos (e.g level one)

Level One

Single-leg deadlift

Band extension control

Variations

-Banded
-Kettlebell/dumbbell
-Contralateral load

Coaching points

-Kick back leg back to target
-Stand tall at the top

Volume

3-4 sets
6-8 reps each

Level One

Single-leg deadlift

Unstable load

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Two

Single-leg hinge at wall

W aquabag rotations

Variations

-Plate punches
-Plate halos
-Aquabag

Coaching points

-Short & fast unlock of the knee
-Keep long with your head, chest stays out

Volume

3-4 sets
4-6 reps each leg

Level Two

Fast step-up

Unstable load

Variations

-Aquabag
-Dangling weights

Coaching points

-Make loud sound on the box
-Stand very tall, very fast

Volume

3-4 sets
6-8 each side

Level Three

Step-up spindle to MB slams

W hurdle

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Three

Single-leg snatch to hip lock

W hurdle

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
4-6 reps each leg holding

Level Four

Single-leg barbell squat

Free foot above box

Variations

-Change box height

Coaching points

-Keep leg lifted above box throughout entire squat movement
-Lift free hip up as high as you can

Volume

3-4 sets
6 reps each side

Level Four

Quarter squat

Heavy & shallow

Variations

-One and a half reps
-Front squat

Coaching points

-Go until fatigue allows
-Don’t push through pain
-Heavy & slow repetitions

Volume

3-5 sets
6-10 reps

Level Four

Split good morning to step

Unstable load

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
4-6 reps each leg holding

Rotational Control

-You should aim to progress through these phases as soon as you are able to
-Focus: rotational & valgus control, for injuries that have arose from deficits in this or as a result of injury
-Examples: ITB syndrome, patellofemoral pain, patella instability, degenerative meniscus, ACL injuries
-Level One: generic mid-stance control
-Level Two: control in hip hinge
-Level Three: control of toe-off

Level One

Single-leg MB rotations

Throws

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level One

Step-off heilos

W plate

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level One

Step-off twists

W aquabag

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
4-6 reps each leg holding

Level Two

Single-leg deadlift

W fast throw betweens

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Two

Step & punch

W rotations

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Two

Step & chop

Or step & rotate (aquabag)

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
4-6 reps each leg holding

Level Three

Canoe snatch

W plate

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Three

Canoe snatch

W kettlebell

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
6 reps each side

Level Three

Canoe snatch

W aquabag

Variations

TBA

Coaching points

TBA

Volume

3-4 sets
4-6 reps each leg holding