Knee Rehab

One of many things I’ve come across in my years of training is people rehabilitating knee injuries.  A lifetime of sitting, (both in life and in the gym, sadly) the inability to decelerate and control one’s own body weight, both lead to weak and desensitized hip and glute muscles which in turn leads to the virtual epidemic of knee problems we have in this country.

 Most of the time, people rehabbing knee problems tell me they’ve received ridiculously vague instructions about how they need to ‘strengthen the muscles around their knee’.  (“No sh!t - really?!?  Thank you Doctor, I wouldn’t have considered that.”)

Leg extension machines, leg curl machines (see photos below) etc. sadly make up much of the prescribed rehab exercises to “strengthen” the muscles around the knee.  Exercises where the feet aren’t touching the ground are supposed to help me stand, walk and run?  That’s some logic with a few missing links in the chain as far as I’m concerned.

What’s the problem with that, you ask?  Isn’t that strengthening the muscles around the knee?

Not really.

The problem is that those machines strengthen the muscles in a manner in which they will NEVER be used.  Bending and strengthening the leg while in a seated or lying position makes up about ZERO percent of the knees’ usage.  The knee is used 99.999% of the time when you are standing and walking/running.  Stopping, starting, changing directions, going up and down stairs, getting in and out of your car – that’s how and when knee musculature is used to stabilize the knee.  Maintaining a seated position requires no knee stabilization, and therefore training in that manner is not only ineffectual but potentially harmful.

The analogy I use is this: 

Imagine your car breaks down.  You bring it to be serviced and the mechanic lifts it in the air on a mechanical lift and spins the wheels.  He then points to the spinning wheels and says “Look – your car works fine!” 

Of course, your response would be “No dude – that’s not how the car works.  I need it on the ground stopping, starting and turning.”

The same thing applies to the knee.  Telling me that my foot flailing around in mid air while I’m sitting is going to improve my ability to walk is not only silly, but grounds for malpractice if coming from a physician or physical therapist.