|Knee stretching should be done on a regular basis
maintain their mobility. Tightness can develop in cases of disuse,
sedentary lifestyles, arthritis, and poor posture. While we can often
function with reduced mobility, it is the pain associated with the
muscle imbalances and joint dysfunction or irritation that brings
people in to the physical therapist eventually. Stretching exercises as
part of a regular exercise program can help prevent injuries and
maintain painfree function. || |
Should we do
Stretching for Knees?
Muscles that Cross the Knee?
can knee stretches prevent injury?
Should we do
Stretching for Knees?
The knee acts as a large hinge joint as it becomes straighter. When
collateral ligaments are looser as in the flexed position, a certain
amount of rotation occurs of the tibia on the femur through the pull
of the medial or lateral hamstrings. For optimal function of the knee
we require a balance of the
length of the muscles around it between flexors and extensors. We also
need a balance in strength. When there is an imbalance it can
predispose you to strains, ligament sprains, and joint wear.
are we stretching
Structures that cross the knee joint are as follows:
- Quadriceps femoris
attaches to the patella which is in turn
attached to the tibia
bicep femoris, semimembranosus and
- Long hip adductors,
Stretches and Osteoarthritis
Exercise is a necessary part of any treatment plan for arthritis. The
type, intensity, and frequency of exercise you do will depend on the
type of arthritis you have and the condition of your joints. As part of
the inflammatory process the body lays down scar tissue. This scarring
creates adhesions around the joints, pain, and dysfunction. Because of
the pain, inactivity typically ensues leading to further stiffness and
weakness. To break this cycle you need to see your family physician
about methods to control the inflammation and your physical therapist
to prescribe an exercise program appropriate for your needs.
Knee stretches ares especially beneficial for
Although you cannot reverse the damage that has been done to the
cartilage you can reduce
the pain due to capsular tightness and painful adhesions that
are associated with arthritis.
By restoring mobility to the arthritic
knee you help normalize the mechanics and reduce the wear and tear that
accelerates the degenerative process. Dealing with osteoarthritis is a
balancing act between exercise and rest. Exercise too much or too
vigorously you can aggravate your pain; exercise too little, and
weakening and instability results, worsening joint wear and tear.
If you suffer from arthritis of the knees be sure to
evaluated by your physical therapist for an appropriate set of
exercises to address stiffness, weakness, balance, and endurance.
Quadriceps The easiest way
to stretch the quadriceps is in standing.
position for the appropriate
beside a chair or counter top so as to hold on with one hand if
necessary to balance.
down and grab your right ankle. You can use the hand on the same side
or the opposite side. Most people find using the opposite hand most
comfortable because it allows the hip to stay in a comfortable
position. If you are unable to reach your ankle you can loop a belt or
towel around your right ankle and pull on that.
your back, lift your chest up and pull your ankle back and up slowly.
you are able to bring your knee behind you as in the picture you can
stretch rectus femoris as well
several ways to stretch the hamstrings. The way I usually tell patients
is in standing so as to minimize strain on the lower back.
position for the appropriate
at the side of a bed/table
your straight leg on the table
the knee straight and lean forward
stretch is valid as an effective method of increasing hamstring
flexibility, but depends on pelvic positioning. If you are able to
maintain a straight lower back while performing this stretch it is
significantly more effective.
hamstring stretches see the page on Stretching
perform this stretch stand and face a chair or table.
your chest up and back straight.
forward at the hips until you feel a stretch in the back of your thigh.
this position for the appropriate
- Kneel onto your right knee
and place your left foot in
front of you to assume the lunge position.
your left foot out to the side and place both
hands on the floor in front of you.
- Try to
straighten the left knee and lean your body
forward while relaxing your hips.
- Rocking the
hips forward and back will
change the pull slightly to get all muscles.
Long adductors can also be stretched in sitting. This stretch also
includes hamstrings biasing the medial hamstrings, semimembranosus and
- To stretch both sides
simultaneously sit with your
legs straight out in front of you with your back straight.
- Slowly work your legs apart as far as they will go.
- Hold this and relax for a few seconds.
as you exhale bend forward at your hips until you
feel more resistance.
- Be sure to keep your
chest up and maintain a lumbar
lordosis (normal inward curvature of the lower back)
- Hold this for the appropriate time.
people will gain a benefit from 30 seconds.
Gastrocnemius The part of the
originates from above the knee is the gastrocnemius muscles. It crosses
both the knee and the ankle joints.
about three feet from a wall and put your right foot behind
you ensuring your toes are facing forward
your heel on the ground and lean forward with your right knee straight
the toes in and out slightly will target the medial and lateral parts
of this muscle separately
- Hold this position for the appropriate
The iliotibial band is a long thickening of the fascia on the outside
of the thigh. It originates from the Ilium and inserts into the tibia.
It receives muscular attachments at the hip and has slips into the
patella so you can see how tightness in this structure could cause a
whole slew of problems. Any good knee stretching program should include
IT band stretches. For a more detailed discussion on the
iliotibial band and more ways to stretch it see my page on The
- To stretch the right
iliotibial band in standing,
stand with your right side facing a wall or leaning on the back of a
- Put your right foot behind your left foot
the toes of your right foot out about 45 degrees.
your left hand on your left hip and while keeping
your right leg straight, push your hip in toward the wall.
- A common mistake made when performing this stretch is
to bend forward at the hips or to rotate the body.
sure you remain upright and keep your torso
perpendicular to the wall.
- Hold this position
for the appropriate
can stretching for knees prevent injuries Proprioception
Joint position sense otherwise known as proprioception is important in
sports and knee function in that it is a contributor to joint
A study published in the British Journal of Sports Medicine used 39
healthy volunteers to measure joint position sense (proprioception) in
those individuals dominant knees.(1)
Results showed that a knee stretching program that included three
static stretches of 30 second duration
improved people's joint position sense. Knee stretching used in the
study targeted the quadriceps, hamstring and adductors.
Improved flexibility has always been considered important in the
prevention of injuries and there are several studies that have shown
this to be the case. (2,3,4)
A study published in The Journal of Athletic Training analyzed the
incidence of lower extremity strains in players of a Division 3 college
football team over 1994-95.(5) The addition of a knee stretching
1995 resulted in significant reduction in strains that required minimum
1 day of play lost in 1995 over 1994.