Quadriceps rehabilitation ladder - heart and lungs

The heart and lung ladder builds up stamina. To rebuild muscle strength, use the strength ladder. These two may be used in parallel. Competitors in power events should concentrate on strength, whilst speed and endurance competitors will find the heart and lungs more appropriate. Competitors in most ball games will use both ladders.

1)Patter and skipping routine

Patter routine

The simple exercise is effective in raising the pulse rate and building fitness without straining the knees or hips. It also takes up very little time. Quality, not quantity, is vital in fitness training. The secret to pattering is not to lift the feet far off the ground. A slow patter is more like a fast jog on the spot, with the knees kept low. The feet must be lifted only 2.5-5cm off the floor. A fast patter has the same low knee and foot lift, but pattering is done as fast as possible. It is testing, but simple.

Routine for an unfit athlete(3 minutes)

1min    slow patter

5s        fast patter

50s      slow patter

5s        fast patter

50s      slow patter

10s      fast patter

Rest for 3 minutes, whilst doing stretching exercises. Repeat the above routine at least twice, preferably four times.

Routine for a fairly fit athlete(5 minutes)

50s      slow patter

10s      fast patter

40s      slow patter

20s      fast patter

50s      slow patter

10s      fast patter

30s      slow patter

10s      fast patter

50s      slow patter

30s      fast patter

Then rest for 3 minutes, whilst doing stretching exercises. Repeat the above training routine at least once, preferably three times.

Routine for a fit athlete(16 minutes)

Perform the routine as for the unfit athlete once, followed immediately by the routine for the fairly fit athlete, repeat.

Skipping routine

If an athlete is good at skipping, use the same timing as for the patter routines. This gives the calf muscles a particularly good workout.

2) Rowing, cycling and swimming routine

With knee problems, keep the knee vertical over the foot, avoid breast stroke for knee and sacroiliac joint problems. Only backstroke may be appropriate for extension back pains.

Swimming routine

Swimming is an excellent way to keep the muscles toned up, especially when the patient cannot “run through” an injury. The water supports the body’s weight but does not offer great resistance. Although less muscle power is required, the pulse rate is still raised by swimming. Running in water whilst using a flotation jacket for stability may be used instead of actual swimming. The patient should not just run with a high knee lift but take large strides, really pulling with the hamstrings, trying to mimic their running style.

Routine for a poor swimmer/non-swimmer

The athlete should jump in, swim of flounder across the width of the pool, climb out using the good leg and stand up, turn around, and then repeat the routine for 3-5 minutes. After the exercise, an athlete should rest for 3 minutes while doing stretching exercises. Repeat the above routine at least twice, preferably three times.

Routine for a good swimmer

As above, but swim one length of the pool each time.

Rowing routine

A rowing machine is required for this. It gives a thorough workout for legs, arms and abdominal muscles, and also builds up stamina. Untrained rowers will find this much harder work than expected. Lying back at the end of each stroke will exercise the stomach muscles. The hand grip can be varied, either over the top or underneath, if the arm muscles ache. Athletes with knee problems should not drop the knees out to the side but try and keep them in line with the first and second toes as they move backwards and forwards. Drawing a mark over the midline of the knee caps will help to keep the knees in line. Make sure the athlete presses equally hard with both legs, trying to get both knees to travel at the same rate, especially when locking them straight. Athletes with back problems should “core stabilize” their back and should not reach too far forwards, or lay back at the end of the stroke.

Routine for patients doing long-distance/stamina events

The patient should be able to carry on a conversation, even if they are painting a lot, and exercise for at least 10 minutes, although more than 30 minutes is preferable.

Routine for patients doing middle-distance events and running ball games

This should include aerobic and anaerobic training such as 2 minutes long distance, 1 minute sprint followed by a 3 minute rest. To be repeated as often as required.

Routine for sprint events and martial arts

Exercise with at least 30 hard strokes per minute, for 1-2 minutes. Rest for 5 minutes. Repeat as often as required.

Cycling routine

This removes impact from the ankles, knees and hips, and avoids jarring the back, whilst still allowing in excellent workout for heart and lungs. It may be done on a stationary exercise bike in a gym or on an ordinary pedal cycle on the road. For stamina training athletes should use easy low gears, at a pace where they are able to talk whilst only slightly panting, but, for sprint training, harder, higher gears are used. Those with knee problems should keep the knees vertical over the first and second toes to avoid a varus or valgus action at the knee, and try to take up pedal pressure at the top of the pedal cycle, not half way down when it becomes easier. Count for rhythm.

Routine for long-distance running

The time on the bike should be equal to the time normally spent training on foot, but over a much longer distance, preferably 2-2.5 times longer than they would usually run. Few of us have the skill to move a bike that fast, but it is the approximate physiological equivalent.

Routine for middle-distance running and ball games(5 minutes)

4.5min stamina training

30s sprint training

Rest for 3 minute, while doing stretching exercises. Repeat at least twice, preferably four times.

Routine for sprint events, strength events, volleyball, basketball, etc. (5 minutes)

2min    stamina training

30s       sprint training

90s       stamina training

1min     sprint training

Rest for 4 minutes, while doing stretching exercises. Repeat at least twice, preferably four times.

3) Calf and Achilles top ladder

 

"Concise guide to sports injuries, 2^nd edition",Churchill Livingstone, Malcolm T.F. Read,  foreword by Bryan English