Quadriceps strength rehabilitation ladder

1)      Stand up, lock knee into extension. Sit, and cros heel of uninjured leg over ankle of injured leg, block quadriceps extension of injured leg. Use rule of 7

2)      Knee extensions. Support inner thigh of injured leg and straighten knee into extension, add a weight, e.g. 0,2kg of a sugar in a bag, and repeat extensions. Increase weights. Miss out this stage for ACL

3)      Balance on injured leg in half-squat position. Use rule of 7

4)      Slow step-ups. Step up, onto a low bench or stair, using alternate feet and use the flat of the foot rather than the forefoot

5)      Leg press machine or leg extensions. If available, use a machine in a gym. For joint problems, use leg press only

6)      Squats. Sit with back, against a wall, with thighs parallel to the ground, and hold for as long as possible. Move onto “squatting light weights”, but not below 90 degrees knee bent

7)      Bike routine. Use as high a gear as is comfortable, with a low pedal rate, continue until the muscle aches. Rest 5-10 min, repeat as fitness allows. Vary the seat height, to make the knee work straighter or more flexed. Maintain rhythm and do not favour the injured leg. Keep the knee vertically above the foot

8)      Depth jumps. Jump down from a low step, 15-20 cm, then up and over a string or bar to the maximum height. Drop this height by 5 cm then repeat 10 times. Jump rhythmically down and over the bar with no bounce in between. Start with both legs. Eventually improve to single-leg jumps. Over the weeks gradually raise the height of the step but not more than 40cm high

9)      Hop, step and jump. The idea is to travel as far as one can and, as this is measurable, one can monitor progress. Start with right toe on a line, hop onto right foot, step onto left foot, jump from left foot, land on both feet, or hop, hop, hop etc. Measure distance traveled. Repeat, starting from the left foot. Repeat 5 times on each side.

10)   Weights. Resume normal weight training to level before injury

 

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