Knee Manipulation Exercises

Knee replacement surgery, or knee arthroplasty, is a procedure performed on patients with severe knee degeneration. Osteoarthritis and rheumatoid arthritis are the biggest causes of this surgery, but other degenerative conditions like avascular necrosis may also lead to this surgery. After a knee replacement, there will be a long period of physical rehabilitation in order to return full functionality to your knee. Your physical therapist will suggest knee manipulation exercises to strengthen different muscles and joints in the knee.

Straight-Leg Exercises

• Some of the best knee strengthening exercises don't require bending the knee at all. These exercises should be performed in two sets of 10 reps each, with a 60-second rest period between the two sets if needed.
  The quad set exercise begins by lying on the ground with the leg outstretched and flat. Tighten the muscles on top of the thigh, and hold. Pull your toes toward your head, push your heel out and press your knee into the ground. Hold this for 10 seconds, pulling harder every second, then rest for five seconds. This constitutes one rep of quad sets.
  A knee-extended leg lift starts much the same way, except with a toilet paper roll under the heel to lift it slightly off the ground. Push the knee down and lock it, then lift the leg up as high as you can. Lower it slowly back onto the toilet paper roll.
  Another exercise that keeps the leg straight is the Drake exercise. Tighten the thigh muscles, and hold for two seconds. Lift your leg 4 inches off the floor and hold it there for two full seconds. Lower it slowly to the floor and hold the tension in your leg on the ground for another two seconds.

Bent-Leg Exercises

• Other exercises for knee manipulation require you to bend your knee. These exercises should also be performed in two sets, but only five times per set.
  The heel slide is the most basic of these exercises. Lie on your back with your legs out straight and flat on the ground. Slide one heel up toward your hips, bringing the knee up into the air. When you can bring your foot flat on the ground, start sliding the heel back forward until the leg is fully extended.
  To strengthen your hamstrings, start with the knee bent about 6 inches off the ground. Tighten the hamstring by pulling the heel down and back--your heel shouldn't move in the process, as you should be pulling it into the ground, but focusing on pulling it down and back should tighten the muscles on the back of your thigh. Pull for five to 10 seconds, then relax.
  Simple flexion and extension is also important for the recovering knee. Sit on something high enough to allow your feet to hang without touching the ground. This exercise is much like pumping while on a playground swing: bend your knee back as far as it'll go, then extend it by straightening your leg as far as possible. Repeat this, as other exercises, in two sets of five reps.
  From the same position, with feet dangling, you can perform an assisted knee flexion exercise. Cross the ankle of your good leg in front of the ankle of the leg that had the knee surgery. Use the good leg to push both of the ankles back, bending your knees. Hold for a few seconds, then relax.