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THERAPEUTIC EXERCISE PROGARMS:

Lower Body Strengthening Program

General instructions

Wear shoes and your brace (if you have one) when performing the exercises.

Determine the maximum amount of weight your unaffected leg can lift by performing each exercise with the most weight you can handle. If the exercise seems easy, do it again with more weight. Record the maximum weight for each exercise that your unaffected leg can lift. This is the goal you work toward with the injured leg. As a general rule, you should be able to lift 10% of your body weight.

Exercise the weaker leg once a day, every day. Perform the exercises slowly, at a rate of one repetition per second.

Start exercising the weaker leg with a weight that will allow you to barely complete the prescribed number of repetitions because of fatigue. If the exercise seems easy, add more weight next time. If the exercise is too difficult, decrease the amount of weight next time. Over time, as the exercises become easier, increase the amount of weight by 1-1/4 or 2-1/2 pounds. Do not add more repetitions, but continue to increase weights as you get stronger.

These exercises are designed to be performed pain free. If you experience pain while doing them, decrease the height of the lift and/or the amount of weight you are lifting. The generalized muscle soreness you will feel is normal and should not be confused with joint pain. As you progress with the exercises, this soreness will diminish.

When the weaker leg can lift the same weight as the stronger leg, continue the exercise with both legs to strengthen both of them to their maximal potential. When you have reached this level, perform the exercise every third day.

Equipment

Use black disk weights with a hole in the center (donut weights). Buy one 1 1/2 lb, one 2 1/2 lb, one 5 lb, one 10 lb weight, and a strap to secure the weights around the instep of the foot. (Do not use sandband or Velcro weights that wrap around the ankle.) This equipment can be purchased at many sporting goods stores.

Wear shoes and your brace (if you have one) while performing the exercises.

The Exercises

Exercise 1: Side Lifts (Hip Abduction)

Starting position: Lie on your side on a table or table or a firm mattress. The body and the top leg must be straight, with the bottom leg bent at the knee. Place the weight around the instep of the foot over your shoe.

Action: Keeping the knee straight, SLOWLY lift the leg to a MAXIMUM of 12 inches and SLOWLY lower the leg back to the starting positions Perform this exercise 10 times, rest 30 seconds, and repeat for a total of 20 repetitions.

 

Exercise 2: Hip Flexion

Starting position: Sit on a high desk, kitchen counter, or table with both legs placed over the edge and the knees bent 90 degrees. KEEP YOUR BACK STRAIGHT. Grasp the front edge of the table with both hands. The weights are secured around the instep of the foot.

Action: Keeping the knee bent with the heel directly under the knee, SLOWLY raise the knee approximately 8 inches above the surface of the table . SLOWLY lower to the starting position. Perform this exercise 25 times, rest for 30 seconds, and repeat 25 times for a total of 50 repetitions.

 

Exercise 3: Straight Leg Raises - Hip Flexors and Quadriceps

Starting position: Lie on your back on a table of firm surface. THE LEG TO BE EXERCISED IS STRAIGHT AND IN COMPLETE EXTENSION. THE OTHER LEG IS FLEXED (bent) at the hip and knee such that the foot is planted on the surface of the table. Secure the weights around the ankle to be exercised.

Action: KEEP THE LEG TO BE EXERCISED COMPLETELY STRAIGHT SLOWLY raise the leg until the ankle is APPROXIMATELY 12 inches OFF THE GROUND. SLOWLY lower the leg back to the starting position. Perform this exercise 25 times, relax for 30 seconds, and repeat again 25 times, for a total of 50 repetitions.

Note:

    1. When raising the leg, the knee must be kept STRAIGHT.

    2. NEVER touch the table with the weight.

 

Exercise 4: Hip Adduction

Starting position: Lie on your side with the leg to be exercised on the bottom and slightly turned inward. The upper leg is rested in front of the bottom leg. The weights are secured around the instep of the foot.

Action: Keeping the leg straight, SLOWLY raise the lower leg four inches. Slowly return the leg back to the starting position. Perform this exercise 25 times, relax for 30 seconds, and repeat 25 times, for a total of 50 repetitions.

 

Exercise 5: Tensor Fascia Lata

Starting position: Lie on your side on a table or firm mattress. Place the weight over the instep of your shoe. Keeping your knee straight, flex your top hip 45 degrees forward (A).

Action: Slowly lift your leg 12 inches off the table (B). Avoid rolling backward. Perform this exercise 10 times. Rest for 30 seconds and repeat an additional 10 times.

 

Exercise 6: Hip Extension - Gluteus Maximus and Hamstrings

Starting position: Lie on your stomach with the leg to be exercised positioned off the side of the table. The weights are secured around the back of the ankle.

Action: Keeping the leg straight, slowly raise the leg as high as you can without causing pain. Slowly return the leg to starting position. Perform this exercise 25 times, relax for 30 seconds, and repeat the exercise 25 times, for a total of 50 repetitions.

Note: When performing this exercise, do not twist or arch your back

 

Exercise 7: Knee Extensions

Starting position: Sit on a high desk, kitchen counter, or table with both legs hanging over the edge. Hold on to the front of the table to support your upper body.

Action: With the weight suspended from your foot, straighten your leg, extending your knee completely. SLOWLY lower the leg back to the starting position. Perform this exercise 25 times. Rest for 30 seconds and repeat an additional 25 times.

 

Exercise 8: Knee Flexion - Hamstrings

Starting position: Lie on your stomach with both legs straight. Secure the weights from the back of the ankle.

Action: Slowly bend the knee to raise your foot as high as you can without the weights sliding down the leg. Return the leg to the starting position. Perform the exercise 25 times, rest for 30 seconds, and repeat the exercise 25 times, for a total of 50 repetitions.

 

Exercise 9: Toe Raises - Gastrocnemius and Soleus

Starting position: Place a 1-inch book or board of similar dimensions under the front of the affected foot. The nonaffected leg is bent at the knee so that the nonaffected foot is off the ground. Hold onto a chair or wall for added support.

Action: Push off the ball of the affected foot by lifting the heel off the ground. Perform this motion 25 times, relax 30 seconds, then repeat 25 times, far a total of 50 repetitions.

Note: As the leg strengthens, increase the height of the book or board from 1 to 2 inches.

 

Exercise 10: Ankle Dorsiflexion (Anterior Tibial Group)

Starting position: Sit on the edge of a high desk or table with the knees bent and the weights above the level of the floor. The weights are secured around the instep of the foot.

Action: Bring the toes up toward the front of the leg by bending the ankle. Perform this exercise 25 times, relax for 30 seconds, then repeat 25 times for a total of 50 repetitions.

 

Exercise 11: Ankle Inversion - Tibialis Anterior and Tibialis Posterior

Starting position: Lie on your side with the foot to be exercised on the bottom; the foot is positioned off the edge of the table. Secure the weights around the instep of the foot.

Action: Turn the ankle so that the toes face up toward the ceiling. Perform the exercise 25 times, relax for 30 seconds, then repeat 25 times, for a total of 50 repetitions.

 

Exercise 12: Ankle Eversion - Peroneal Muscles

Starting position: Lie on your side with the foot to be exercised on top; the foot is positioned off the edge of the table. Secure the weights around the instep of the foot.

Action: Turn the ankle upwards, raising the toes as high as possible. Perform the exercise 25 times, relax for 30 seconds, and repeat 25 times, for a total of 50 repetitions.

 

Exercise 13: Short Arc Quadriceps

Starting position : Sit on floor or table with both arms behind you, supporting your back. Place a rolled towel, soccer ball, or basketball under your knee.

Action: With the weight suspended from your ankle, slowly extend your knee until it is completely straight. SLOWLY lower the foot back to the starting position. Perform this exercise 25 times. Rest for 30 seconds and repeat an additional 25 times.

 

Exercise 14: Prone Knee Extension

Starting position : Lie on your stomach with both legs straight. Flex feet upward and rest on your toes.

Action: Press your toes into the floor and straighten your knees, lifting them off the floor. Keep your hips down. Hold this position for 6 seconds. Perform this exercise 25 times. Rest 30 seconds and repeat an additional 25 times.