21.04.202027.05.2017

Therapeutic physical education (gymnastics) underlies the treatment of arthrosis. Exercises that are necessary for arthrosis of the knee joint are usually performed in a sitting or lying position in order to reduce the load on the affected knee as much as possible.

Therapeutic exercise for sore knees is designed to improve the general physical condition of a person, strengthen cardiovascular system and skeleton. But it’s worth doing only according to the method approved by your doctor, since the set of exercises should be selected taking into account the stage of arthrosis of the knee joint and the general well-being of the patient.

Overloading is undesirable, do not think that the more repetitions you perform, the faster the tangible result will be. On the contrary, excessive zeal can aggravate the situation and wear out the joint even more. Exercises should be done slowly, avoiding jerks and focusing all energy on the sore leg.

At the very beginning, you need to relax the limb a little in order to create an influx of fresh blood with nutrients to the arthritic knee and improve the “lubrication”.

It should be remembered that if the condition worsens and pain increases, you need to reduce the number of repetitions and consult your doctor for advice.

Basic Treatments

The intensity and method of treatment of arthrosis depends on each individual case. During the period of exacerbation, you can undergo a course of inpatient treatment, and during the period of remission - use physical methods restoration of diseased joints.

It is not bad to use microwave, ultrasound therapy, electrophoresis and thermal procedures, mud applications and radon, hydrogen sulfide, turpentine baths. Therapeutic physical education (LFK) is well combined with massage sessions.

Training rules

It is important to follow the following rules at the time of training:

maintain a balance between rest time and a period of intense stress on sore joints. On average, it is required to rest the knee joint every 4-6 hours in order for the cartilage tissue regeneration to be successful;
the total amount of time for classes per day is 30-40 minutes, but they must be divided into small periods of 10-15 minutes;
in the first minutes, exercises are done slowly, gradually increasing the range of motion;
during classes, mentally imagine how blood rushes to the diseased joint, replenishing it with nutrients, and it is restored.

Do not expect instant improvement even in the initial stages of the disease. Give up the maximum load on the knees, as this only aggravates the situation, but in no case leads to a positive result. In the mornings, you can conduct additional general strengthening exercises for the whole body, so that it is “more fun” you can combine them with watching your favorite programs.
All exercises are performed at least 3 times a day, repetition - 5-6 times for each movement, but total time should not exceed 30-40 minutes.
Do not take medicinal substances that give a short-term effect.
After the set of exercises is over, lie down with your legs stretched out and completely relaxed. Do not rest while sitting, knees should not be in bent state. The result can be consolidated by applying self-massage for 5-7 minutes, the doctor will tell you how to do it correctly.

Physiotherapy methods

electrophoresis

The principle of operation is based on the movement of charged particles (drug ions) in an electromagnetic field (two electrodes).

A current is used that is not felt by a person. The interlayer between the electrode and the body is a napkin soaked in a medicinal substance. Its ions, under the action of current, rush deep into problem area resulting in a high drug concentration. It immediately begins to "work" - relieves pain, inflammation and improves nutrition of the arthrotic joint.

Electrophoresis can deliver medicinal substance directly to the center of the problem, and not affect the body as a whole, thereby avoiding many unwanted side effects.

"Depot" of the drug can remain under the skin for another 2-3 weeks, providing a long-term therapeutic effect.

Ultrasound

Indicated for arthrosis knee joints, the method is based on the ability of high-frequency sound to interact with human tissues and create a number of beneficial effects - warming, micro-massage, improving metabolism and increasing blood flow.

Acting on a joint affected by arthrosis, ultrasound promotes the penetration of nutrients into it and maintains cartilage tissue, preventing it from further destruction.

A magnetic field. There are local and general action. The first - acts locally, the second - improves the overall protective and regenerative characteristics of the body. With a certain effect on tissues, many useful functions can be extracted - improving the rheological properties of blood, reducing inflammation, normalizing vascular tone, accelerating lymphatic blood flow and regeneration processes.

A magnetic field has a positive effect on a joint damaged by arthrosis, it improves metabolic processes and reduces inflammatory reactions, which increase the destruction of cartilage tissue.

Radiation therapy

Laser radiation and various light ranges in the right quantities help to fight arthrosis of the knee joint. Exposure to laser and light is usually prescribed when all other physiotherapeutic methods are contraindicated. But they can be carried out in combination with other physiotherapy.

Contraindications for physiotherapy

You can not carry out physiotherapy under the following conditions:

malignant neoplasms and active tuberculosis;
mental illness, epilepsy and psychomotor agitation;
severe heart disease (stage 3 hypertension, heart failure) and atherosclerosis;
pregnancy;
tendency to sudden bleeding;
cachexia (general weight loss, wasting).

Special exercises for sore knees

Performed sitting on the bed:

legs are closed and lowered down. It is necessary to alternately bend and unbend them at the knees, and the feet only slide along the floor;
starting position, see above. While inhaling, pull the knee to the stomach, exhale. Repeat the same with the other leg;
same starting position. Straighten your legs and point your feet towards you;
Straighten your right leg on the couch, and lower your left leg down. Make a half turn to the right, place your hands on the knee of your right leg. When exhaling, make three springy tilts at the same time pressing on the knee joint, as if straightening it. Repeat on the other leg;
feet on the floor, feet wide apart, hands on knees. Stand up - direct your hands to the sides, sit down - put your hands on your knees and exhale;
on the bed, legs straight, hands on knees. Tighten the muscles of the thighs about 20 times for 30 seconds, while the popliteal fossae should be firmly pressed against the bed;
on the bed, press your knees with your hands and counteract their pressure, as if shifting the right and left hips forward alternately;
on the bed, straight legs spread apart and bring them together without resorting to the help of hands;
on the bed, spread your arms to the sides - inhale, pull your knees up with your hands to your stomach and lower your head down - exhale;
on the bed, spread your arms to the sides (sigh) and, without bending your knees, touch your feet with your hands - exhale.

Performed lying on your back:

arms along the body. Lift them up and back, stretch a little and at the same time direct the feet towards you (inhale). Lower your hands and relax - exhale;
inhale, pull the knee to the stomach with your hands and exhale. Repeat with the other leg;
bend your knees and raise your pelvis;
bend your legs, then straighten your right leg up and release. Repeat with left leg;
take the straight leg to the side and return to the starting position, repeat with the other leg;
raise your leg and both arms up, take a breath. As you exhale, lower your leg and arms;
"bike", repeat this movement for 15 seconds.

Performed lying on the stomach:

hands under the chin. Without bending, raise your legs up alternately and do not hold your breath;
bending your head to raise, keep your shoulders and legs straight - inhale. Lower yourself and exhale.

Performed standing:

take your legs to the side, holding the back of the chair with your hands;
grab the back of a chair with your hand and stand sideways. Perform swings back and forth alternately.

How to properly massage (self-massage)

Self massage is The final stage gymnastic exercises, aimed at improving the blood supply to the diseased joint and restoring cartilage tissue.

Technique and sequence of movements:

massage of the thigh muscles, combined stroking, squeezing with the edge of the palm and crests of the fists, stroking - shaking the legs, single and double ring kneading (all repeat 3-4 times);
on the joint itself, circular and concentric stroking of the lateral sections is used. Rubbing - with the base of the palms of both hands rectilinearly, "forceps", circularly and again rectilinearly;
repeat the massage on the thigh, but less intensively and reducing the number of repetitions and return to the massage of the knees. Finish again with a deep thigh massage (item 1);
carry out active exercises: flexion and extension of the legs (5-7 times), rotation of the lower leg. In conclusion, we return to the massage.

The force with which self-massage should be carried out depends on the local sensitivity of the tissues. It is not bad to combine massage with warm baths (37-39 degrees) or immediately after the steam room.

Rules for conducting physiotherapy exercises

All physical exercise will undoubtedly benefit, you just need to follow simple rules:

all movements should be smooth, and performed at a slow pace;
the amplitude of movement should increase gradually;
when pain occurs, the exercise should be stopped;
the duration of each lesson is no more than 10-15 minutes, but they must be performed regularly, every day.

Hatha yoga is here to help you

A feature of asana yoga (hatha yoga) is that diseased joints and muscles receive a static load without active movements. That is why yoga is recommended for osteoarthritis of the knee joint.

The sequence of exercises:

standing straight, feet shoulder-width apart with arms freely lowered. Exhale and tilt the torso forward, reach for the big toes and slightly pull the torso to the bottom. Do not bend your legs, breathe calmly and measuredly. If you can’t reach it, then you can clasp your shins behind your hands and do the exercise;
on a soft bedding on the floor, kneel down, keep your torso upright, lower your arms. Slowly sit on your heels and stay in this position for a couple of minutes;
sitting on the floor, legs straight in front of you. Tilt forward, grab your big toes, it is advisable not to bend your knees. Slowly draw your torso towards your feet. Perform the exercise for 2 minutes.

And, finally, one more valuable advice from experts. If a person has excess weight and symptoms of arthrosis in the knees began - you should first lose weight, and then, to normalize the functioning of the joints, take a course of exercise therapy.

Gymnastics for sore joints

Gymnastics for the joints is one of the important conditions for alleviating the condition with arthrosis. A set of exercises for the joints should be performed daily, for fifteen to thirty minutes. Then after enough a short time, a month and a half, joint mobility will improve, arthrosis will begin to recede.

Gymnastics for joints - how not to harm the body

Therapeutic gymnastics for the joints is different from the usual sports activities. Its peculiarity is that the exercises provided in the complex are not aimed at increasing the load on the muscles, but at improving the mobility of the joints. Therefore, they are quite simple, it is easy to perform them.

You can assess the condition of your joints and choose exercises yourself. Small tests will show how mobile certain parts of the spine and limbs are.

Before doing exercises to strengthen the joints, do the following:

Tilt your head down, touching the sternum with your chin;
Tilt your head left and right, trying to touch your shoulder with your ear;
Pull your shoulders back, connecting the shoulder blades;
Join hands in a “lock” at the back, at the level of the shoulder blades;
Sit down five to six times without the help of hands;
Lean forward without bending your legs. Try to touch your knees with your forehead;
Putting your feet shoulder-width apart, reach your palms to the floor;
While standing, bend back so that you can see an object lying on the floor behind.

If you managed to perform all the exercises easily, therapeutic exercises for the joints are not too necessary for you yet. However, active healthy way life should not be forgotten, and with a hereditary predisposition to arthrosis, it is necessary to do exercises to strengthen the joints two to three times a week.

One of the most common joint diseases in the world is arthrosis. At the age of 45, up to 15% of the population suffers from it, at the age of sixty, every third person suffers from this disease, and at the age of seventy, every second person. Of course, there are exceptions, such as, for example, herbs, which can become a provoking factor in the development of arthrosis at a young age.

Arthrosis is one of the many diseases that inevitably overtake the age part of the population.

Pain in the joints manifests itself during movement, and at rest, they practically do not bother. As a rule, pain relievers are ineffective. Various warming ointments, compresses and mud help best of all. Blood tests usually do not show any visible changes. It is possible to detect the disease with the help of x-rays or MRI.

Arthrosis is characterized by degenerative damage to the cartilaginous tissue of the joint. With age or as a result of injury, the amount of fluid in the core of the intervertebral discs decreases, thereby reducing the elasticity and mobility of the joints. Most often, arthrosis worries the knee and hip. Often you can find arthrosis of the big toe on the leg. A knee with arthrosis often makes itself felt with pain while walking, squatting.

Effective treatment of arthrosis

The approach to the treatment of this disease of the joints should be comprehensive. First of all, you need to contact the clinic at the first manifestations of the disease. Remember that only a doctor can make a correct diagnosis and prescribe adequate treatment.

Many of the symptoms of osteoarthritis are similar to those of other joint diseases, but their causes and treatments are very different. Therefore, self-medication can not only be useless, but also have a negative impact on the course of the disease.

Only a doctor can prescribe a set of measures from drug treatment, physiotherapy, diet and physiotherapy exercises, which can stop the further development of arthrosis. Since treatment is most effective in the early stages of the course of the disease, it is advisable to consult a doctor at the first symptoms of a knee joint disease.

Importance of exercise in osteoarthritis

One of aids at, is therapeutic gymnastics. One of its main principles is "do no harm"! Depending on the stage of the disease, a set of exercises is also formed. In the early stages of the disease, vigorous movement is an excellent way to improve joint mobility and increase blood flow.

If the joint has already begun to collapse, then vigorous exercise can only worsen the patient's condition. Therefore, before proceeding with the implementation of the complex for the treatment of arthrosis of the knee joint, it is necessary to consult a competent specialist.

Physiotherapy trainer selects individual complex exercises that can help you and not harm your joints. For acute period during the course of the disease, exercises are selected to improve lymph flow, blood supply to the joint, relax the muscles around it and reduce pain.

In the stage of remission, the emphasis is on strengthening the musculoskeletal apparatus of the joint and restoring its functions.

Rules for performing physiotherapy exercises

Gymnastics for arthrosis of the knee joint basically adheres to three principles - caution, regularity and gradualness. All exercises are recommended to be performed either sitting or lying down. No vigorous exercises "through pain" should not be in the complex. The load increases gradually, as does the range of motion.

The duration of the exercises should be a few seconds, but you need to repeat them several times a day. One of the main principles of any medical complex, is the regularity of its execution. Classes from time to time not only do not bring results, but can also have the opposite effect, causing an exacerbation of the disease.

Knee Exercises

All exercises for therapeutic effects do not tolerate sudden movements, they are performed smoothly and slowly:

Lying on your back with straight legs, stretch with your heels without stretching your socks. This exercise well relieves tension in the muscles, and also helps to improve metabolic processes in the knee joint;
Lying on your back, stretch your arms along the torso. Raise alternately straight legs 15 cm from the floor. The back and lower back are firmly pressed to the floor;
Lying on your back, arms along the body. Raise the leg bent at the knee in turn to the stomach;
Exercise "bike";
Lying on your back, swing with straight legs at a height of 20 cm from the floor in a horizontal plane;
Lying on your side, lifts the upper leg to a small height. The lower leg is bent at the knee. Perform on different sides;
Lying on the stomach, arms along the body. Fulfill alternate bending legs at the knees;
Lying on the stomach, arms along the body. To make lifts with a straight leg to a height of 15-20 cm from the floor, the toe “on itself”. IN this exercise it is important that the pelvis and chest are firmly pressed to the floor, and the rise is made due to the tension of the muscles of the thighs;
Sitting on a chair, perform relaxed swaying of the leg, bending and unbending the knee joint.

Static knee exercises

These exercises are performed several times with an interval of ten seconds:

Sitting on a chair, raise your leg, straightening it at the knee joint and hold for up to 30 seconds. Then perform the exercise with the other leg;
Standing at the back of a chair, rise on your “toes” and stand up to 60 seconds. Having done this exercise several times, you can repeat it in a dynamic version;
Standing at the back of a chair, lean on your “heels” and hold out for up to 60 seconds. This exercise is recommended to be carried out in a dynamic version, that is, to change position more quickly;
Standing at the back of the chair, perform smooth transitions from the “heel” to the “toe”, as if in waves smooth movements, causing blood to rise more actively to the knee joint.

Self massage

After performing a therapeutic set of exercises, it is recommended to perform self-massage of the thighs, its front and side surfaces. It is performed for three to five minutes with vigorous rubbing from the bottom up, from the knee to the groin. Should be warm and comfortable. None pain not allowed.

Recommendations of nutritionists for patients with arthrosis of the knee joints

One of the factors contributing to the development of arthrosis is excess weight. Weight loss has a beneficial effect on the treatment of arthrosis of the knee joints. However, only reducing the patient's weight cannot cure arthrosis.

Must be connected to the complex of therapeutic measures balanced diet. Patients with osteoarthritis should include as many fruits and vegetables as possible in their diet. Among the fats, vegetable oils should predominate, for example, olive, sesame and butter in small quantities. From meat it is necessary to give preference to chicken, turkey and veal. Any fish is recommended, but not fried.

Particular attention should be paid to lactic acid products, especially cottage cheese and natural yogurt. Of the cereals, buckwheat is best suited. Bakery products can only be consumed whole grains.
Much attention is paid to the complex of vitamins that must be consumed by everyone suffering from arthrosis. In addition to chondroprotectors, it is necessary to use a complex of vitamins of group B. All this can be selected for you by your doctor, in accordance with your stage of the disease, your physical condition and preferences.

Video - Gymnastics for arthrosis of the knee joint

Chronic knee diseases are more common among the elderly, and their injuries are common among teenagers, people who are professionally involved in sports or who are fond of extreme views entertainment. Gymnastics for the knee joints is the main method of their rehabilitation. When to start doing exercises, and which ones?

Therapeutic exercises for the knee joints are prescribed by a doctor or exercise therapy specialist.

In doing so, they take into account:

type of pathology or injury;
whether it was fulfilled;
duration of immobilization of the knee;
individual characteristics of the course of the disease;
the presence of complications and / or concomitant diseases of the musculoskeletal system and the hematopoietic system;
age and general condition health.

Exercises for sore knees fall into the following categories:

static tension for the muscles of the thigh and lower leg;
passive (assistant) movements in the affected joint with the help of a healthy leg (see photo above) or mechanotherapy devices;
exercises to strengthen the knee ligaments and joints of the affected leg, including the ankle and hip joints;
power movements for interested muscle groups;
stabilization exercises;
developing exercises for contracture;
knee traction performed independently or with the help of an assistant;
exercises for rehabilitation after traumatic injuries.

Exercise after surgery or knee replacement is included in the above classification. Their only "difference" is more early dates permission to perform certain types of movements compared to similar ones used for the treatment of fractures.

Attention! Doing exercises for pain is allowed only for diseases of an indirect traumatic nature (arthritis) and pathologies of an infectious-inflammatory nature. If the knee hurts after an injury, then first they seek medical withdrawal discomfort, and then begin treatment with movement, but in such a way that it does not cause pain.

As an example, here is an excerpt from exercise therapy for the knee joint - a video of one simple movement that is performed 1, maximum 2 times a day. Such a five-minute exercise will help relieve pain in case of gonitis, arthritis and arthrosis, and prepare the affected joint for further therapeutic physical exertion.

The timing of the appointment of exercise therapy, depending on the type of injury or pathology of the knee

Human knees are the largest and most complex joints that are subjected to increased loads throughout life and are often injured. In addition to damage or pathological changes in bone and cartilage structures, damage to the ligamentous apparatus, capsule, synovial bags, muscles, nerves, blood and lymphatic vessels can occur in the knee joint.

Traumatic knee injury

Swimming and exercise equipment are a great choice

Therapeutic exercise for a knee injury consists of:

During the immobilization period:
1. when stretched - breathing exercises, finger wiggling and static tension of the muscle groups of the broken leg, exercises for a healthy lower limb, exercises for preparation shoulder girdle to walk on crutches;
2. during plastering - movement with crutches (at first without starting, and then stepping on a broken leg a little), available movements in the hip and ankle joints while lying and standing, exercises to relieve tension from the shoulder girdle;
3. with the Ilizarov apparatus - movements based on a broken leg with crutches and a cane, accessible movements of the injured limb in different starting positions.
In the post-immobilization period:
1. gymnastic complex with a gradual increase in dosage and duration - 4-6 sessions per day, lasting from 20 to 30 minutes;
2. mechanotherapy;
3. movements on blocks or with overcoming the resistance of an elastic band;
4. dosed walking;
5. dosed swimming.
In the rehabilitation period:
1. gymnastic complex, including exercises in motion - 2 times a day for an hour;
2. work on simulators and with expanders;
3. dosed walking;
4. swimming with special devices (pictured above).

The timing of the start of exercise therapy classes depends on the type of knee injury:

The main types of damage	Start dates and features of exercise therapy
	Exercise therapy after - bruising of soft tissues and the patella, is prescribed immediately after the disappearance of acute pain. All exercises for the knee joints are performed without restrictions. If necessary, during the day, between joint training, you can wear a knee brace. The price of frequent injuries and untreated knee bruises is the development of arthrosis or delayed arthritis.
	there are III degrees - stretching, partial or complete rupture. Exercise therapy for rupture of the ligaments of the joint is prescribed after the end of the period of immobilization and the disappearance of the pain syndrome. The ligaments grow together very quickly, so exercises to strengthen them after a slight stretching begin to be done already on the 3-4th day.
	When to start exercise therapy in cases, the doctor decides. The timing depends on the severity and number of tears, one or both menisci were damaged, whether a reconstructive operation was performed. If the cause of meniscopathy was a rotational injury, then special exercises to strengthen the knee with its rotation are performed only at the stage of late rehabilitation.
	A significant proportion of exercise therapy for injuries - subluxations and dislocations, are physical exercises to strengthen the knee joint, as well as to stabilize it. In a conservative way, rotational and lateral dislocations are reduced, and other types are corrected only surgically. Recovery movements are available after immobilization is canceled - from 3-6 weeks. The term of complete rehabilitation is up to 1 year.
	For fractures and fractures light gymnastics for the development of the knee joint, excluding vertical loads for it, it is prescribed immediately after the traction is canceled or the orthosis is removed. For early rehabilitation, such forms of exercise therapy for the knee joints are shown as dosed swimming + work on an exercise bike, and in later dates- exercises to strengthen the muscles with minor weights.

On a note. With bruises of the knee joint and ruptures of its ligaments, applying cold to the anterior and lateral parts of the joint area is the primary method of assistance after an injury. You can continue cold procedures only 48 hours from the moment of injury.

In severe types of bone fractures with significant displacement and damage to the meniscus, especially with open fractures, tendons can be torn, nerves and large blood vessels, and other anatomical components that are surgically removed can be infringed.

After the reposition of bone fragments with the help of osteosynthesis, the necessary manipulations are carried out to stitch the torn tissues together. Exercise therapy for damage to the knee joint begins a week after surgery and is carried out according to the method of treating the main diagnosis - a fracture. However, exercises to develop the knee after osteosynthesis surgery are performed immediately with the attack on the broken leg, and when immobilized with a distraction apparatus, with a sparing, but full load on the damaged limb.

From the middle of the post-immobilization period, exercise therapy for fractures or dislocations of the knee consists of the following daily activities:

morning joint exercise;
mechanotherapy or movements on the block - a total of 2 times a day, for half an hour;
self-massage of the knee - before or after a therapeutic gymnastic lesson;
gymnastics - 4 half-hour lessons a day;
if possible, measured swimming - twice a week for 30-45 minutes;
walking tours with a gradually increasing distance and an emphasis on correct technique gait.

The video in this article, presented below, will help you master the technique of proper knee self-massage.

Neuralgia, degenerative-dystrophic pathology of the articular surfaces and periarticular tissues of the knee

For all chronic pathologies, gymnastics for the knee joint is performed daily, with the exception of periods of sharp exacerbation. Movement therapy is performed until complete, if possible, cure of the disease or for life.

The set of exercises includes:

movements that help reduce or relieve pain;
exercises to restore mobility;
with hypermobility - exercises for the knee joints, which help strengthen the ligamentous-muscular apparatus, including maintaining the balance of the body in a stance on a sore leg;
with spasms - a combination of alternating static and dynamic movements with holding poses with passive isometric stretching, which allows you to relax the muscles, increase their elasticity;
with narrowing of the joint space - passive and active distractions (see photo above);
auxiliary loads to help with weight correction;
movements for the prevention of flat feet, gait correction, postural and femoral-tibial axis distortions.
poses that help normalize the psycho-emotional state.

Important! Only regular exercise therapy classes will help prevent the adhesive process and allow you not to include rather uncomfortable and aggressive movements from exercise therapy during contracture into the set of exercises.

Prosthetic knee joint

rubbing articular surfaces knee metal and plastic can be partial or complete. An indication for prosthetics is a chronic severe pain syndrome that interferes with walking and leading a normal lifestyle.

They resort to such an operation for the following diseases:

necrosis of the condyles;
cartilage damage of an autoimmune nature;
post-traumatic bone defects;
arthritis and arthrosis (III degree).

The main tasks of exercise therapy after knee surgery with implant placement:

promote the fastest healing of sutured muscles and engraftment of the prosthesis;
restore strength muscle fibers, elasticity of the tendon-ligamentous apparatus;
return motor amplitude in the ankle and hip joint;
re-establish normal gait skills.

A day after prosthetics, the patient must learn how to sit in bed correctly. He is allowed to lower his legs, make movements in the knee in a prone position. For the elderly, special breathing exercises are needed, which increases the resistance of the heart and peripheral vessels to a high content of CO2 in the blood serum.

Further, exercises for the knee joint after the operation are selected and performed with a gradual increase in the complexity of movements. The active period of rehabilitation begins after 15-25 days, when the body adapts to the presence of foreign materials of the prosthesis.

On a note! During rehabilitation after arthroplasty of the articulation of the femur, tibia and tibia, as well as after other traumatic injuries of the knee, special attention should be paid to the 4th head of the thigh muscle. To do this, in addition to articular gymnastics and other forms of exercise therapy, during the day, you need to do exercises that will help build the strength of her muscle fibers (pictured above).

Exercise therapy for gonarthrosis and osteoporosis of the knee

If you have been diagnosed with arthrosis or osteoarthritis of the knee, then you should not hesitate to treat with movements. Despite the fact that the etiology of these ailments is different, the progression of the pathology, the scheme of exercise therapy and the consequences of non-treatment are the same.

With stage I arthrosis, although for a long time, a cure is possible, and with osteoporosis, thinning of bone tissue can be stopped or significantly slowed down.

To do this, you need to choose the right combination of such components:

limitation of physical activity during the day;
special exercise therapy complex from arthrosis or exercises for osteoporosis - the movements are the same, but the load is selected individually;
drug therapy;
physiotherapy;
diet food.

In stage II gonarthrosis or osteoporosis, the disease takes a chronic form and exercise therapy for osteochondrosis will have to be done for life, because further progression of the pathology will inevitably end in the destruction of the articular surfaces, and complex and expensive endoprosthetics.

We recommend a complex for gonarthrosis and osteoporosis of the knee, compiled by Dr. Evdokimenko. After performing the complex, the affected joint may hurt. This is fine. Lie down for 30 minutes. If during this time the pain does not subside, then this selection is not suitable for you.

Advice from an exercise therapy specialist. With gonarthrosis of I-II degree, 1 or 2 times a day, it is shown to do articular traction. In each of the traction positions presented in the photo gallery, you need to stay for only 1 minute, and then lie down for 3-5 minutes in the Dead Man's pose, placing unevenly high “linings” under your knees and heels.

Important exercise therapy exercises and restrictions for chondromalacia knee

Chondromalacia is the thinning of cartilage on the inside of the kneecap. Rarely, but sometimes the cartilaginous surfaces of articular bones are also involved in the pathology. Small foci, continuous thinning or through "holes" in the cartilage lining may be the result of instability or incorrect position of the calyx, trauma, or dislocation of the joint.

A characteristic dull pain appears during movement with an axial load, while the leg becomes difficult to straighten. The pain syndrome is caused by a narrowing of the gap between the calyx and the femur.

For conservative treatment or for rehabilitation after surgery, the following special exercises for chondromalacia must be included in the gymnastic complex.

Image and title	Execution instructions
	With chondromalacia, it is paramount to strengthen the oblique part of the medial broad muscle group with the 4th head of the thigh muscle. Put a rigid loop with a diameter of about 40 cm on your feet. Take a position as in the photo: Tighten the muscles of the legs, spreading the feet to the sides - from 5 to 15 seconds. Relax for the same amount of time. Bring the number of repetitions to 3-5.
	Perform this movement in the same time algorithm and dosages as the previous one. Assuming the starting position: Squeeze the ball with your feet. Hold the ball with your knees so that it does not fall.
	Strengthening the quadriceps with chondromalacia should be performed in a position where the knees are not strongly bent - the bend angle is greater than 90 °. Sit with your back against the wall, squeezing an object between your legs until you get tired. Raise your heels alternately or walk in this position on your toes - 15 seconds. Repeat the cycle 1-3 times.
	Maintaining balance with an emphasis on one arm will help strengthen the lateral group of muscles and ligaments on the leg located closer to the floor, but you need to perform the asana in 2 directions for 15 seconds. Please note that the supporting arm is not vertical! Do the same as in the photo.
	Her one archival movement. How to properly stretch the extensor muscles of the iliac-tibial tract - gymnastics for the knee joint, see the video immediately below the table. Start doing it 1 time with each leg, gradually increasing the time from 5 seconds to the indicated 15. Then bring the number of repetitions to 3 times with each leg, but perform them alternately.

Attention! All the way last stage rehabilitation of chondromalacia do not do deep squats, kneeling, avoid climbing stairs, do not sit for a long time with knees bent don't run.

Rehabilitation complex of exercise therapy after surgery on the posterior cruciate ligament of the knee

We want to draw your attention right away - the exercises below, strengthening the ligaments of the knee joint and muscles, are selected specifically for the rehabilitation of the posterior cruciate ligament. For its antagonist or lateral collateral ligaments, other exercises are needed.

Moreover, the presented restorative exercise therapy after a knee ligament rupture is designed for patients under the age of 40, athletes or people with a good physical training. However, older patients, if they succeed, can adopt all or some of the exercises, but perform them with a small number of repetitions and long (up to 1 minute) pauses for rest. For the elderly, jumping is contraindicated.

Before starting to perform special movements aimed at strengthening the ligaments of the knee joint after plasty of the posterior cruciate, it is imperative to do a 5-7 minute joint warm-up.

Title and Image	Explanations
	Increase the depth of the squat gradually. It is not necessary to squat too deep, so that the angle between the thigh and lower leg is sharp.
	During execution, try to keep the supporting (operated) leg in a slightly bent position, and take the healthy leg back and slightly to the side. After a series of jumps described below, make a balance while standing on the floor, but stand at the point of attachment of the tape with the “affected” side, take your healthy leg (with the tape) clearly to the side.
	When performing jumps from side to side, dose forward progress. At first, the “snake” zigzags should be short, then medium, and at the end - long. After that, rest and repeat the jump series of 3 sets, but now increase the speed.
	After taking the healthy leg to the side (see explanation in exercise 2), do a step-down for 3 minutes, while descending from the platform and climbing onto it from the operated leg. Look down and follow the correct setting of the foot, do not “fill up” the knee to the side.
	Jump across the squares on two legs in a clockwise direction. After resting, perform a series of counterclockwise jumps. Start with "3 squares" in a row, and gradually increase the number of repetitions to 10-12.
	Place the foot of the operated leg on the platform, the height of which should be just below the knees. Make a slow lunge, resting your hands on the operated knee. Freeze for 5 seconds, and then for another 5 seconds, make small, literally "centimeter" swings. To complete the exercise, slowly return to the starting position.

jumping on step platform- forward, and then left and right side;
long jump from a sore leg with a landing on it;
running with side steps, knees bent, heels do not touch the floor;
walking backwards.

If possible, every day you need to work on an exercise bike with shortened pedal levers.

On a note. Any gymnastic complex of exercise therapy in case of damage to the ligaments of the knee joint should contain several balancing positions in the stance on the sore leg. First, they are performed standing on the floor, and then in more complicated versions, for example, a pillow or a special platform is placed under the foot.

A complete plan-outline of exercise therapy classes for medial meniscopathy

Therapeutic exercise in case of injury - tear of the menisci, can save from surgery. The lesson outline below is for patients who have an injury to the medial meniscus. It will include not only exercises for the knee joint after a meniscus injury.

Pain in the knee causes a person to step on the foot incorrectly. From this, the natural curves of the arches of the foot begin to change, and the posture is disturbed. Therefore, the warm-up includes movements to prevent flat feet, and special exercises for the knees in the prone position will correct the spine.

Warm up

The warm-up is carried out in the following order:

One palm rests on the stomach, the other on the chest. Inhalation and exhalation of the stomach alternates with inhalation and exhalation of the chest - 30-60 seconds.
Chin movements: "pendulum", outlining in front of you circles parallel and perpendicular to the floor - 6-8 times.
Circles with shoulders - 8 forward and 8 back.
Rotation in the wrist, fingers clenched into a fist ( thumb inside) - 10 times.
Pelvic circles clockwise and counterclockwise (hands on the belt) - 10 times.
The palms rest on chest under the armpits, fingers pointing forward. On an inhale, push your pelvis back. On exhalation, return to the place with a twist of the coccyx. Dosage - 30-60 seconds.
In a stance on one leg, draw circles with outstretched fingers of the other - 8 times clockwise and 8 against. Make movements with the other leg.
Put your feet slightly narrower than your shoulders. Slowly rise on your toes, try to bring your heels together, smoothly return back. Repeat 6 times. Then make 6 lifts on the toes, but do not bring the heels together, but spread them apart (pictured above).
"Soles-caterpillars". It is necessary to move forward without taking your feet off the floor - due to flexion / extension of the soles. First, bend your fingers “clinging” to the floor with them, the arch bends, the heels move forward. Then, standing on your heels, straighten the sole, spreading your fingers and moving them forward. Make movements until tired, rest and repeat again.
Alternating legs, quickly touch the heel of the buttocks. After 50 times (25+25) make a deep forward bend, the forearms of the hands are connected and brought to the top of the head, the palms grab the opposite elbows. Repeat cycle 2 times.

Main part of the lesson

Table 1 - Exercises in a standing position:

Image	Explanation
	We are in position 1 as long as possible - up to 2.5 minutes. Lift your heels as far off the floor as possible, but don't bend your knees more than 90 degrees. After a static hold that develops quad muscle strength, stand for 10-15 seconds in compensating pose 2. Dosage - 2-3 times.
	Put your feet as wide as possible, turn your toes outward, bend your knees, hold your hands as you like (fragment of photo 1). Get up on your toes and take 10 short steps (without dropping your heels to the floor) forward and 10 back. Straighten your legs, rest. Do 3 sets, then bend (fragment 2) and stand like this for 15 seconds.
	In position 1, do not bend your knees more than 90 degrees, do not tear your heels off the floor, leaning your back against the wall, holding a brick or book, you must stand for 90 seconds. Then we give the muscles a rest and “sit” for another 90 seconds. Then we lie down in position 2. You can move your legs, make vibration movements. It is necessary to lie down for 2-3 minutes.

Naturally, the indicated temporary dosage will not be affordable for everyone at once. Start exercising as soon as you can and gradually build it up by adding a few seconds every day.

Table 2 - Supports and asanas lying down:

Image	Explanations
	In this position, lift one leg low off the floor, and draw circles clockwise and counterclockwise with outstretched fingers. Do 10-14 circles in each direction. After resting for a couple of seconds, move the other leg.
	Place the rubber band behind the foot and pull the leg towards you (1). Then move your leg outward (2) and then inward (3). Try not to tear your shoulders and pelvis off the floor. Repeat the movement with the other leg. The number of cycle repetitions is 2-3 times.
	This asana in dynamics can be done only if the emphasis on the knees does not cause pain. During the movements, try to keep the heel as close to the buttock as possible. Do 10 backward leg movements and then freeze for 20 seconds in position 2. Repeat the same with the other leg.
	To begin, bring the fixation of the side bar to 90 seconds. Holding must be done in two directions. Then gradually increase the difficulty of the exercise. Raise your top leg a little and turn your shin, turn your heel up and your toes in. In this position, you need to stand for 15 seconds.
	In this asana, you need to lie down as much as you can. The recommended hold time is 30 seconds. Asana must be done in both directions.
	Plank - 60 seconds. The emphasis on the shins and forearms - 60 seconds. "Bicycle" - 30 seconds forward and the same amount back.

Movement with resistance to elastic band

Do the exercises in the following order:

Slowly bring your knee up to the level hip joint- 14 times.
We take the leg diagonally forward - 14 times.
We move the leg to the side - hold the position for 30 seconds.
We bend the knee, trying to touch the buttocks - 14 times.
We start the leg inward, as far as possible - 10 times.
We take the straight leg outward - 10 times.
Maintaining balance while standing on a sore leg (on a pillow) - 3 times for 15 seconds.
Traction of the knee in the position of the Dead Man, a large-sized roller lies under the knees - 3 minutes.

Hitch

Do asanas from 1 to 4 for 30 seconds, and in position No. 5 - straight legs are pressed against the wall, wake up for 3-5 minutes

And in conclusion, let us remind you once again. In case of injury or chronic disease of the knee joints, it is necessary to treat them with the help of movement. Only exercise therapy can protect against the formation of complications, disability and prosthetics.

The knee joint is one of the most complex and mobile in the human body. It bears a large load while walking, running, jumping, climbing stairs, static loads. As a result of injuries, inflammatory and degenerative-dystrophic diseases of the knee joints, blood supply and tissue nutrition deteriorate, the cartilaginous layer of the intraarticular surfaces of the bones becomes thinner, the menisci are destroyed, and the functioning of the musculoskeletal apparatus is disrupted.

Arthritis, osteoarthrosis, changes in the integrity of bones and ligaments lead to chronic progressive inflammation and impaired mobility of the knees. For the treatment of diseases, drug treatment, surgical methods of therapy, physiotherapy and exercises to strengthen the knee joints are used. Physiotherapy exercises (exercise therapy) are prescribed at different stages of the disease and significantly improve the function of the musculoskeletal system.

Tasks and rules for conducting training

Complex therapeutic gymnastics is prescribed by a doctor depending on the nature and severity of the pathological process, concomitant diseases, the age of the patient. Complete workouts begin during the period of remission of the acute phase of the disease - reducing pain, normalizing body temperature, reducing local inflammatory manifestations. The main task of gymnastics is:

increased elasticity of the ligamentous apparatus of the knee;
strengthening the muscle groups of the thigh and lower leg involved in the process motor activity knee joint;
normalization of blood circulation, as a result of which metabolism improves, synovial fluid synthesis is activated, cartilage tissue cells are restored;
improvement of general well-being and emotional background, which favorably affects recovery.

Exercise therapy can be done in groups under the supervision of a specialist

With the daily performance of a set of exercises, the function of the knee joints is restored completely or partially, depending on the degree of violations of the anatomical structures.

During exercise therapy, you should adhere to the following rules:

training should be regular, the course of treatment is from 14 to 30 days;
gymnastics must be done 2-3 times a day for 10-15 minutes, the total exercise time is 30-45 minutes;
the load on the joints of the knees should gradually increase, the frequency of repetitions of exercises starts from 3-4, bringing up to 10-15 in one approach;
amplitude at the beginning of the workout is low with an increase towards the end gymnastic complex;
each exercise is performed carefully, muscles and ligaments are well worked out;
after physical education, you should rest in a prone position on a hard surface with knees bent, which helps restore blood flow in the trained joints;
after a set of exercises, you can take a contrast shower, perform self-massage of the affected joint and surrounding soft tissues;
gymnastics should not bring discomfort and pain, if discomfort occurs, you should stop training;
pain syndrome during subsequent workouts requires a visit to a doctor.

Don't expect fast positive effect, exercise therapy improves the condition of the knees in arthrosis and arthritis as a result of long-term patient treatment, which does not exclude other types of therapy.

A set of exercises according to the Evdokimenko method

Effective complex Exercise therapy for the rehabilitation of inflammatory and degenerative diseases of the knee joints was created by the Russian academician, rheumatologist and psychologist Evdokimenko Pavel Valerievich. Based on his many years of experience, he developed exercises that positively affect the musculoskeletal system and improve the emotional mood to fight the disease.

Most often, dysfunction of the knees occurs in osteoarthritis, which is characterized by the destruction of cartilage and bone tissue, impaired synthesis of synovial fluid, and a decrease in the range of motion of the lower extremities. The disease develops after an injury, as a result of a metabolic pathology, an inflammatory process of the structures of the knee joint (arthritis, periarthritis, bursitis).

The complex structure of the knee joint and its mobility lead to the frequent development of pathology

Before you start physiotherapy exercises, you should familiarize yourself with the list of contraindications to classes:

arterial hypertension;
increased intracranial pressure;
abdominal hernia and inguinal hernia;
acute blood diseases;
severe chronic diseases of the heart and blood vessels;
acute inflammatory process internal organs;
increase in body temperature;
menstrual bleeding;
recovery postoperative period within a month.

The complex of physical education for arthrosis of the knee joint includes 9 exercises that must be performed in the proposed sequence.

Lying on the stomach, arms are located along the body. Alternately raise the straightened leg up to a distance of about 15 cm from the floor and hold it on weight for 40 seconds. In this case, the pelvis is tightly fixed, and the movements are carried out due to the muscles of the thighs and abdomen.
Initial position Same. Left leg bend at the knee joint at an angle of 90 degrees and slowly raise to a height of up to 10 cm from the floor, holding on weight for at least 10 seconds. Then do the exercise with your right foot.
The starting position is the same. Slowly raise both legs to the highest possible height, then smoothly, without jerking, spread your legs apart and bring them together. Exercise can improve blood pressure therefore should be performed with caution in patients suffering from ischemic heart disease and hypertension.
In the position lying on the right side, bend the leg of the same name, and the left lower limb straighten and lift as high as possible, hold for 20-30 seconds. Then repeat the exercise on the left side.
Sitting on a chair, alternately straighten and lift your leg, holding it in weight for up to a minute. If your knees hurt a lot when doing gymnastics, reduce the range of motion until the feeling of discomfort stops.
Turn to the back of the chair with your face in a standing position and, holding on to it with your hands, gently rise on your toes, linger in this position for 3 seconds and lower your feet to the floor.
The starting position is the same. Now you need to stand on your heels, lifting your feet as high as possible.
The starting position is the same. Raise the left leg to the toe with the right leg stationary, then do this exercise with the other leg. It turns out a roll from one foot to another. Feel the rush of blood to your knees.
At the end of the gymnastics complex, self-massage the anterior-lateral surface of the thigh from the knee joint to the groin for 5 minutes. First, rub the skin, then knead the muscles, at the end of the procedure, stroke. After the massage, pleasant warmth should be felt.

Joint gymnastics according to the method of Evdokimenko is available for patients of all age categories

Exercises for knee arthrosis improve its motor function and relieve pain from the first days of training, however, to consolidate the positive effect, it is important to complete a full course of physiotherapy exercises. For correct execution gymnastics should consult a doctor who will help put the training technique. In addition, numerous visual videos are posted on the Internet that explain in detail the features of exercises for diseases of the knee joint.

Exercise therapy for the knees effectively restores their functional activity and is an important part of the complex treatment of diseases of the musculoskeletal system. The right approach and following the recommendations of a specialist when doing gymnastics will help maintain the health of the knee joints and prevent the progression of the pathological process.