Session 1: Front of the Knee — Foundations

# Session 1: Front of the Knee — Foundations

Welcome to the practical block. Here we'll talk about exercises for pain in different areas of the knee joint. We'll start with the front of the knee joint. If you have discomfort here, these two lessons are for you. We'll start with an easier lesson, doing it on, say, Monday or Tuesday. You can supplement this lesson on Thursday or Friday with a more challenging workout to increase the strength and endurance of key muscles. To do the exercise, you'll need a mat, a chair, two yoga blocks, and a yoga strap. If you have good muscle strength and endurance, grab one, or better, two weights of half a kilo to a kilo. We'll start with stretches. Let's agree, we stretch dynamically or statically. We'll do one set with you, but you can increase the number to two or even three sets. If you're doing the dynamic stretch, you should reach a discomfort level of 2-3 on a 10-point scale. 10 is the maximum pain you've ever experienced. We're aiming for 2-3 points. And no less than 20 repetitions. Let's start with a thigh front stretch. Stand with your back to a chair, place your leg on the chair back. If your balance isn't great, place a second chair in front of you to steady yourself with your hand. Once you feel a moderate stretch along the front of your thigh, slightly tilt your pelvis backward, From this position, use your glutes to shift your pelvis. Your goal is to feel discomfort no more than 3 points. As the discomfort lessens, you can increase the chair back height by placing a blanket there. Or you can increase the forward pelvic shift or the backward pelvic tilt. This will intensify the stretch on the front of the thigh. Perform 20 repetitions. With each repetition, maintain discomfort at 2-3 points at the peak of glute contraction. You can also hold the pause at the peak for 2-3 seconds. After you've stretched one knee, stretch the other one too. Monitor your pelvic control; it should remain tilted back. If needed, place a blanket on the chair back if flexible. If you lack flexibility and feel pronounced discomfort along your thigh front, reduce the height. You can place your leg on the armrest of a sofa or a lower chair. Excellent.

We've stretched the right and left thigh fronts. Now, let's stretch the back of the thigh. For this, you'll need a yoga strap. And we lie on our back. Place the yoga strap... like half of a figure eight, take the strap in your hands, bend your hip, bend your knee, and feel a light stretch along your thigh back. keeping the strap still, push your heel towards the ceiling and return it. Here, our task is also to feel a fairly strong stretch, either in the popliteal fossa or along the entire thigh back. But don't forget, you shouldn't feel severe pain. 2, maximum 3 points out of 10. Here, you can also hold the stretch for 2-3 seconds, if it doesn't increase pain. Or move dynamically, but then, please, do at least 20 repetitions. If, during repetitions, you progressively feel a decrease in tension, then take a short break, shift your foot a little higher, and in the new range, extend your leg fully at the knee. Of course, you can start from a smaller angle and work here first, but that's if your flexibility is poor. The goal is to reach about 90 degrees with a straight knee, 90 degrees at the hip joint. If you can immediately achieve 100-110 degrees, then stretching is not required for you, and you can skip this exercise. And you can skip this exercise, or just do it as a light drainage. 120, right? Switch legs. Reach a very light tension and push your heel towards the ceiling. Ensure your pelvis doesn't tuck back or twist during push-off. of your foot towards the ceiling. It's vital that the pelvis, as a foundation, is stable. Maintain discomfort at 2-3 points. If it decreases, raise your thigh higher. Maintain pelvic stability and breathe freely. Excellent! The next exercise is very important for coordinating the work of the back and front of the thigh. With knee problems, the quadriceps often starts to slow down and engage a little later than it should. This exercise retrains quadriceps engagement, despite thigh back activity. Let's call it "Quadriceps Leading Activity." We'll do 15 repetitions. In your workout, you can perform 1 to 3 sets.

And to perform this exercise correctly, you need to take two yoga blocks place one block in the popliteal area, the second under the heel. Your task is to create pressure with two points on the blocks. Without losing top pressure, hyperextend the knee, lift the heel. Hold tension for 2-3 seconds, lower, maintaining pressure. Thus, the pressure in the popliteal fossa is stable and constant, and pressure on the heel for 2 seconds, then the heel lifts. Your task is to perform 15 repetitions of this exercise. Don't lose pressure at the top. Make sure the sensation of pressure on the block is stable. Switch legs. At first, if you feel you're not doing very well, ask someone at home to place two fists in the popliteal fossa and under your heel. And have them give you feedback, whether you're losing pressure at the top when you lift the bottom point. If pressure leaves both fists simultaneously, you're doing it wrong. Pressure on the upper fist should always be stable. Once you learn to do this with help, you can move on to the blocks. To perform the next exercise, you need to lie on your side. Ideally, lie against a wall. If you control your pelvis, stay on the mat. Let's lie down so your arm is under your head. The bottom leg remains bent, and the top leg extends, and you can place it on a yoga block. Keep your pelvis stable; it shouldn't twist or rotate. The pelvis is our foundation; it must stay still. If you want more stability, take and place your first interdigital space on the iliac crest. No movement should occur here. From this position, abduct your straight leg, keeping your foot parallel to the floor, up to 40-45 degrees, no pelvis movement. And then slowly return your leg back. If this task turns out to be too easy for you, a half-kilo or kilo weight will help. The goal is to do 8 to 12 repetitions. By the 8th-9th rep, you should feel a burn in the gluteus medius/minimus. This is the side of the pelvis. Why a wall? Because as this muscle fatigues, the load will shift forward, and the foot will move forward. If you notice this, return your leg slightly to start, so your foot, knee, pelvis, and shoulder girdle are in one line.

Turn to the other side and repeat the exercise. Slightly back with your pelvis. Just a bit. Your knee is straight. Foot parallel to floor. Ascent and descent time is about 2-3 seconds each. Don't cheat or swing your leg. This is a smooth, controlled lift and lowering. Control not only the extended knee and perpendicular foot, and the foot parallel to the floor, but also your pelvis. Thus, you will not only train the target muscle but also develop control of the lumbopelvic region. Excellent. The final exercise of the first workout is the glute bridge. The glute bridge has different variations. You can do it on two legs, or on one leg. How you do the glute bridge depends on your fitness level. I'll give you the simplest way to do this exercise. To perform it correctly, place your feet opposite your knee joints. Maintain slight pressure with palms on the floor, then exhale— a deep breath, and on the exhale, you gently tuck your pelvis and lift it as high as possible for a straight line between your knee and pelvis. Goal: your lower ribs don't pop out too much. This shouldn't happen. An important nuance. In this exercise, we do a large number of repetitions. From 20 to 25 times in one set. I'll ask you to do one set with us now. But you can increase the number of sets in the following weeks to three. Also, ensure that at the top, both halves of your pelvis are parallel to the floor. If one half of your pelvis leads, correct it. I tell patients the pelvis moves like an elevator, up and down. Tilts should not occur, neither in the horizontal plane nor in other planes. So, we've completed a short first workout. Dmitry Gorkovsky was with you. See you in the next class.