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Writer's pictureSharon Duffey

Overcome the Limits of Knee Arthritis One Step at a Time (Part 2)

Strengthen Your Leg Muscles – Part 2 by Sharon Duffey, PT, FCP


JACK’S STORY - SUMMARY

Part 1 recap: A star football player in his youth, 64-year old Jack is less active than he wants due to knee pain. His doctor says it’s only a matter of time until both knees need replacement. Jack did the Sit-to-Stand Functional Test to get a baseline of his leg strength and began his plan to regain better muscle control by consistent practice of a simple but HIGH VALUE EXERCISE.


To read more on Jack and his start to overcome Arthritis a more practical way, click here.



GET LEG STRENGTH QUICKLY & SAFELY

The average person gets up and down from sitting 45 times every day. If the way you do it is less than ideal, the cumulative impact is negative on your back and knee joints.


Fine-tuning this daily habit is a great way to reverse joint wear and tear, and get both your muscles to work better and your body to move better.


Just as a tennis player improving his backhand doesn’t happen overnight, your body moving better requires a similar type of focus and attention. Initially, some frequent practice is needed to gain both the skills of muscle strength without joint stress and to make subtle changes to an everyday movement habit. A little patience and discipline go a long way to give your body a chance to learn to do things differently. It is worth it.


Let’s work on how you rise to standing from a seated position and how you sit down.


PRACTICE GETTING UP/DOWN, AS A SKILL

Sit to Stand to Sit – To get stronger legs!

  • Begin by using a seat that is about 18-20 inches above the floor.

  • Be sure your hips are higher than your knees.

  1. Position yourself toward the edge of a chair. Sit tall, chest upright but relaxed, eyes focused straight ahead.

  2. Position your feet apart and back as far as possible so your heels are still flat on the floor. Your knees should be wider than your feet; if not easy to do then point your feet slightly outward. If your knees tend to bow, place feet even a little wider.

  3. Place your hands on the chair seat or armrests. If you discover you can do this exercise without any push-off with your hands, that’s even better.

  4. Bend forward from your hips, leading from the chest [IMPORTANT]. You will want to exaggerate the feeling of your body moving forward, with your hands pushing you forward, not upward. This is often overlooked yet is important to protect your hip/knee joints and gain leg strength. Continue forward until you feel your pelvis start to come off then, begin to straighten to standing. Do this in a 2-second count slowly and smoothly coming to standing.

  5. Sit down, reversing the motion. It will look like a ‘squat’. Your hips and knees will bend, with your bottom moving backward, allowing you to balance your body weight so you don’t fall back in the chair. Continue to bend your hips and knees, allowing your knees to relax apart as you lower your body weight gently to the chair. Your leg muscles are working hard! Do this in a 2-second count slowly and smoothly to your start sitting position.

Start with 3-5 reps, 3 to 5 times/day for one week.

Increase by one rep each day until you reach a goal of 10 reps 3 times/day.

 

TIPS – Important for Sit to Stand to Sit Mechanics



If you feel any knee strain, try subtle changes in the positioning of your feet. If you’ve had prior sciatica or knee problems, double check your feet position.


Often with the problematic side, the foot automatically is positioned too far inside or outside in comparison to the knee.

[Check, by leaning forward and look down directly on top of the knee; the foot should be further back but in line with the knee]



If you continue to feel any joint strain or discomfort, STOP.


Remember, our muscles need to protect the joints that support our body weight. You may need to go back to Part I exercise and practice, doing without having knee strain. Also try raising the height of the chair 1 or 2 more inches, then practice the Sit to Stand to Sit mechanics.


In some cases, you might need a coach to help you overcome any blind spots as your body learns this new habit. Be patient with your learning; it takes practice, focus, and time to move differently.


 

JACK'S PRACTICE & RESULTS

Jack did a great job learning this skill; he felt his thigh muscles work hard, without any knee strain. From a seat—20 inches above the floor—he increased the number of daily reps until he could do three sets of 10, twice a day. When he got to this level, he was able to start to wean his hand use. Over the following week, he progressed to 30 reps without using his hands.


Then, Jack lowered his chair height an inch or two; which made his legs work harder. With this increase challenge, he followed the early principles of practicing a lower number of reps but repeated them more often each day. This safety guideline gave his muscles time to get stronger with no knee joint stress or discomfort. His short-term goal was to be able to stand up from his couch without his hands.


When we retested Jack’s leg strength in just two weeks following his first Sit-to-Stand Functional Test, he was amazed he had already improved his test score by more than 50 percent. Stay with it; improvement takes attention and a little time. Give yourself at least two to three weeks of regular practice, progressing your repetitions, then do a re-check.

Jack was pleased with his progress but his ultimate goal was to walk the nine-hole golf course and not use a golf court.


If you’re like Jack and have some arthritis that limits your walking, read Overcome Arthritis Limits: one step at a time – Part 3.



 


Sharon Duffey PT, FCP, is a Physical Improvement & Pain Relief Expert, founder of SmartBody. [www.smartbody50.com]




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