Hesperian Health Guides

Progression of Exercises for the Child with an Arthritic Knee

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HealthWiki > Disabled Village Children > Chapter 16: Juvenile Arthritis: Chronic Arthritis in Children > Progression of Exercises for the Child with an Arthritic Knee


(Arthritis often starts in the knee and later affects other joints.)

CONCEPTS:

  1. Strengthen the muscles that straighten the knee (without strengthening those that bend it).
  2. Do not move the knee when doing exercises.
  3. Keep changing the position in which you do the exercise, and add weights to make the exercises harder as the child’s strength increases.


First exercise: leg on ground

First do the exercise without motion lying down.
child tightens the muscle on top of the thigh
Tighten here without moving and count to 25. Relax and repeat 10 times. Do it 3 or 4 times a day.
After a few days, do it sitting up.
child tightens the muscle on top of the thigh
Tighten here without moving.

Second exercise: straight leg raise

1. With the leg straight, tighten the muscles on top of the thigh (as in the first exercise).
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2. Then lift the leg without bending the knee, and slowly count to 5 or 10.
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3. Lower the leg slowly.
4. Rest.



When you lift the leg, be sure that the knee points up or slightly out to the side. DVC Ch16 Page 141-5.png Do not let knee bend at all. (If the knee bends even a little when you lift the leg, it means that the muscles here are still too weak. Go back to first exercise.)
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NO


When the child can do this exercise lying down without bending his knee, begin putting weights on his leg:

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First ½ kilo,
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gradually increase the weight to
1 kilo,
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and 1½ kilos.
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For the weight, you can use a small bag full of sand.


After a few days, have him do the same exercise sitting up:

CAUTION! Do not do this sitting exercise if the child has arthritis in the hip, or hip contractures. It uses the hip-bending muscles that will make the contractures worse.



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First without a weight.
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Later, with a weight.
Again, gradually increase the weight. Begin with half a kilo, and build up to 5 kilos. But do not increase the weight until the child can do the exercise at the first weight without bending his knee.

When the child can do the exercise at 2 kilos without bending her knee, she can begin doing the following variation. Keep the leg raised the whole time.

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1. Tighten the muscle on top of the thigh. 2. Lift the leg, keeping it straight. 3. Move the leg to the side and turn it outward. 4. Move the leg back in and turn it inward. 5. Lower the leg and relax.


IMPORTANT! If there is also arthritis in the hip, or hip contractures, do these exercises lying down, not sitting up.


Third exercise: knee slightly bent

1. Lie down with a rolled towel or blanket under the knee. 2. Turn the leg out to the side. 3. Lift the foot and slowly count to 5 or 10. 4. Lower it slowly.
5. Rest.
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6. Repeat the exercise 10 to 30 times.
Make sure that only the foot is raised, not the thigh, and that the knee is lifted as straight as possible.

As the child gains strength, continue with the same series of steps as for the second exercise.

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1. Lying down, lift the foot with a weight on it. Build weight up slowly to 5 kilos. 2. Sitting up, lift the foot without a weight. 3. Sitting up, lift the foot with a weight. (Build up to 5 kilos.)
child lifts leg with inner tube
strips or inner tube (or use sandbag)
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Do these 2 exercises only if there is no danger of hip contractures.
If arthritis or contractures have begun in her hip, it is best to do the exercise lying down with the hip as straight as possible (nothing under the knee).

To strengthen the muscles, continue the exercise until the child can no longer hold the leg straight or it begins to shake slightly. The more often the child does these exercises the faster the muscles will get stronger. These exercises can be done even when the joint is swollen and painful. However, if the joint hurts more during or after the exercise, use less weight and repeat fewer times.


This page was updated:21 Nov 2019