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Quadriceps/ Reading, links and downloads
The quadriceps (quads) are the four muscles that make up the bulk of flesh on the front of the thigh. Their contraction causes the knee to straighten, and controls the movement of the kneecap. They are especially active in cycling, running, climbing, jumping and kicking.
Almost any acute knee injury is associated with some degree of quads wasting. This occurs remarkably quickly and may be evident as early as four days after injury. The weakness that is associated with quads wasting may result in pain under the kneecap, a knee that tires easily, or even a tendency for the knee to give way. Only an obsessive daily commitment to a quadriceps strengthening exercise program can restore bulk and strength to this muscle: even then, the wasting which occurs in one week may take months to build up again.
Exercises which straighten the bent knee against resistance exercise the quads, but put a lot of pressure across the kneecap, and may make symptoms of knee pain worse. For this reason cycling, squats, jumping, climbing and kicking are not recommended exercises to build up wasted quads. The best exercise program is one of graduated static resisted exercises, performed with the knee very slightly bent. They are graduated because they are increased on a daily basis; static, because there is only very limited movement in the knee in performing the exercises; resisted, because they are performed with weights against gravity. These exercises can be performed without the need for special equipment, time off work, supervision, instruction or expense.
They are done in the following way:-
Take a 2 litre plastic milk container, and fill it with 2 litres (2kg) of water. Thread a belt through the handle of the bottle, and close the belt to make a loop. Lie flat on a bed or bench with your ankles hanging over the bottom end, place a rolled towel under your knee and thread your foot through the loop so that the bottle of water hands freely from your ankle. Lie back with your head on a pillow and your hands folded under your head, and with the foot twisted outwards and away from the other foot. Now straighten the knee by contracting the quads, without lifting the knee from the rolled towel. This should cause the ankle to rise slightly from the end of the bed, together with the belt and bottle of water. Count off 10 seconds slowly, then lower the ankle to the bed and rest for 5 seconds before repeating the exercise. Start by doing 20 such exercises in the morning, and a further 20 in the evening. This should take no longer than 5 minutes per session.
Graduate the daily level of exercise by gradually adding more weight with a second bottle of water, to which a small amount of water (say 300mls or 300 grams) is added each day until you can no longer comfortably lift the weight. Then, instead, increase the number of exercises performed at each session, or lengthen the amount of time for each successive lift.
Finally, calculate and record the amount of work you have done each day by the formula:
Work = sessions x weight x exercises x seconds
For example, a 10 second lift performed 20 times lifting 2kg for 2 sessions every day represents 10 x 20 x 2 x 2 = 800. The result may be charted to demonstrate that you are working harder each day, and the chart compared with your clinical improvement.
Finally, remember: no amount of surgery or medicine can build up muscle. It is your responsibility alone. Furthermore, what takes only a week to waste away, may take months of hard work to build up again. DON’T DELAY.