Strengthening for CMP

The Aim of Strengthening Exericses

Which muscles need strengthening?

• It is usually the Vastus medialis obliques (VMO - on the inside of the thigh near the knee) and the gluteus medius muscle on the outside of the hip that require strengthening.
• The aim of strengthening should be to encourage the patella to track in the proper position and to spread the forces throughout the joint.

When can strengthening begin?

• As soon as the exercises can be performed without pain. It may be necessary to tape the patella to relieve the athlete of pain.

Quad contraction

• This is a good early stage exercise to use whilst standing exercises are painful.
• A foam roller or rolled up towel is placed under the knee so that it is slightly bent.
• The vastus medialis muscle is palpated (just above and to the inside of the knee cap) to feel it contracting.
• It is essential that the athlete learns to isolate this muscle and feel it being used during strengthening exercises. A muscle stimulator or tens machine can help in the early stages.
• Contract the muscle, hold for 3 to 5 seconds, relax and repeat 10 times.
• The foot should lift up off the floor as the knee is pushed down into the towel.
• This exercises should be performed 3 to 5 times a day if pain allows.

Clam

• The athlete is in a side-lying position with the knees bent to and feet in line with the spine.
• The top knee is lifted away from the bottom knee.
• Make sure the lower back and pelvis are kept still and don't rock backwards.
• The Gluteus Medius muscle at the back, top of the hip should be felt to be working.
• Start with 2 sets of 10 repetitions and gradually increase to 3 sets of 15-20.

Lunge

• This exercise can be started as soon as pain will allow. Tape the knee to avoid pain if necessary.
• With one foot in front of the other and the injured knee in front the front knee is bent enough to feel the vastus medialis working. Aim to keep the knee pointing forwards - don't let it fall inwards.
• Return to starting position and repeat. Aim for 3 sets of 10 repetitions.

Step down

• This is a more advanced exercise than the lunge.
• Again it should be emphesised that it is the vastus medialis on the inside of the knee that is working.
• The athlete bends the standing knee to lower the other heel towards the floor as far as is comfortable (this does not always need to be all the way down) and returns to the starting position.
• Repeat 10 times and aim to perform a number of sets throughout the day.