PT on the Net Research

Leg Surgery: Low Impact Exercises


Question

I have a client who was in an auto accident and she now has a steel rod in her leg. What low impact exercise would you recommend?

Answer:

This is just not a lot of information to go on. First you should seek the advice of your medical professional before you start any exercise program. With that said, one of my favorite rehabilitative exercises for the lower - body is the multi planar step and hold. The intensity of this exercise can be manipulated for anyone. The step and hold is started with very low intensity. The idea is to have your client step in each plane: sagittal, frontal and transverse, and try to control each step without letting the ankle wobble when you transfer the load from one leg to the other. Once again, it does not sound all that challenging, but it is! I will then use that exercise with added speed and a flight phase. In other words, it turns into a multi planar hop and hold. The exercise can then turn into a multi directional foot drill by having the client go from front to back, side to side and turn and turn back, to develop great agility and coordination. Another exercise I will do with my clients is the standing terminal knee extension. Have your client face you. Take a resistance band and wrap it around the back of the client’s leg just above the knee. Have the client bend one knee with the resistance and then contract the quadriceps to extend the knee against the resistance of the taught band. Remember to have the client’s foot on the floor at all times. This exercise will really get the quad to work. The force profile does not line up exactly with that of walking, but it is a much better alternative than an open chained seated knee extension. I would also want to put some focus on the anterior tibialis. A great little trick I saw the other day has really worked out well for me. Have your clients try to walk normally except their toes or front part of their feet don’t touch the ground. Remember to step slowly so you don’t put too much stress on the rest of the body. By stepping in essence on your heels, you will be placing load onto the anterior tibialis in an eccentric and isometric manner. Functional anatomy will tell us that the primary roll of the anterior tib is to decelerate plantar flexion of the ankle. By not letting the toes come down, you are overloading the anterior tib and at the same time keeping fairly consistent with the force profile in walking. Without more info, I think these three exercises are a good place to start.