People  have an injury, it stops hurting and then they return to their normal activities. Ideally it would be this simple but often you are left with tightness/discomfort.  This happens partly due to the fact that tissues tighten and shorten as they heal.  There may also be sensitivity issues which affect how tight things feel when trying to get back to your ‘normal’ activity.  In the following section I am going to look at a basic simple progression on how to get back your knee flexion mobility following a resolved injury.

To start with the simplest thing to do is just repeat the movement that is tight. For example one could just repeat the tight movement and the anterior thigh muscles should loosen to a degree just from doing that same movement.  This is a basic stretch that you can see footballers doing on the side of the pitch before and after a soccer match-

If this basic stretch isn’t enough then you can progress the stretch as tolerated depending on how sensitive the knee is.  If the restriction appears to just be soft tissue tightness and not a problem within the joint, then this second stretch might allow you to progress to a pain free state.  To do this stretch you use a pillow to gap the knee joint so avoid joint compression while stretching the thigh muscles.  The joint might be painful simply because the soft tissues crossing the joint are tight. By using the pillow ,and external support, you may avoid joint pain and see whether the knee/thigh can be more comfortable once the soft tissue tightness is relieved-

Whatever you are stretching, you need to consider what factors might be in play that could be producing discomfort or restrictions.  I mentioned that sometimes as area can be tight because of external factors making the area sensitive.  Another factor that can affect tightness is whether there are any muscles involved that cross more than one joint. When a muscle crosses more than one joint then you need to adjust your stretches to make sure that both ends of the muscle are being stretched to get the soft tissues to fully relax and allow good extensibility.

In this last stretch there is an emphasis to get the rectus femoris muscle stretched. It is important to tighten the abdominal muscles to make sure the stretch isn’t being overly focused in the lumbar spine.  Be careful when doing this stretch that you don’t fall over.  You may need to do the stretch near a wall. You might also find that you can’t reach back fully so a towel or belt might be needed to allow you go get to the stretch you are capable of even if your arms won’t reach.

So a recap.  In this instance I have gone from an easy stretch, to a more difficult stretch to finally a specialised stretch to get full comfortable flexion of my thigh muscles.  As mentioned other procedures might be needed if the knee joint is affected. Sometimes you might need to use a foam roller or cross tissue massage to loosen any tightness that is in a direction unusual for the muscle being stretched.  If the joint is affected then you may need to apply pressures across the joint to allow better mobility.  Joint work is something you need to discuss with a professional before trying on your own.  Finally remember that once you regain your mobility you should be performing strength and co-ordination training to enable the limb to work normally. You might find that these last two procedures can be added into the mix earlier as tolerated and in fact may be necessary in order to regain full flexibility.

Lots to consider. I hope that this information at least gets you started in your quest to regain your function.  It is a bit artificial to separate things out but by doing so it might help to localise and identify where problems are occurring.  Please let me know if you have any suggestions or comments that might be useful in these endeavours.  Regards.

Ross