In the past, Bill and bryanc have recommended the following program for improving knee-cap tracking, as well as patello-femoral pain (I think):
The drop squat program:
1) Position/Body Alignment
-feet shoulder width apart
-knees pointing straight ahead
-knee caps aligned to drop over your second toe
-squat or lunge to a dept of no more than 45 degrees (1/4) depth at the knee
-bend at the knees and hips, but do not lean forward
2) Speed
SLOW- for the first week to allow you to become comfortable with the action and alignment
FAST- allow your knees to 'collapse' momentarily, then rapidly contract the quadriceps to stop further collapse, then stand slowly
3) Progression
Build-up phase: gradual increase in knee function and decrease in pain
Maintenance phase: to prevent recurrence of injury
The Build-Up Phase
You will perform one exercise session for 5 days out of the week. You can pick your 'rest' days. You can incorporate the exercise and stretches into your regular workout or do them separately. Each week you will have one exercise. You should perform 3 sets of 20 repetitions of that exercise.Stretching should be done before and after these 3 sets of 20 reps.
Week 1: Drop squat (SLOW no weight) (see above for description of SLOW and FAST).
Week 2: Drop squat (FAST no weight)
Week 3: Drop squat (FAST w/5lbs in each hand)
Week 4: Drop squat (FAST w/10lbs in each hand)
Week 5: Drop squat (FAST w/15lbs in each hand)
Week 6: Lunges (moderate speed, no weight, not walking lunges)
Week 7: Single leg drop squat (FAST, no weight)
Week 8: Single leg drop squat (FAST w/ 5lbs in each hand)
Single leg squats and lunges are 20 reps PER LEG.
After reaching the last stage of the Build-Up Phase, Maintenance Phase is just Week 8 (Single leg drop squats w/5lbs) performed 2-3 times a week instead of 5.
You are encouraged to continue your usual sporting activities _WITHIN YOUR PAIN TOLERANCE_. However, modification of the time and intensity of the activity may be required if it causes knee pain.
Stretches
There are three stretches in this program. Strech the hip and quadriceps muscles to the point that it is slightly uncomfortable. Do not bounce. Hold the strech for 20 seconds. Repeat each stretch 5 times on each leg.
Seated Spinal Rotation: Sit with both legs straight out in front of you. Curl one knee up and cross the foot over the straight leg. Turn your torso so that the tricep/elbow of the opposite arm to the flexed leg is resting against the flexed knee. Push against the flexed knee.
Lying spinal rotation: Lie down with your arms out to the side. Bend one knee and then rotate your hips into that knee (i.e. to the opposite side of that leg. If you bent your right knee, rotate to the left). Keep your shoulder blades on the floor.
Lying quadriceps stretch: Lie on your front. Grab the ankle of one leg and stretch your quadriceps. It's like the standing quad stretch. Only you're lying down.
There you have it. Some tips:
1) Your routine should look like this:
Stretch->drop squats->stretch
2) It is quite common to experience some pain in your knees during the Build-up phase. You can continue if the pain is mild, if the pain is severe, go back a stage (i.e. the previous week) for the remainder of the week before trying that stage again the following week.
3) You can do other strengthening exercises (leg press, leg curls) but leg extensions should be avoided.
4) Cycling is a good supporting exercise.
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....bastard
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