We just got this question emailed to us from a student:
This is Christi Tuck from Colorado Springs YMCA. I am a certified STOTT PILATES instructor and I have a question.
I have an inquiry from a possible student regarding some knee issues and if the reformer would be beneficial and are their any concerns. Basically they had surgery recently and the doctor informed them they have no cartilage around the knee. I believe they had the meniscus repaired.
My guess is the reformer would be helpful to strengthen the surrounding muscles and that starting at light resistance would be best. I welcome any comments or suggestions.
Hi Christi-
Thanks so much for your question. As far as your client’s issues are concerned; yes, the reformer would be very beneficial to her recovery. Doing footwork starting with lighter resistance is a great start. I would also do single leg pulses in a variety of positions–laterally rotated, parallel and medially rotated. Make sure when she is doing footwork or single leg that she is really using her quads to draw the kneecap up as she straightens the leg. VMO (vastus medialis oblique) is especially important for knee stabilization and it tends to be weak for many women. I find I really feel the VMO muscle more when doing lateral knee pulses, but that may vary from person to person, so check in with her to see if she is feeling that muscle. Strengthening the posterior leg muscles will also help to stabilize the knees, so make sure you are doing some glute and hamstring work as well.
Melanie Byford-Young has a great workshop on Knee Stabilization if you ever get a chance to take it! She created an exercise where you are sitting on the reformer carriage with no springs attached. One foot is on the floor between the rails and the other leg is lifted up supported by the hands or with a flexband around the thigh. If you have a rotational disc, place the foot on top of the disc and keep the ankle, knee and hip tracking as they slowly move the carriage out and in. This helps to stimulate and strengthen the popliteus muscle which is another deep knee stabilizer.
The more those stabilizing muscles are activated and strengthened, the less wear and tear will occur to the knee and the remaining cartilage. Eventually, you can increase the resistance as those muscles get stronger, but at the beginning we don’t want to overload those stabilizing muscles.
Let me know how things go or if you have any other questions.
{ 3 comments… read them below or add one }
Hi Jean,
I love that idea about footwork pulses with ball between knees for stabilization & activate VMO. Melanie’s workshop on Knee stabilization is awesome. I have a question here, which range of motion is a better choice for activation of VMO (small or end range)? I remember Melanie mentioned about VMO is an anticipatory muscle for extending knee joints.
thank you
Hi Jeff!
I find I have more success getting people to fire and maintain VMO activation when working in the mid-range of knee extension and in the lateral rotation. You may need to experiment with yourself and with clients as to where the “sweet spot” is for them to feel that muscle. You can palpate the VMO while they are doing the pulse to make sure you feel it engage and hopefully remain engaged while they pulse. I then try to get them to maintain that muscle engagement as they press all the way out to extend the knee. VMO should be firing at the end range, but to build strength in the muscle I find it works best in the mid-range. Hope that helps! When do we get to see you again?
Hi Jean,
I had a similar thing happen to myself after a skiing accident. I tore my right knee’s ACL and had the worst rehabilitation post surgery. One thing that really helped though was my reformer pilates. My instructor was amazing and I feel that I got more accomplished with her than my PT.
Thanks for this information above, I’m still in the process of recovering and will mention these methods to my instructor, won’t hurt to try right.