How to perform Quad Sets: An Important Exercise in knee Rehabilitation.

I discuss quad sets in many of my previous articles. Quad sets are one of the most important exercises in knee rehabilitation. It can be done preoperatively or postoperatively, with or without pain. It not only helps to increase muscle strength but also reduces a little amount of pain. This is the first exercise that you will do in rehabilitation after knee replacement or with degenerative arthritis pain. This exercise surely prepares your muscles to perform other exercises. And thereby it gets your body ready to be able to participate in functional activities.

When to Perform Quad Sets:

• Knee rehabilitation: s/p total knee or arthroscopy
• Hip rehabilitation: like total or partial hip replacement
• Arthritis: OA or RA
• Knee ligament injuries
• S/p Knee ligaments repairs
• Knee meniscus repair
• Reduces knee pain, mainly chronic pain
• Can be used as a part of relaxation techniques: contract-relax method during a spasm.

So How to Perform Quad Sets:

Technically you can perform quad sets in any position, including standing. If you are doing this exercise for the first time, you may want to start in a long sitting or supine position. Personally, I like the long sitting position better, as a person performing the exercise can see it. Visualizing the movement, and feeling it at the same, makes it easier to grasp it.

Position:

Lay on your back or in a long sitting position as shown in the picture. You can do it while standing once you know how to do this exercise and feel comfortable with it.

Place a rolled towel behind the knee. Try to push down the towel with your kneecap while contracting/tightening quadriceps muscles. Hold it for 3 to 5 seconds in a pain-free range. Increase the hold to 10 to 15 seconds.

Frequency:

Repeat it for 10 to 15 times for 3 to 5 times a day. In reality, you can not overdo this exercise. I tell my replacement patients, to perform these exercises 15 to 20 times every hour in their first four to five postoperative days. More you do this, faster you get your strength back and be able to perform your other functional movements like standing, walking, steps climbing, etc.

Few Important Points to Note: 

The key point here is not to have pain while performing the exercise. This depends on how much you contract the muscles. So when you are tightening the kneecap, hold the contraction/ tighten the muscle just prior to hitting the pain point. You may have to perform this exercise a few times to figure out when to stop the contraction. You need to hold this contraction for a few seconds. Start with a hold of 3 seconds and work your way up to 10 seconds if you can.

Once you are comfortable with the exercise and the feeling of it, try to perform this in a different position. You can perform this in sitting (you will have to kick the leg on which you are performing the exercises out) or in standing. Make sure you are not holding your breath while performing the exercises.

Don’ts While Performing Quad Sets:

1. Don’t hold your breath.
2. No pain while performing the exercise
3. No visible knee movement while performing quad sets.
4. Make sure you are not pushing down or using heels or back during this exercise
5. Sit or stand straight. No leaning backward or forwards during quad sets.

And as usual, below is the link to download the PDF version of this exercise.