Quad Sets - Strong Leg Foundation

love em or leave em.

Best Leg Exercises Quad Sets

Quad sets. Love em or leave em. Unfortunately, most leave them for several reasons...

  • They are too painful (especially in the early stages of a total knee replacement

  • They seem trivial

  • They can seem impossible if you don't have the strength or range of motion

So, let's figure out what we need to do with this simple, yet essential exercise.

The quad set is designed is designed to help you learn how to contract or flex your quad muscle. This are actually 4 muscles that work as a team to extend and lock your knee so you can take a safe step! No quad, no walking. It is an essential exercise especially after knee or hip surgery, when the quad muscle tends to "check out for lunch."

Quad Sets - Key Points to Remember:

  • Ask your doctor if you should be doing this exercise.

  • These should be done gently at first - get a feel for what the exercise feels like.

  • Hold your muscle contraction (isometric) for 8-10 seconds.

  • Use a small folded washcloth or dish towel under the knee for some support.

  • Tapping on your quad muscle can help to "wake it up."

  • Focus on QUALITY vs. QUANTITY when doing any exercise.

  • Remember slow and controlled vs. fast and jerky.

  • Follow any precautions your doctor may have given you.

  • Be sure your weight bearing status matches what your doctor ordered.

  • Sometimes you need to stretch more to enhance your quad set contraction.

  • Pain can inhibit progress, a tennis ball can give you great relief!

How To Do A Basic Quad Set

The best way to do a quad set is to lie or sit with your leg as straight as possible. Gently push your knee into the floor or surface you are lying on by tightening your thigh muscle. You can do this sitting or lying down. Begin with a slow, gentle contraction that is controlled. Once you have a good, solid contraction, hold it there for 8-10 seconds. No skipping the hold. Holding this isometric contraction actually builds strength.

Step One
Do-It-Yourself knee strengthening exercises - step one for quad sets
Step Two
Do-It-Yourself knee strengthening exercises - step two for quad sets

Quad sets for extreme weakness or lack of range of motion (ROM)

If your quads are so weak that you can't see the muscle twitching/contracting at all, try tapping on the top of your thigh with your fingertips. This helped the quad muscle "know" that you are requesting a response and has proven helpful in my experience.

You may think you have enough range of motion when in fact you are somewhat limited. Place a small towel fold) under your knee so that you can actually feel something under you knee and then push into that. I have seen in the past, that sometimes there is psychological block if a patient anticipates any pain. This towel roll/fold will keep the knee joint from moving too far yet, allow the quad to push against the towel, therefore improving strength. You may also want to use this towel roll or a pillow under your knee at night for the first couple weeks to manage your pain so that you can get deep into the REM sleep you need to heal effectively and efficiently.

Using a rolled towel for quad set and sleeping comfort

But my doctor said...

I know what your doctor said, but remember that he has to play an insurance game...he wants to see results quickly. You do to...but, loss of sleep will counteract your efforts far more than you realize... be kind and gentle to yourself... doctors treat all body's as if they are exactly the same. That is where protocols come from. When in fact, every body is uniquely different.

As a physical therapist I would rather see you start out doing any exercise pain free. And, if this means putting a roll under your knee to support the knee joint at the point where it is not painful, that is where you should start. Excessive and unnecessary pain will only serve to prolong the body's guarded defenses. There's an effective tennis ball trick you can try to work on the myofascial restrictions in your body that may help you knee pain!

As your knee heals, your quad gets stronger and your activities through the day increase, you will find that your towel roll or fold will need to be thinner and thinner until you eventually don't need it anymore.

Remember, you need to be able to do a full quad set with full range of motion before moving on to a straight leg raise!

Take it easy. There's no hurry. Be consistent with improving your quad strength and your knee extension range of motion. Generally speaking the big hurry in the hospital after a knee replacement is protocols and insurance games. They can't let you go home until you show sufficient range of motion in straightening your knee.

If you take it slow but consistently push yourself a bit every day - you should improve as the days go on. No need to keep throwing your knee joint into the pain cycle day after day after day.

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