Balancing exercises for knee injuries - why they are important and how to do them
Kim van Deventer

Kim van Deventer

Why you should be doing balancing exercises for knee injuries (and how to do them properly)

Want to know why balance exercises are so crucial to your knee injury recovery? Need better advice on how to do them? Then this article is for you.

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Something seems off. Your movement feels difficult, and you haven’t exercised pain-free since your knee injury.

You’ve done the research and found out that it could be your balance. But you’re still not sure why balance exercises can solve your knee problems, and you don’t know how to do them. 

So, let us clear this all up for you. 

Why Balance Exercises can help your knee problems

What do balance exercises do?

When you have a knee injury (or any joint injury for that matter), there’s usually some pain, a change in muscle strength and reduced joint mobility. These factors affect how your brain ‘communicates’ with your knee, when you’re moving or at rest.

Balance exercises train this body-mind communication. They fine-tune muscle coordination and improve your proprioception or position sense. 

What is proprioception?

It’s your joint position sense. This is your ability to know where your body is in space without needing to look at it. Proprioception is one of the most essential elements of human movement.

Why? Well, if you’ve ever walked into a dark room suddenly, you’ll know! 

To help explain a little more about what proprioception is, let’s look at the task of climbing stairs. 

It's good proprioception that allows you to climb stairs without looking at your feet.

When you climb up a flight of stairs, do you need to look at your feet as you go up? Likely not. How is it possible that you know precisely how high to lift your leg so that your foot lands directly on the next step? 

That’s proprioception! Good balance, coordination and agility are the three cornerstones of good proprioception.

Why are balance exercises important when you have a knee injury?

Because it improves your position sense, balance exercises lead to an improvement in your balance, movement coordination and agility. Which in turn leads to better spatial awareness and faster reaction times with sudden or unexpected changes in your movement and environment. 

For example, suppose you step on a stone while running. In that case, good position sense allows your brain to quickly recalculate your movements, and you can carry on without injury.

It also enhances your posture – which helps align your joints and primes you for movement. 

What all this means is that you move better, which reduces your risk of falls and reinjury. It also helps to prevent future knee injuries and muscle strains.

Balance exercises hold several benefits for knee injuries.

How should you do balance exercises?

Where to start

Start at a level that is comfortably challenging for you. 

How do you know what this level is? 

Excessive pain or swelling is a tell-tale sign you’re working at the wrong level. Keep in mind, having some discomfort is expected while you’re recovering. 

Is it a meniscus tear, runner’s knee or an anterior cruciate ligament (ACL) injury you’re dealing with? Knowing what’s typical for your type of injury is an excellent way to benchmark your symptoms. 

In this respect, it’s also crucial to be realistic about where you are in your healing process. For example, balancing on an unstable surface (like a balance board) on top of a fresh knee injury will only make it worse. 

As a guide when starting your balance training, your knee pain should not be at an intensity of more than 3/10 on a pain scale (0/10 = no pain and 10/10 = most severe pain). More than this, and you risk worsening your knee injury or causing a new one. 

The Exakt Health app uses functional tests and your feedback to introduce balancing exercises at the right time and level for your knee injury. So to save yourself the time and effort trying to figure out where and how to start you can download the App for free from the app store.

How to progress

Simply put, you should only move to the next level once you’ve fully mastered the previous level.

It’s essential to monitor your knee pain. It should not increase during or after your balance exercises. If this happens, bring your exercise level down a notch and see how your knee responds. Repeat this process until you have no increase in your knee pain, either during or after the exercises.  

Generally, following the 3/10 pain intensity rule mentioned above should keep you exercising at a safe level.

Common mistakes when doing balance exercises

Starting too early in your recovery

While you still have moderate to severe knee pain, swelling, and inflammation, you should avoid balance exercises until these symptoms subside.

As soon as you feel your knee is out of the ‘angry and inflamed’ stage, you can start with low-level balance challenges and progress from there. We’ve included examples below.

Progressing too quickly

It’s tempting to want to speed up the process by skipping progression levels.

Especially as some of the exercises look easy. However, moving too fast through a balance training program after a knee injury means you may miss out on its full benefit.

It can also do more harm than good if you do too much too soon! This may set your knee injury recovery back.

Stay patient, trust in the process and reap the rewards.

Not adding all the dimensions of balance into your training

Balance training after a knee injury is not only about standing on one leg for as long as you can. It’s slightly more complex than that.

Firstly, both static (for holding a yoga pose) and dynamic (for lunging and landing over a rock face) balance must be developed when recovering from a knee injury.

The more senses, movements (in different directions), surfaces and environments you add to your balance training mix, the better.

This ensures that your brain learns to sense and control your knee properly, no matter what position you’re in or the movement you’re doing.

Ultimately, there will be no more surprises!

Examples of balancing exercises for knee injuries

Key principles:

  1. Have something solid to hold on to in case you lose your balance.
  2. Adding or taking away certain elements increases the difficulty of the exercise. For example, vision (eyes open/closed), movement (of your head, arms, legs) or surface changes (stable and unstable).
  3. With each exercise, aim for 30 seconds x 3 without any wobble or sway.
  4. Only progress to the next level once you’ve fully mastered the previous level.

Level 1: Balancing on a stable surface, looking straight ahead

Balancing exercise level 1: Balancing with eyes fixed on one point.

This is one of the easiest exercises because your brain can use feedback from your eyes to help it stabilise your body and it doesn’t have to deal with any movement. 

Level 2: Balancing on a stable surface while turning your head

Balancing while turning your head.

By moving your head, you force your brain to rely less on the feedback from your eyes and more on the messages that it’s receiving from your joints, ligaments, tendons and muscles.

Level 3: Balancing on a stable surface, eyes closed

Balance level 3: Standing on one leg with eyes closed.

Closing your eyes forces the brain to listen to and fine tune the messages your body is sending if it wants to maintain your balance.

More progression options

Balance exercises have to also be progressed to resemble more real life situations e.g. balancing on unstable surfaces or while moving limbs. These progressions are usually only introduced once you’ve built enough strength and control in your knee through the rest of your rehab exercises.

How do I know my balance training is working?

Patients report that improved balance gives them a better body awareness. An enhanced sense of stability, coordination and smoothness in their movements that wasn’t there before.

And most of the science agrees. A combination of balance and coordination exercises alongside a strength, flexibility, and aerobic exercise program improves your physical and cognitive function, which positively impacts your quality of life.

Your daily activities simply feel much easier to do when your balance is good. 

Need some extra help with your balance exercises? The Exakt Health App is designed to progress your balance exercises as you move through the stages of your knee injury recovery. Download the App to get started.

References

  1. Bulow A, Anderson JE, Leiter JRS, MacDonald PB, Peeler JD. Safety and Effectiveness of a Perturbation-based Neuromuscular Training Program on Dynamic Balance in Adolescent Females: A Randomized Controlled Trial. Int J Sports Phys Ther. 2021;16(4):1001-1015. Published 2021 Aug 1. doi:10.26603/001c.25685
  2. Halvarsson A, Dohrn IM, Ståhle A. Taking balance training for older adults one step further: the rationale for and a description of a proven balance training programme. Clin Rehabil. 2015;29(5):417-425. doi:10.1177/0269215514546770
  3. Dunsky A. The Effect of Balance and Coordination Exercises on Quality of Life in Older Adults: A Mini-Review. Front Aging Neurosci. 2019;11:318. Published 2019 Nov 15. doi:10.3389/fnagi.2019.00318
  4. DiStefano, Lindsay J1; Clark, Micheal A2; Padua, Darin A3 Evidence Supporting Balance Training in Healthy Individuals: A Systemic Review, Journal of Strength and Conditioning Research: December 2009 – Volume 23 – Issue 9 – p 2718-2731 doi: 10.1519/JSC.0b013e3181c1f7c5
  5. Heitkamp HC, Horstmann T, Mayer F, Weller J, Dickhuth HH. Gain in strength and muscular balance after balance training. Int J Sports Med. 2001;22(4):285-290. doi:10.1055/s-2001-13819
  6. Kim, N. J., Yoo, K. T., An, H. J., Shin, H. J., Koo, J. P., Kim, B. K., … Choi, J. H. (2014, May 30). The Effects of Balance Exercise on an Unstable Platform and a Stable Platform on Static Balance. Journal of International Academy of Physical Therapy Research. International Academy of Physical Therapy Research. 

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