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D) PILATES EXERCISES IN PATELLAR TENDONITIS REHABILITATION :
Pilates exercises are a series of exercises which were specifically designed for dancers. The exercises concentrate on ‘core stability’. This is strengthening and stability of the central muscles in and arround the spine, pelvis and shoulder girdle. The exercises increase flexibility, strength and balance or proprioception which is very important in the rehabilitation of patellar tendon injuries. The exercises are generally quite complicated and instruction from your physiotherapist of Pilates instructor may be required. Generally these exercises can be started 2-4 weeks following surgery.
Pilate’s one leg stretch: Lying on your back with the knees bent and slightly appart and the feet flat on the floor. The abdominal and pelvic floor muscles should be slowly contracted whilst one leg is strainghtened along the floor and then slowly bent again. The other leg should then be used followed by a rest in the relaxed position before repeating.
Pilate’s ball exercises : Place a large 80cm diameter pilates ball against a wall. Standing in front of the ball with your feet wide appart. Fell for the ball behind your with your hands. Stabilise the ball as you gently sit on the ball. Find a stable position. With your feet flat on the floor use your legs to balance. Progress to using your legs to slowly and steadily move the ball in a small circle away from the wall and back to the start. Repeat the exercise in the other direction. Progress to moving the ball away from the wall before starting and to not using your hands for stability.
Finally undertake the exercise lifting the non-operated leg partially and then fully off the ground. Progress slowly. Balance and control from the operated leg will improve. Be careful not to fall off the ball, move too quickly or too far, and take care when getting on and off the ball.
One legged stand and dips on trampette: Standing on a trampette initally holding onto support. Balance controling the muscles of the back, hip, thigh and calf to maintain a balanced position for 1 minute. Graduate onto controling balance whilst undertaking a dip on the trampette. Further try the exercise without support and undertake gentle bouncing whilst controling the balance position. Progress to undertaking hops.
Pilates ball wall slide: Standing against a 60cm Pilates ball whilst leaning against a wall. Undertake a dip exercise bending the knees to 90° whilst maintaing balance against the ball.
Pilates shoulder bridge : Lying on your back with the knees bent a little distance apart and the feet on the floor. The abdominal and pelvic floor muscles should be slowly contracted whilst the pelvis is slowly lifted a little distance off the floor. Then slowly the lower back is lifted and then the chest so that the head, shoulders and feet remain on the floor. Slowly reverse the exercise back to the resting position.
As strength and control increase over the weeks the exercise can be repeated and when in the bridge position the non-operated leg may be lifted off the ground leaving support and balance only from the operated leg. The good leg should be replaced before returning to the rest position. This should be attempted perhaps only after 6 weeks. With time the exercise can be repeated only using the operated leg throughout the exercise.
This should be attempted perhaps only after 6 weeks. With time the exercise can be repeated only using the operated leg throughout the exercise.
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