Again and again you’ve heard me stress the vital importance of a proper clinical assessment when you have knee pain.

One of the KEY factors in a knee pain assessment (because we have to check it is a knee problem and not a hip or foot or lower back problem – they all cause knee pain too!) is examining knee extension – basically how straight you can get your knee.

This is for 2 key reasons:

1. This is a key indicator in a developing joint problem
2. Being unable to straighten your knee affects how the joint works, making any other problem much, much worse.

If you can’t straighten your knee you change:

1. Pressure on the remaining cartilage – wearing it away in certain spots
2. How your quadriceps (thigh) muscles control the knee
3. The ligaments – some stretch, some don’t
4. Hamstring length – they get shorter which starts to cause lower back pain
5. The pressure in your foot and ankle making them more prone to injury.

Straight knees and surgery

If you want to get the best result from your knee replacement surgery (partial or total) you should get the knee as straight as possible BEFORE surgery. (there’s a whole other article on what physiotherapy you should do before surgery, I just need to write it!).

And after surgery – the number one priority is getting the knee straight. Getting a full bend will only happen if the knee can straighten (it’s funny like that). So you should be doing your knee straightening exercises 3 times a day from the second you wake up!

Can you straighten your knee?

Sit down so that you can put your feet up, sitting on a sofa with just your heels supported on a coffee table is ideal. Now, with your knees “hanging”, straighten your legs and flex your feet so that your toes are pointing toward you. Are both your knees the same height? Is one more bent than the other?

The back of your knees should feel smooth and flat from your calf to thigh.

What to do?

Getting that knee straight is essential! I’ve put my basic knee exercises here. Do them daily and it will start to make a difference. But whatever you do and whoever is managing your treatment you must NEVER push on the knee to help it straighten. If you need to apply pressure it should be equally on the thigh and shin, and even then must be carefully controlled.

At the clinic I have imported a specialised tool from the USA called the Elite Seat ®. Developed by Dr Shelbourne, an American knee surgeon, and the world expert in this area, the Elite Seat ® is designed to improve knee extension by gently stretching and straightening the knee. It’s designed to be used for 10 minutes daily and you are completely in control of the process.

The introduction of this one piece of equipment has dramatically increased my success rates, taking them from a “I’m happy with that” 75% to a “yippeeeee” 95% for knee treatment. Not bad for an extra 10 minutes?