6 Exercise Tips to Help fix Knee Hyperextension

Image showing hyperextension of the knee in this football player

​Hyperextension is the forward movement of the knee joint caused by weakness of the quadriceps muscle which functions to actively extend the knee and flex the hip, or injury to the anterior cruciate ligament which passively translates the shin bone or “tibia” of the lower leg forward. This is common among people with neurological conditions such as stroke, cerebral palsy, and spinal muscular atrophy, and post-surgical patients who have undergone ACL reconstruction and knee replacement.

Because of their knee hyperextension, they have problems walking, particularly experiencing knee buckling when bearing weight on their affected leg, and this makes them susceptible to falls.

Definition of a Hyperextended Knee

If the knee extends more than 10 degrees past neutral, that is classed as hyperextension. Genu recurvatum is more common in women due to increased ligament laxity and there is often a genetic link. There are a number of other things that can cause genu recurvatum syndrome including Ligament Laxity.

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Here are some useful exercises that can be done to fix knee hyperextension and improve your walking.​

1. Isometric strengthening of the quadriceps

This is easiest way to strengthen your quadriceps muscle especially when you are still too weak to do strenuous exercises. Roll a towel and put that in the space behind your knee. Then lie down and press it backwards with your knee. Hold for 6 seconds and repeat 10-20 times. Don’t forget to breath while doing this exercise! To prevent holding your breath, count from 1 to 6 while doing each repetition.

2. Short arc quads

Roll a bigger towel and put it behind your knee. This time, try to lift your lower leg upwards until your knee and thighs are aligned. Then lower your leg slowly until your heel touches the ground again. Do this for 10-20 repetitions. You may add ankle weights (1-2 lbs) as a progression.

3. Straight leg raises

While laying down, lift your whole leg up and hold that for 6 seconds. Once you’re done with a repetition, make sure to lower your leg slowly towards the ground. In the beginning you may use your body weight as resistance, and then progress by putting ankle weights. Do this 10-20 times.

4. Squats

You may do this with your back flat against the wall if you don’t feel confident without a support.

Stand with your feet shoulder-width apart. Then bear your weight onto your feet by lowering your whole body and flexing both of your knees. Make sure that your knees don’t go past your toes. Hold the squatting position for 6 seconds then slowly go back to your starting position. Do this for 10-20 times.

5. Step ups

If you have stable balance and need a more challenging exercise, you can proceed to doing step ups. Step onto a block with your right leg and then use it to lift your body up until your left foot reaches the top of the block. When going back to the ground, use the left foot to lower yourself down. Do this for 10-20 times for each leg. You may put ankle weights on both of your legs as a progression.

6. Biofeedback device

Using nCounter’s Joint Angle Feedback can assist with faster improvement of knee hyperextension. It gives you real-time feedback if you are doing the right movements and thus activating the right muscles. At the same time, you will be able to know the range of motion of your knee, whether the hyperextension is improving or not with the exercises. Just put the device on the affected knee using the associated Velcro strap and you will be good to go!

Essential Angle Monitor giving feedback on knee flexion