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Innovative Knee Rehab Techniques


Innovative Knee Rehab

Many, many years ago in a galaxy far away I was in high school.  While I was there, I was not only the most handsome, smart, cool young man, I was also on the wrestling team.

During my senior year, wrestling at a thick 125lbs and about 5’11”, I injured my knee.  How bad?  Who knows?  I grew up on a farm and never had been to the doctor.  And after the knee injury, I didn’t go either.  All I know is that it swelled up light a balloon and hurt like hell.  From that point on it started a downward spiral of compensations and avoidance that I am still paying for today.


Injuries Will Knock You Out of the Game

Injuries Will Knock You Out of the Game

Maybe that is why I have been so deep into studying shoulder (injured that too wrestling), knee, back, elbow, ankle and hip injuries.  And it is also the reason, most recently over the past 2 years, that warming up, activation and foam rolling has become part of the system I use to train my clients.

Today I am going to show you an underground technique that I’ve used with many athletes who are recovering from knee injuries and surgeries of the knee.

Terminal Knee Extensions (TKE)

Terminal Knee Extensions or TKE’s are an exercise used to rehab knee injuries and make them strong again.  Of course they are only one part of a comprehensive rehab protocol for the knee which should also include hip and ankle mobility, glute activation, SMR work and many others.

Benefits of TKE’s:

  • quad activation
  • re-establish full knee extension (something you lose from compensating and “staying off” or “taking it easy” on the injured knee
  • knee stability and tracking

How to Perform TKE’s:

You fix a band to a stationary object and the other end around the back of your knee.  From there you step backwards creating tension in the band and letting your knee translate forward.  Now, flex your quad hard and drive your heel downward straightening your leg.  We like to do them with no shoes on of course.

There are also several variations you can do.  You can do them:

  • on an elevated platform with no band (also considered a one leg squat)
  • on an elevated platform with a band

Here is a simple diagram depicting an extended ROM TKE:


So, let’s get to the good stuff.  The underground technique.  But first let me tell you, yes it is weird.  Yes, you will get stares.  But you know what?  Who cares.

Strength coaches and fitness professional; use this for your clients.  Use it often because it works.  Trust me.

3D Terminal Knee Extensions

Why do I call them 3D if the knee is a hinge joint?

Because the bands create non-uniform tension across the hips, knees and ankles and forces the quads to activate, contract and stabilize in a multi-planar fashion.  Plus, as you move, your kinetic chain needs to stabilize, absorb and generate power in a 3D fashion.  Remember that strength training movement patterns are GPP and develop the foundation for real-world movement.

Here is the setup.  Put on your weightlifting belt with two Elite bands looped through the belt itself on each side of the body.  Do NOT tighten the belt really tight.  Keep it on loose but not too loose.  Now take the ends of the hanging bands and stretch them down under your feet.

Now, wear this setup throughout your workout taking the bands off when you are performing exercises and putting them back on the whole time you are not.  At the end of the workout, you actually forget you have them on!

What is the training effect?  How about 100’s of terminal knee extensions by the time you are done with your workout!  In fact, these terminal knee extensions (TKE’s) are better than the stationary, basic version because you are moving.  As you move, you are actively flexing your quad and emphasizing the tracking of the knee in real-time.

I would also recommend changing the tension and angle of tension on the bands throughout the workout. All you have to do is move the bands on the belt to a different location and then anchor them back under the athlete’s feet.

movarrowIf you want to know how to setup rehab and activation exercises into your program, check out the Net’s ONLY complete muscle building, strength training system – AMD


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3 Responses to “Innovative Knee Rehab Techniques”

  1. skibird93 Says:

    Great video for your fans. I agree that this can be a great exercise for rehab and just getting a lot of reps in if you have an inury. A PT that I used to work with has done these with patients that have had total knee replacements as a way to increase the amount of knee flexion that they get during gait (walking). The band acts as an assist in this instance to help flex the knee when the foot is lifted off the ground during walking. We use a variety of exercises like this and they tend to work really well. Great exercise to reestablish neuromuscular control of the quads, hamstrings, and glutes also. This is a 5 star video for sure!

  2. Mike T Nelson Says:

    Hi there Smitty!

    I just hit you up via email on my thoughts, but in general the knee need rotation too (3 D as you say).

    As odd as it sounds, many time opposite ELBOW mobility work is great for the knees.

    Humans it seems are hardwired to walk (gait) and think if the hamstring action as you extend and contract your bicep on the opposite arm.

    Working on LEFT elbow mobility will help the RIGHT knee. I first learned this in the Z-Health R Phase cert.

    More info here on my blog at

    Rock on
    Mike T Nelson PhD(c)

  3. Matt "Wiggy" Wiggins Says:

    Thanks for this great info. I think too many people in the game (and I’m guilty of this) focus on getting stronger, faster, etc. and not enough on posture, flexibility, re-/prehab, etc.

    I know I need to put more of it into my own training. So thanks for bringing more of this to our attention.

    Question – how much of your overall training should be dedicated to this type of training? B/c I see a few coaches (which I won’t name) who seem to make up the vast majority of their programs with this type of training. Now, while I understand that, I still think that you gotta get stronger.

    Having f’ed up posture and flexibility, but being able to squat 650 is no good. At the same time, having perfect posture, great flexibility, and well prehab-ed joints doesn’t do you any good if you’re a puss and only squat 225…lol.



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