Quad-Setting Exercises

"Quad sets" are simple thigh exercises, commonly prescribed to someone who has suffered an injury or recently had surgery. Quad sets involve isometrically contracting your quadriceps muscle -- tightening the muscle on the top of your thigh without moving any joints. Quad sets are normally the first exercise performed after surgery, and the exercise can be completed in different ways as rehabilitation progresses.

  1. Rehabilitation

    • After an injury, patients often lose muscle control, which can range from a slight decrease in strength to major muscle dysfunction. Quad sets are used early in rehabilitation on to focus on dysfunctional muscles, and begin strengthening them. Perform quad sets by sitting with your legs straight, contract the muscles on the top of your thigh and hold for six seconds. The University of Michigan Health Systems recommend performing eight to 12 repetitions, resting up to 10 seconds between each repetition. Douglass Black, a sports physical therapist from Duke University, recommends performing quad sets up to 10 times a day following surgery.

    Extension

    • Knee injuries often lead to a loss of knee extension range of motion; this will prevent you from fully straightening your knee. Limited knee extension is partially caused by a lack of quadriceps strength, because your quadriceps control the extension of your knee. If you have limited knee extension, roll up a small towel and place it behind your knee. As you quad set, focus on squishing the towel with the back of your knee. As you gain range of motion, place a prop beneath your heel, which will elevate your knee slightly and allow a wider range of motion.

    Seated

    • If you are not in an immobilizer and have full range of motion, seated quad sets can help you regain strength for everyday activities. To perform seated quad sets, sit in a chair, with your knees at 90 degrees. Press down through your heels into the floor, and tighten your quadriceps; do not move your knees or try to stand up. This exercise mimics the first phase in standing up from a chair, a functional activity that can be very difficult for post-surgery patients.

    Electrical Stimulation

    • Sometimes muscle trauma can be too great for you to overcome on your own. If muscle control is particularly hard for you, a health care professional may prescribe neuromuscular electrical stimulation, or NMES, to assist your quad sets. NMES machines send strong electrical pulses into your muscles via skin pads. Two pads will be placed on your quadriceps, and you will feel a very strong pulse in the muscle as you quad set. NMES will allow you to contract with much greater force than you could on your own. NMES also aids in muscle re-education by syncing your nervous system with your muscles.