The centre ‘Paupio Kinezioteka Clinic’ offers non-surgical treatment of knee joints according to the method of Bubnovsky. Effective rehabilitation programmes after injuries, arthrosis, after surgeries. Modern simulators, individual approach, proven results. Return mobility to your joints without pain!
Comprehensive Knee Joint Rehabilitation Programme¶
Basic principles of knee joint rehabilitation in the centre ‘Paupio Kinezioteka Clinic’.¶
At our centre, knee joint rehabilitation is based on the principles of kinesiotherapy, a method that restores joint health through dosed loading.
The main focus is on:
- Activation of the knee stabiliser muscles
- Restoring proprioception (feeling of the joint in space)
- Elimination of biomechanical abnormalities.
We use author's methods, including the Bubnovsky approach, which allow us to rehabilitate even complex cases (after ligament tears, endoprosthesis, 3rd degree arthrosis).
Each programme is made individually, taking into account:
- The nature of the injury
- Age of the patient
- Associated diseases
Key feature
The key feature of our methods is the combination of specialised exercise equipment, joint exercises and myofascial techniques. Modern interactive systems help to accurately dose the load, monitoring progress at every stage.
Our centre uses special simulators for knee rehabilitation:¶
- Specialised exercise bikes - allow you to perform joint exercises without axial loading
- Biomechanical complexes - monitor muscle activity in real time
- Special orthoses - for passive joint development after surgery
- Vibration platforms - improve microcirculation and tissue elasticity
Main causes of knee joint problems¶
The knee joint does not suffer in isolation - its condition depends on muscle balance, correct biomechanics of the whole leg and the consequences of previous injuries. Effective rehabilitation must therefore address not only the symptoms but also the underlying causes - gluteal muscle weakness, foot dysfunction, scarring and poor movement habits.
Muscle imbalance as a cause of knee joint disease¶
The knee joint is a complex joint that depends on the coordinated work of muscles.
Weak gluteal muscles (especially the middle and small gluteal muscles) lead to a valgus (X-shaped) knee position when walking or squatting, increasing stress on the inner meniscus and ligaments.
Hypertonus of the quadriceps (anterior surface of the thigh) pulls the patella outward, causing pain in the front of the knee (around or under the kneecap) that results from the patella not sliding properly over the femur and accelerating cartilage wear.
Normally, the antagonist muscles (gluteal, posterior thigh, calf muscles) should compensate for this load, but when imbalanced, the knee works in chronic overload mode and deteriorates.
The Right Approach in Knee Treatment
Knee pain is a signal that the muscles and joint are not working properly, not just an ‘inflammation’ that can be anointed.
Ointments temporarily dull the pain, but do not strengthen weak gluteal muscles, relieve quadriceps hypertonicity, or correct valgus positioning of the knee.
As a result, the load continues to be distributed incorrectly - the cartilage wears out, the ligaments are overloaded, and the problem returns again. Without correcting the muscle imbalance - the root cause of the pain - the knee will deteriorate further, even if the symptoms are ‘masked’ for a while.
It is not the effect (pain) that needs to be treated, but the cause - weak and overloaded muscles - otherwise the disease will progress.
Violation of biomechanics is reflected in knee joint problems¶
The knee is a ‘hostage’ of the foot and pelvis.
Flat feet lead to pronation of the foot (this is the inward tipping of the foot), which causes the shin bones to rotate inwards, and the knee has to compensate for this deviation, increasing the risk of meniscus and cruciate ligament damage.
Pelvic misalignment (e.g. due to weakness of one gluteal muscle or scoliosis) causes asymmetrical pressure: one knee receives more load, leading to early osteoarthritis.
Even improper walking (e.g. insufficient hip extension) causes the knee to ‘overwork’, taking over the functions of other links in the muscle chain.
The effects of injuries and surgeries affect the knee joints¶
After trauma (ligament tears, meniscus tears) or surgery (arthroscopy, endoprosthesis), scarring changes impair tissue gliding: for example, adhesions in the fat body of Goff limit mobility and fibrosis of the joint capsule reduces range of motion.
Prolonged restriction of knee mobility (cast, orthosis) causes atrophy of the quadriceps muscle (anterior surface of the thigh), the main stabiliser of the knee.
Without restoration of muscle control, the joint remains unstable, which provokes chronic inflammation and repeated injuries.
In addition, after injury, an altered motor pattern (e.g., gentle claudication) often develops, which overloads the healthy leg and exacerbates the imbalance.
Goff's Fat Body
The Goff fat body is a cushion of fatty tissue inside the knee joint, located under the kneecap (patella). It is needed to cushion and soften shocks during walking and jumping, to protect the ligaments and bones by preventing friction, and to nourish the joint, as it contains vessels that supply cartilage with nutrients.
Influence of the lumbar spine on the knee joints¶
The knees do not work in isolation! The lumbar spine is a key link in the chain that transfers load from the torso to the legs.
How lower back problems destroy the knees?¶
- Nerve impingement - herniated or protruding nerves in the lower back (L4-L5-S1) can compress the nerves that control the muscles in the thigh and lower leg, causing the knee to lose stability.
- Muscle imbalances.
- Weakness of the gluteal muscles (due to lumbar tightness), cause overloading of the knee joint.
- Hypertonicity of the lumbosacral muscle - changes the angle of the pelvis and disrupts the axis of loading on the knees.
- Compensatory overload - limitation of mobility in the lower back, provokes the body to transfer extra work to the knees (e.g. when squatting or walking).
Examples of links between lower back problems and knee problems¶
- Lumbar Osteochondrosis - the person subconsciously transfers weight to one leg, which will manifest as asymmetrical wear and tear on the cartilage in the knee.
- Pear muscle syndrome (spasm in the buttock) irritates the sciatic nerve, this makes the lower leg muscles weak and the knee ‘loose’.
How do we treat this at the centre?
- Myofascial release of the lumbar and pelvis - we remove the clamps that prevent the legs from working.
- Neuromuscular Activation - retrains the body to distribute the load correctly.
- Posture Correction - correct misalignments that start in the spine.
Important
Without correcting these causes, simply relieving pain will have a temporary effect. Our programme eliminates exactly the root causes of problems.
Comprehensive programme of knee joint rehabilitation by kinesiotherapy method¶
Our centre uses a three-level system of knee joint rehabilitation combining the principles of kinesiotherapy and Bubnovsky's methodology. Each stage lasts 5-7 weeks according to the scheme: ‘doctor's consultation - 6 sessions - intermediate examination - 6 sessions - final diagnosis’.
Module 1: Decompression and Management of Acute Knee Pain¶
Goal
To eliminate pain syndrome, improve cartilage nutrition, restore basic mobility.
Main treatment methods:¶
- Antigravity therapy:
- Special hangs to relieve joint pressure
- Dosed load on the exercise bike
- Myofascial Correction:
- Work on trigger points of the quadriceps and calf muscles
- Kinesiotaping to improve lymphatic flow.
- Joint Gymnastics:
- Micromovements in pain-free amplitude
- Passive flexion-extension on a robotic orthosis.
Performance monitoring:¶
- Measurement of the volume of movement with a goniometer
- Visual Analogue Pain Scale (VAS) test
- Ultrasound monitoring of synovial fluid status
The Bubnovsky Principle
‘The right movement cures, the wrong movement - cripples’. All exercises are carried out strictly on an individually calculated trajectory with control of load angles.
Module 2. Restoring the muscle balance of the knee joint¶
Goal
Normalise muscle tone, strengthen the ligamentous apparatus, correct the biomechanics of movements.
Key areas:¶
- Correction of muscle imbalances:
- Isometric stresses for the quadriceps
- Eccentric loads for the posterior thigh
- Stabilisation of the patella with rubber shock absorbers.
- Proprioceptive training:
- Balance platform exercises
- Neuromuscular activation suspension systems.
- Biomechanical Correction:
- Training the correct walking pattern
- Elimination of compensatory movements
- Deep muscle retraining:
- EMG-controlled contractions
- Biological feedback via pressure sensors
Exercise examples:¶
- ‘Soft squats’ with axis correction.
- Steps in weightlessness on an anti-gravity track.
- ‘Clocks’ for coordination development
Module 3. Functional rehabilitation and consolidation of results¶
Goal
To regain full range of motion, to prepare for domestic and sporting activities.
Comprehensive approach:¶
- Dynamic stabilisation:
- Low-impact plyometric exercises.
- Imitation of sports movements
- Integrative training:
- Foot-knee-pelvis-lumbar connection
- Intermuscular coordination
- Recurrence Prevention:
- Self-correction training
- Home support programme
- Specialised Techniques:
- Vibration training to improve trophicity
- Kinesiological taping
Plyometric Exercises
Plyometrics is a special type of exercise designed to develop explosive strength and improve neuromuscular coordination by rapidly switching from eccentric (lengthening) to concentric (shortening) muscle contraction.
How it works in knee rehabilitation:
- Amortisation phase:
- Muscles are pre-stretched (e.g., when landing)
- Elastic energy builds up in the muscles and tendons.
- Push-off phase:
- Instantaneous conversion of stored energy into powerful movement
- Activation of proprioceptive receptors
- Therapeutic effect:
- Improved ligament elasticity
- Increase joint stability
- Development of defence reactions to unexpected stresses
Control Tests:¶
- FMS Functional Screening
- Assessment of load symmetry on a stabilometry platform
- Dynamic gait analysis
Functional Screening FMS
FMS is a standardised system for assessing the quality of fundamental human movement, detecting:
- Muscle tone imbalances
- Mobility limitations
- Motor stereotypic defects
- Compensatory movement patterns.
7 key tests of the system:
- Deep squat - assessing symmetry of pelvis, knees, and feet function
- Overcoming Obstacle - analyses stability in the uni-post position
- Line Lunge - testing hip mobility and trunk stability
- Shoulder girdle mobility - identifying upper kinematic link limitations
- Active leg raise - testing flexibility of the posterior muscle chain
- Roman push-up - assessment of trunk stability
- Rotational Stability Test - testing interhemispheric coordination.
Features of Our Knee Treatment Methodology¶
- Individualised Programmes:
- A unique package is selected for each patient
- Taking into account age, degree of injury, comorbidities, etc.
- Modern equipment:
- Biofeedback training equipment**.
- Load visualisation systems
- Comprehensive approach:
- Working with the entire kinematic chain
- Addressing root causes, not symptoms.
Expected Results
- Reduction or complete disappearance of pain
- Restoration of full range of motion
- Improvement of cartilage quality
- Prevention of further damage
- Return to an active lifestyle
‘There are no bad knees - there are weak muscles’ (S.M. Bubnovsky). Our programme proves that even in complex cases, recovery without surgery is possible.
Real examples of knee joint treatment at our centre¶
Case 1: Rehabilitation after a ruptured ACL in an athlete¶
Patient: Andrei, 28 years old, football player
Diagnosis: Complete rupture of the anterior cruciate ligament (non-operative)
Rehabilitation period: 5 months.
Programme:
1. 1-2 month:
- Decompression on an anti-gravity track.
- Neuromuscular activation.
- Isometric exercises for quadriceps
2. 3-4 month:
- Eccentric posterior thigh exercises
- Proprioceptive exercises on a balance platform
- Kinesiotaping to stabilise the joint.
3. 5 month:
- Plyometrics with flexion angle control
- Simulation of football movements with EMG control.
Results:
- Full restoration of joint stability
- Return to professional sport after 6 months
- Increase in muscle strength of the operated leg up to 95% of the healthy leg.
Case 2: Treatment of Grade 2 Gonarthrosis.¶
Patient: Olga, 54, teacher
Diagnosis: Bilateral gonarthrosis with pain syndrome.
Rehabilitation period: 3 months
Programme features:
1. Biomechanics correction: 1.
- Elimination of foot hyperpronation (customised insoles)
- Restoration of gluteal musculature
2. Joint Rehabilitation:
- Vibration therapy to improve cartilage trophism
- Dosed walking with 30% of body weight offloading
3. Home Complex:
- Exercises with elastic band
- Self-massage with myofascial roll.
Results:
- Reduction of pain by 80% on VAS scale
- Increased pain free walking distance from 200m to 2km
- Cancellation of elective endoprosthetic surgery.
Case 3: Recovery after endoprosthetic replacement.¶
Patient: Victor Sergeevich, 68 years old
Diagnosis: Condition after total endoprosthesis of the right knee joint
Rehabilitation period: 4 months
Stages of recovery:
1. Early postoperative period (1 month):
- Passive development of the joint on the robotic orthosis
- Lymphatic drainage massage
- Electrical stimulation of quadriceps muscle
2. Main stage (2-3 month):
- Biofeedback walking training
- Hydrokinesiotherapy in the swimming pool
- Posture and gait correction
3. Strengthening stage (month 4):
- Training on a staircase simulator
- Functional tests with simulated household loads
Results:
- Full recovery of range of motion (120° flexion)
- Disappearance of claudication
- Ability to lead an active lifestyle (walking 5-7 km/day).
Why do our programmes work?
- Comprehensive approach: we treat not only the knee, but the entire kinematic chain.
- Individualised selection of loads with precise dosage
- Use of objective monitoring methods (EMG, stabilometry)
- Patient education in self-monitoring and prevention
‘These cases demonstrate that correct rehabilitation can restore mobility even in difficult situations. The main thing is not to miss the time and to work with the cause, not the effect’ - Margarita Kitova, Senior Kinesitherapist at the clinic.
It's time to regain your freedom of movement! Sign up for a consultation right now¶
Your knee doesn't have to hurt! Every day of delay worsens the condition of the joint and increases the recovery time.
At our centre we offer:
5 reasons to start treatment with us:¶
- Non-surgical methods - 87% of our patients have avoided surgery
- Expert Team - Rehabilitation therapists with 10+ years of experience working with athletes and age-related patients
- Result Guarantee - we record progress with objective measurements at every stage
- Unique equipment - the only one in the region with a full set of Bubnovsky exercise equipment.
- Comfortable conditions - individual schedule, free parking, no queues
Special offers for new patients:¶
How we work: 1. You leave a request on the website or by phone 2. Our administrator selects a convenient time 3. At the first consultation the doctor conducts: - Detailed examination - Functional diagnostics - Drawing up a preliminary programme 4. Start your training programme at your convenience
Don't delay! The earlier you start, the faster the results:¶
- Osteoarthritis of 1-2 degrees - improvement in 2-3 weeks
- After injuries - recovery up to 30% faster than standard recovery times.
- Ages 60+ - noticeable relief after 5 sessions.
‘Don't wait until the pain becomes unbearable! 90% of our patients confess: they only regret that they did not turn to us sooner’.
Remember - healthy knees are:
- Freedom of movement at any age
- The ability to play your favourite sports
- No debilitating chronic pain
Do not deprive yourself of this! Trust the professionals.