58 Curr Rev Musculoskelet Med (2008) 1:53–60 Fig. 12 Quadriceps set exercise Fig. 13 Straight leg raise exercise Fig. 15 Stationary bike exercise patients participate in quadriceps strengthening exercises including a walking program, the use of a recumbent or stationary bicycle, a swimming program, or utilizing an elliptical machine. It is especially important to make sure that patients avoid knee extension exercises (Fig. 16), because open chain exercises can cause plica irritation and limit patient’s improvements with an exercise regimen. Concurrent with a good quadriceps strengthening pro- gram, it is also important to make sure that patients work on a frequent hamstring stretching program (Fig. 17). They should work on stretching their hamstrings several times a day and not just once daily. As mentioned previously, tight hamstrings place extra stress on the anterior aspect of the knee when the patient tries to extend their knee and this is a frequent cause of medial plica irritation. Thus, it is important to make sure that patients do stretch their ham- strings concurrently with strengthening their quadriceps to maximize the beneﬁt from an exercise program. Fig. 14 Leg press exercise circumstances, this program will alleviate the patient’s symptoms and the patient can often follow-up with their physician on an as needed basis if symptoms persist after this rehabilitation program. In this therapy regimen, Fig. 16 Leg extension exercise