Hello Fellow Knee Warriors! I am 12 weeks out from surgery. Flexion is 125+, but I cannot get full extension. I work on it every day, only to find my leg bent again every morning. It stretches out some, more quickly than it did before, but it is still bent every morning and any improvement seems to be minimal. I stopped going to PT at around 10 weeks. I was tired of hearing my PT yell “Push that leg straight!!“ at me across a crowded treatment room as I was leaving every session. I continue to do my stretches at home daily. I know this is a long recovery, but will the extension improve? Any recommendations on how to regain extension? This has sidelined me more than I ever expected and I have spent many days sad and frustrated. I am a very active person and I miss my pre-replacement life.
TKR LTKR - 1/3/24 - Extension Problems
- Thread starter LeonGirl
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Jcx
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A lot of people find extension slower to come back than flexion. You don't need aggressive PT to gain extension.
The best way to gain extension is to try to walk with as full a stride as possible heel toe style. The other exercise that I found helpful was to lie on my tummy on my bed with my lower leg hanging off the bed. This allowed my leg to stretch under its own weight. Don't allow any weights to be added.
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Hello and Welcome to BoneSmart! Thanks for joining us.
I see you received some ideas above. Here is an article on Extension also -> Extension: how to estimate it and ways to improve it
I will leave our Recovery Guidelines even though you're 12 weeks out as you may find sone of the info beneficial.
Let us know if you have any questions and feel free to share your journey with us, we love updates.
A great rest of the week to you!
KNEE RECOVERY GUIDELINES
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
I see you received some ideas above. Here is an article on Extension also -> Extension: how to estimate it and ways to improve it
I will leave our Recovery Guidelines even though you're 12 weeks out as you may find sone of the info beneficial.
Let us know if you have any questions and feel free to share your journey with us, we love updates.
A great rest of the week to you!
KNEE RECOVERY GUIDELINES
As you begin healing, please keep in mind that each recovery is unique. While the BoneSmart philosophy successfully works for many, there will be exceptions. Between the recommendations found here, your surgeon's recovery protocol and any physical therapy you may engage in, the key is to find what works best for you.
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary.
If you want to use something to assist with healing and scar management, BoneSmart recommends hypochlorous solution. Members in the US can purchase ACTIVE Antimicrobial Hydrogel through BoneSmart at a discount. Similar products should be available in the UK and other countries.
2. Control discomfort:
rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.
3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these
the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy
5. At week 4 and after you should follow this
Activity progression for TKRs
The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?
Nutrition is of paramount importance. Available here are dietary tips, nutrition basics and additional food supplements. These articles are both general advice on food and specific guidelines aimed at people both pre- and post-surgery.
There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds
We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
Strengthening your quads will help. Gentle PT exercises focused on building strength in the quads worked well for me as did elevating my leg leaving my knee unsupported for a few minutes letting gravity help with straightening.
Golden rule for me is don't push beyond where the joint is comfortable and patience (the hardest thing of all) is key.
Golden rule for me is don't push beyond where the joint is comfortable and patience (the hardest thing of all) is key.
I'm glad you stopped going to PT. Only a poor therapist would shout at you across a room full of people. And shouting never helped anyone improve range of motion.
I can tell you from personal experience that extension does continue to improve with time. WIth my first knee, it took me months to get my knee flat. I never forced it -- I just kept moving and as the inflammation inside the knee when down, my range of motion did too. In fact, I continued to improve well into my second year.
You will get there, it just takes time.
My extension lagged in coming back in, too. The best exercise for me for to walk with a longer than normal stride, making sure I put my heel down first and then rolled onto my toes. This helps to stretch out those large muscles and tendons in the back of the leg. My improvement didn't happen overnight, but it did come, and now it's 0, with no problem! Good luck.
LeonGirl
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@sistersinhim - did you concentrate on walking like this all the time? I try to do this, but often forget in my daily activities. I'm wondering if I should add a period of walking heel-to-toe to my daily exercise and stretching routine.
I think your idea of doing a period of focused heel-toe walking during the day is a good idea. Remember, the trick is to slow down and really concentrate through the entire step.
This involves striking the ground with your heel first, then rolling through your heel to your toe, and pushing out of the step with your toe. Here is a visual
Like developing any new habit, it takes time and repetition. It can feel awkward at first, but after a week or two of practice sessions, you should be able to ease into doing all the time.
Oh, no, I wasn't able to do it all the time. It was tiring and pulled on those sore back muscles and tendons. Plus, walking with an extra long stride can be unstable, so I was always around something I could hold on to.
Walking at a slower pace but with correct placement and properly rolling through from heel to toe was key for me too. Agree that working on a larger stride (when safe!) is brilliant but just focusing on walking correctly helps me.
