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What exercise helped your flexion the most?

Discussion in 'Knee Replacement Recovery Area' started by kneeworn, Feb 17, 2011.

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  1. kneeworn

    kneeworn Graduate

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    I am currently trying to break past scar tissue to get the rest of my flexion. Currently if I strain I can get 120 but not as a functional amount. One thing that seems to help the stretch for flexion for me is the leg press machine. I am able to relax into the stretch and let the weights help apply pressure to bend the knee. However I do not have that machine at home and heel slides are not enough as I really struggle trying to pull past the stiff point against the discomfort.

    I was wondering what others have found helpful to them.
     
  2. Oldie

    Oldie Senior

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    Re: What excersize helped your flexion the most?

    Hi kneeworn, I found that riding the exercise bike as very good for flexion. Take it slow in the beginning and slowly build up the time. Also sitting on a rocker or glider and putting your foot back as far as possible and slowly rocking. Another one is sittin on a stool with rollers and pushing yourself forward. Wishing you the best recovery.
     
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    • referee54

      referee54 Moderator

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      Re: What excersize helped your flexion the most?

      X2 on the stationary bike. I used it a great deal (still do) and it helped with strengthening muscles, ROM, and keeping the knee loose. It is also gentl on the legs, too. Remember, ROM can be gained for quite some time, so do not worry and do not try to hurry it.

      Tim C.
       
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      • ruppbike

        ruppbike Sr Bonesmartie

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        Re: What excersize helped your flexion the most?

        In my recovery and rehab I have sought to increase flexion and did it by asking what prevents flexion.

        This is just my opinion, but here is what I think:

        #1 is swelling of the knee - if what you are doing increases swelling, until the swelling goes down, do not expect flex to increase.

        #2 scar tissue around patella and quad where it connect to knee - heat and massage of incision, patella, medial and lateral tendons and the scar in the quad helps reduce swelling and stretches theses connective tissues and starts to break up the scar tissue. I just this week started using a chiropractor that uses A.R.T. (Active relase Technique) http://donatochiropractic.com/ which is helping to break up scar tissue.

        #3 - Tight and stiff muscles and tenden/ligaments distant from the knee joint prevent flex beyond 120 degrees. Again the A.R.T. work will address this.

        #4 Muscle weakness - atrophy of hamstrings, quads gluts can prevent flex from not being able to contract with enough power.

        I also just started water therapy this week. What a difference! Again, reduces swelling by going from hot tub to pool temperature. Having bouency of water allows you to really stretch and push the amount of flexion to get the stretch but reduce the risk of causing more swelling. Cycling and walking are very effective ways to break up scar tissue, strectch tight tissues and build weak muscles - as long as not causing excess swelling, you can see why so many say these are helping to gain flex.

        Again, this is all my opinion from recent experience. At 6 weeks I was up to 120 and 124. At mid week of #7 I am guessing (did not measure officially) I am up about 5 degrees. More importantly, I am increasing all activities and controlling inflamation and pain with ease, so gaining strenght and stamina as well as flex (and extension).

        Kurt
         
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        • Josephine

          Josephine NURSE DIRECTOR, BONESMART Administrator

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          :th_heehee: Ruppbike, you have been reading in the Library! I've been preaching that for about 4 years on here - you can 'read all about it' in the pain management thread.

          Swelling acts like a plaster cast and blocks flexion with great efficiency!

          For me, two things helped with flexion
          1. simple heel slides
          2. the exercise bike
           
        • bigbruce

          bigbruce Junior Member

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          I've found swelling, tight hamstrings and quads to be the biggest impediment to increasing flexion. The swelling bit will get better with time. Strengthening and stretching the hamstrings and quads on my Universal weight machine - presses and extensions and recumbent cycle have helped. Another stretch is to lay on stomach and bend knee towards bum. I wrap a strap around my foot and gently pull it towards my bum. Your quads will tighten, but if you push back against the strain a few times then pull again, they will stretch out. Hope this makes sense...
           
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          • jugornot

            jugornot Member

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            For leg presses I picked up a Total Gym for about $90 off of craig's list. Its a good machine for the stretch and leg press. And once again the bike is great for rom. If it gets too easy lower the seat a little at a time to get even more flex. Do not use high resistance with the seat lowered. It puts too much strain on your knee. Go for a smooth motion less weight higher rpm. Its the old story of spinning out and cranking home. Use less resistance and higher rpms to warm up and accomplish most of your workout. Save the higher resistance for a proper setup and warm and tired muscles. Prevents injuries.

            Bill
             
          • referee54

            referee54 Moderator

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            Right! Too many people feel that when they ride either a stationary bike or the real thing that they have to "mash" the pedals and pound them with high resistance. Keep the RPM's high and pedal free and easy---down the road, you can also build up cardio too.

            Tim c.
             
          • Tykey

            Tykey Sr Bonesmartie

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            Most things just get better just by leaving them alone, who is to say that ANY exercises do any good. We have a perfect example in our group that doing nothing can be equally effective to working strenuously.

            Personally, I wouldn't advocate either extreme approach, but just get on with an active fit life and it'll just get as well as it ever would.
             
          • Delta1

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            kneeworn, like many of the BS'ies, the stationary bike is an excellent method for me to increase flexion and leg strength. When starting, you may be more comfortable with the heel of the operated leg over the middle of the pedal because your knee may be tight. As you loosen up after a few minutes, slowly move that foot back so the near the end of the workout your ball of the foot or toes are over the center of the pedal. This translates to a larger angle of bend at the knee, greater ROM.

            Another exercise for me is squats, where I stand with feet about shoulder width apart and then I bend both knees while I lower my body down. When I began, I was able to lower myself to about where my upper legs are parallel to the floor, roughly 90 degree flex. I now go a little lower, to increase ROM, but do not attempt the full deep knee bend squat. This increases the strength of the quads/upper thigh muscles. I do 3 sets of ten. For support and balance, the squats can be done with your back against a wall.

            Something that can be done constantly while at home or at work is to sit on a chair with wheels. Raise the seat height so that when you are seated your upper legs are parallel to the floor. Plant your operated leg/foot flat on the floor and roll the chair forward as far as you can tolerate and hold for several minutes. This will cause your leg to bend past 90 degrees: the farther forward past your foot, the better. I find myself subconsciously tucking my foot under the chair whenever I sit down.

            Finally, a great simple exercise is to stand with your good leg straight and bend and lift your operated knee up as high as you can in front of you, like you were marching in a band. Do as many as you can and as high as you can. This can be a great cardio workout as well as help with ROM. In the beginning I stood next to and held a counter or held onto a chair for balance.

            Don't neglect doing other exercises to for leg straightening/extension.
            When I'm sitting at work or at home, I'll prop my foot up on something that is approximately the same height as the seat, Support your calf and let your knee dangle.
             
          • Josephine

            Josephine NURSE DIRECTOR, BONESMART Administrator

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            I think 'doing nothing' is the other extreme, Tykey. I would never advocate that. Doing little maybe! :wink:
            Though I didn't use it all that much, my exercycle certainly was a great help in getting good functionality in my knee.
             
          • bigbruce

            bigbruce Junior Member

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            Frankly, I think "doing nothing" is downright foolish. I believe it is essential for long term knee health to ensure the muscles both above and below the knee are strong and flexible. This will go a long way towards minimizing the strain on the joint itself. My exercise regime is designed to minimize joint pain while at the same time stretch and strengthen quads, hams, and calf muscles as well as the hip abductors and adductors. I am a few days short of three months post op and have been off pain meds for two months. I workout on my eliptical and recumbent bikes and have both an upper body and leg workout every other day. I can walk pretty much as far as I want - and was even dancing the twist last Saturday night. I attribute most of my recovery success to the regular workouts - particularly the parts that are strengthening my leg muscles.
             
          • kneesrus

            kneesrus Sr Bonesmartie

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            Hi Donna,
            There is a great deal of good advise on exercises. There is not one I would disagree with. Let me add a simple one.
            If you have a ladder, put your left foot on the second rung, then push forward. You can do the same on a set of stairs, use the second step.
            If you feel a sharp pain, don't push it. Mild pain is OK, no sharp pain. That is the body telling you to back off.
            Best of luck.
            David
             
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            • kneeworn

              kneeworn Graduate

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              Thanks everyone I'm getting lots of good information. I have an upright programmable excersize bike too. I will be using it more.

              Today in therapy I tried to concentrate on easing my foot further back on the pedal after I got the seat moved up as far as the knee would flex. I have also found my recently added deep tissue massage on the areas that are trying to form dense scar tissue is making the stretching easier.

              Donna
              LTKR 12/06/2010
               
            • referee54

              referee54 Moderator

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              Thinking back, there was one other thing that helped me. I would sit in my computer chair, as it has casters, and using my heelas, I would rock the chair back and forth. I would bring myself back and forth by just using my heels, and this would stretch my quads. It worked quite nicely.

              Tim C.
               
            • Tykey

              Tykey Sr Bonesmartie

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              I didn't actually suggest doing nothing, Jo, I actually said "get on with an active fit life and it'll just get as well as it ever would. "

              Doing nothing doesn't constitute an active life, which means walking, housework, chasing the grandkids, climbing stairs and all the myriad of things we do in an active life. After the first few weeks getting it working again, you can forget about doing all the straining exercises to try to increase bend. I did loads of exercises in the gym to try to improve it, but it made absolutely no difference, as soon as the swelling went down, that was it!

              And I'm still delighted with the results:smile:
               
            • Josephine

              Josephine NURSE DIRECTOR, BONESMART Administrator

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              I know you are, and I was just 'poking' you! :th_heehee:
               
            • cotton1958

              cotton1958 Supremo

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              Kind of like the suggestion by 'oldie', if you have a bar chair in your house, it's a good way to sit up and pull those knees up by putting your heels in the top foot rest. I definitely got some feel in that. Or you could just go to a bar and do the same thing if you want to get out. Or just eat at a bar and pull those knees up. :whis:

              Also lie on your bed if it's near a wall. Put your legs straight up and slowly creep your feet down. I was doing 2 knees so this was a good one.
               
            • jerseychick

              jerseychick Sr Bonesmartie

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              Another good one is to roll a small ball back and forth using the ball of your foot. I used a 4 pound weighted ball. You can hold for a few minutes on the flexion part.
               
            • ladydi8676

              ladydi8676 Senior

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              Hi Donna,
              I find the exercise bike and also sitting in a chair and pulling my bad leg back with the good one helps a lot! I do this every night for a few minutes at a time and usually the next day I feel that i have more of a bend so far so good.

              Best of luck to you!
              Diane
               
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