TKR Extension issues

[Lilkat]

Hello all..I had TKR on Jan 25. I cannot extend my leg. My numbers have been the same. 11 to 14 degrees from full extension. In addition to PT I have hired a medical massage therapist and no luck with getting better extension. I am using a joint activation brace 3 times a day for extension.
I am now experiencing hip pain in the middle of the night. I am 53 / 119 pounds. I have always been pretty fit. I have been feeling defeated Any one else experience issues with extension and bad hip pain?

 

[Jockette]

@Lilkat Hi and Welcome to Bonesmart!

Extension often takes longer to come back than our bend does. This recovery does take an average of a year, so you are still in early days. Was your leg straight before your surgery?

I wonder if the brace is causing some issues resulting in hip pain. Do you walk around with it on?

What is PT doing to help your extension?

BoneSmart philosophy for sensible post op therapy

You will have noticed there is a significant opinion here about the potential hazards of PT. You may feel that your therapists are experts and know what you should be doing. However, over the last several years I've been here, I have observed that the more intensive the regimen of exercising...

bonesmart.org

 

[Jockette]

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

Knee Recovery: The Guidelines

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

2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

​

If you want to use something to help heal the incision, ​

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.​

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​

6. Access to these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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?

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 the 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 the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[Lilkat]

Hello I lost extension about 2 months before surgery. I cannot walk with the “JAS” brace on. I use it 3x a day for 30 minutes each session. I sit on the floor and crank it down every 5 minutes.
PT does massage work and then pushes down holds and releases. Stretch calves. I gain a degree but when I begin to walk I default back to where I was before.

 

[Jockette]

PT does massage work and then pushes down holds and releases. Stretch calves. I gain a degree but when I begin to walk I default back to where I was before.

There is no need for your PT to push down on your leg. As you can see, using force does not help you, and it can increase your swelling and inflammation, as well as pain, which can lengthen an already long and slow recovery. I suggest you stop allowing them to do this.

Do you feel the brace is helping you?

Saying no to therapy - am I allowed to?

Walking with a heel to toe motion will gently help you regain extension. Also, some members find taking a longer stride (bigger step forward) helps, but if you try this, make sure you have something to hold on to, so you don’t fall.

 

[mendogal]

I agree that PT is actively hindering your progress by creating more swelling.

The leg has to heal more, have swelling resolve more, and have the muscles relax. Gentle range of motion and stretching will help loosen, and your massage therapist can focus on releases so tight muscles are encouraged to kick let go.

 

[Alwaysmoody]

Hello I lost extension about 2 months before surgery. I cannot walk with the “JAS” brace on. I use it 3x a day for 30 minutes each session. I sit on the floor and crank it down every 5 minutes.
PT does massage work and then pushes down holds and releases. Stretch calves. I gain a degree but when I begin to walk I default back to where I was before.

Hi Lilkat,

Hello all..I had TKR on Jan 25. I cannot extend my leg. My numbers have been the same. 11 to 14 degrees from full extension. In addition to PT I have hired a medical massage therapist and no luck with getting better extension. I am using a joint activation brace 3 times a day for extension.
I am now experiencing hip pain in the middle of the night. I am 53 / 119 pounds. I have always been pretty fit. I have been feeling defeated Any one else experience issues with extension and bad hip pain?

Lilkat I had my right TKR 18th December 23
Within 3/4 weeks of physio I had ROM of 120 and 130 degrees by 6 weeks very good extension too the PTs were delighted with themselves, BUT ….., Now I’m at home and can’t sleep properly and when I told my surgeon my hip was hurting he said maybe I need to get that done too, I then informed him I had it done in 2015. Please take it easy on the physio, they pushed me to get the results they wanted and now I’m paying for that. Give yourself time you will be fine. God bless

 

[Lilkat]

@Jockette
I am finding the brace is helpful for a short time. I have gained more flexion with it and extension is only temporary and then that knee just goes right back to that position.

 

[Layla]

Happy Three Month Anniversary, Lilkat
I hope you have a nice day and a wonderful weekend!
@Lilkat

 

[Lilkat]

Thank you ! Have a great day