TKR Graduated!

[Celle]

*sigh* After 4 weeks of PT, no progress at all on extension, stuck at 6 degrees. I'm bummed. He says I should have kept my leg straight after surgery, I probably bent it and it stuck there. :(

I hate it when PTs try to blame you for something!
It's not your fault and you did nothing wrong.
What your PT said is absolute rubbish.

Your knee being slow to gain extension is more likely to be a reflection that your tendons and ligatures had probably shrunk a bit before your surgery and they now need time, in order to stretch again.

Don't worry. It often takes longer to gain extension than flexion. You can help yourself, by gently doing some of these exercises at home:
Extension: exercises for improvement
Don't try to do them all - just choose one or two that you like. Start doing them for a short while and gradually increase the time.

 

[jmdearras]

Does anyone know if these devices help?
broken link removed: https://www.djoglobal.com/sites/default/files/pdfs/empi/2013-2569-Advance-ROM-Instructional-Sheets-Knee-Extension.pdf

 

[jmdearras]

The PT guy say my hamstring tense whenever he works on my leg. Well, after the very first session, where he used all his strength to force my knee straight, leaving me bed-ridden for the weekend, I am sure I tense up every time he touches me.

 

[hawk2go]

My PT massaged my popliteal (sp?) muscle to help extension. He used a Grafton device and really worked it while I lay on my belly with my legs hanging. My extension continues to improve but much slower than my flexion.

 

[jmdearras]

My PT massaged my popliteal (sp?) muscle to help extension. He used a Grafton device and really worked it while I lay on my belly with my legs hanging. My extension continues to improve but much slower than my flexion.

Interesting. I never heard of the Popliteus muscle. I wonder why the PT never mentioned it.

 

[KarriB]

It'll come. All I did was prop my leg on an ottoman a foot or so away from my chair and let my leg lay there. I did this every day and gravity did the rest.

 

[jmdearras]

It'll come. All I did was prop my leg on an ottoman a foot or so away from my chair and let my leg lay there. I did this every day and gravity did the rest.

Thanks. It just bummed me out when the PT guy said we made no progress since we started, like that was a bad thing. But after 3 weeks of no progress, he thought I needed six more. I turned him down.

 

[Celle]

Does anyone know if these devices help?
broken link removed: https://www.djoglobal.com/sites/default/files/pdfs/empi/2013-2569-Advance-ROM-Instructional-Sheets-Knee-Extension.pdf

They probably work but why go looking for a complicated and uncomfortable mechanical solution when the gentle exercises I suggested will work just as well?

There's no need to rush to get full extension. It's normal for it to take longer than flexion.
Given time and patience, extension will happen.

It's only about 5 weeks since your surgery and this recovery is a year-long journey. What's the rush? Don't let your PT's goals affect your goals. Your knee will recover fully on its own time schedule, not your PT's schedule.

 

[jmdearras]

They probably work but why go looking for a complicatedadn uncomfortable mechanical solution when the gentle exercises I suggested will work just as well?

My PT just kept harping on the fact I sleep on my side, in semi-fetal position, knees generally bent. He said it was undoing the extension work. I could try sleeping with that on.

But more and more, I do not like the PT approach. 3 and a half weeks and no extension or flexion improvement. 125/6 start and yesterday. I think I would be in the same place, or even ahead, without the PT sessions.

 

[skigirl]

LOL, that is what we have all learned at Bonesmart!!! Seriously though, I had some trouble getting full extension on my right leg as well. It took almost 3 months, but I have full extension right now. No rush. Your quad does not fully fire until the extension is about a 3, so you are almost there. I will also tell you that these numbers are subjective. One day a new PT would be there and I would be a digit or two different with that one. so, this is not a huge problem to spend a lot of time worrying about. perfection is an elusive goal.

Just like others have said, sit with your heel on an ottoman and let your knee hang down while you are reading or watching tv. When it starts to hurt, relax and let it losses up before you do it again. I used to lie on my stomach with my legs hanging over off the bed for 5 min. every morning. I could sit on the floor with a five pound weight draped over my knee----all of this resulted in full extension, I am not even sure when it happened.

Also, when waking you can feel your knee pull when you are walking---be aware if you are walking to get the full extension of your knee. You will be fine in a month or two--worry more about getting outside and breathing some fresh air. You are doing great and your knee will be fine!!

When you leave formal PT, you will have more time to do the things that you like---I walked the dogs for two miles every day and rode my bike---it was fun~~

 

[jmdearras]

Friday is my last day of formal PT. PT guy wants six more weeks, but the OS and I agreed I could handle it myself, he feels I am very much ahead of the game for 5 weeks. Thanks for the advice. I do extend my leg when walking. I am to walk 30 minutes a day. Concentrating on extension and gait slows me, but that doesn't bother me. I sit at my desk in the office with a plastic trashcan upside down under the desk and I prop my heel on that periodically throughout the day.

 

[hawk2go]

I sleep on my sides (both) and have since the surgery. In the hospital, they had me in those huge foam heel saver thingies so I could comfortably sleep on my back. That didn't matter, I found a way to sleep on my side, sometimes holding onto the bed bars. At home, I used body pillows behind or in front to keep from over rotating in my sleep. I used regular pillows, sometimes as many as 3 to prop/protect the knee. Now I can get away with no pillow or just one between the knees. Turning in bed gets easier and easier.

I was never chastised for sleeping in my most comfortable position especially during that time when sleep was very elusive.

 

[skigirl]

Really if you think about it---getting to work, working and then getting home involve quite a bit of exercise during your day. I always walked during my lunch hour when I worked. I needed to go outside, get some fresh air and clear my head. My boss would try to get me to a meeting or something during lunch---but, hey, I was not being paid for that 45 minutes---and I needed the time to relax. Eventually he began joining me on the walk!!!!

Nothing is a "must". so, sure, walk 30 min a day---it is a great way to relax, but don't beat yourself up if you are too tired one day to do it. Relax, you are really doing very well, it is time to start enjoying life without knee pain and to find some fun stuff to do!!

 

[jmdearras]

Today is the first day I did not park under the building in the limited "executive" parking handicapped space in months, I used the usual parking deck three blocks away, again! Increasing my exercise, now that I'm essentially pain free.

 

[jmdearras]

wow, 5300 steps, 2.5 miles today. Both legs worn out, but no knee pain. I have to get in shape, State Fair time with my little grandson sunday week.

 

[jmdearras]

OK, referencing my post above, both legs are sore and tired. My body is saying skip the extension exercises tonight. Is it OK to listen to it?

 

[Celle]

Yes. Listen to your body. Skipping for a day will do no harm.

 

[hawk2go]

5300 steps, 2.5 miles today. Both legs worn out, but no knee pain.

Even with the recovery, that's pretty amazing stuff JM.

At 4 weeks out I attended a convention, walked a mile or more each day for 3 days and really paid for it every night. On day 2, I got a lymphatic massage that felt wonderful! I have to find a nearby masseuse.

 

[jmdearras]

OK, after researching my DePuy knee on the internet, I am now starting to get targeted ads for Depuy surgical tools!

 

[jmdearras]

As I sit here nursing my tortured (only slightly!) knee, I am finished with office PT! Last session this morning. 4 weeks ago, I started with 126/6. Today I graduated with 126/6!! PT was reluctant to let me go, but the OS said I could continue PT on my own. I get so tense with the PT guy, after the second session where I was tearing up as he pounded my knee, that I think I can never get anywhere with him.