PKR JusticeRider’s rehab adventure

[JusticeRider]

Ok, I’ve been wanting to share about my new PT because she. Is. Fabulous! But first…I lowered the bike seat another click yesterday!! Yay!! More progress I can’t remember how many clicks I’ve gone now but I can tell you that there is only one click left before it’s all the way down! Keep in mind that my husband installed smaller crank arms on the pedals for me before I could make a full rotation. So on a ‘normal’ stationary bike, the flexion would be greater than it is on mine. But regardless, I’ve come a long way!

 

[JusticeRider]

Ok, so this great PT…! Her approach is so gentle and holistic. It is not the same old repetitive leg lifts, clamshells, step-ups, box squats, etc etc. (Do those sound familiar to anyone??) She is looking at my whole body and addressing imbalances, compensating patterns, muscle weakness, tension, etc. She does a lot of manual therapy and a lot of cluing me in to what my body is doing through different NORMAL, natural movements.

She does not measure my ROM or fixate on it. In fact, regarding my flexion she said, “You know your knee. It seems like you have been making good progress with your flexion with what you’ve been doing, so if you want to keep working on that on your own at home, there are PLENTY of other things we can work on here. And all of it will help with that flexion anyway, either directly or indirectly.” (A PT who actually trusts me to know what works for my knee? Wow!) Oh, and she does not buy into the whole ‘time limit’ mindset for gaining ROM at all. She said she sees patients continue to progress for years.

Here are some examples of my ‘homework’:

-stand squarely on L foot, leg like a column
-external rotation (toe turn-outs) for knee and hip, square pelvis
-various stretches for tight hips, adductors, ribs, and quads (including the best quad stretch I’ve ever done!)
-Let ribs ‘float’, while standing and while walking, to release tension in torso
-Cat-cow (thinking of you, @EalingGran!)

All these are done very mindfully ‘for a few minutes each’ whatever feels right.

There are a few other things, but those are some examples. So different from all the PT (years!!) I have had before. She is such a BoneSmart-y PT, haha! Love her.

 

[EalingGran]

All these are done very mindfully ‘for a few minutes each’ whatever feels right.

Very like the pilates approach. Working with your body not against it.
Are you managing the kneeling for cat stretches ok?

 

[Mettleinside]

@JusticeRider - YES, sadly, all of those exercises are very familiar.

 

[JusticeRider]

Are you managing the kneeling for cat stretches ok?

Hi there, EalingGran! Yes, I’m kneeling on my bed and it feels fine! I just started these, so I haven’t tried any other surfaces yet, but I think I’ll be able to work up to it. We’ll see…!

YES, sadly, all of those exercises are very familiar.

One reason I decided not to go back to my old PT. I know exactly what they’d have me do, and I wanted something different than the cookie cutter approach. I must have done millions of leg lifts over the years!

Are you currently in PT, Mettleinside?

 

[Mettleinside]

@JusticeRider - No, I am not in PT anymore but had 2 months of it though. It had almost all of the exercises you described plus some WONDERFUL manipulations. Meaning very uncomfortable manipulations. I actually liked all the leg extensions, leg press, box squats, etc., The only thing I didn't like were the manipulations, although I do believe I got some good out of them ultimately. I probably only had 1 or 2 little swelling setbacks due to those manipulations. Quick icing session got me through those.
Have approximately 125 on flex and 0 on extension at this stage of my game.
I am glad you are avoiding that and I can see in realtime how you are progressing with your recovery with no "traditional" PT.

 

[EalingGran]

Yes, I’m kneeling on my bed and it feels fine! I just started these, so I haven’t tried any other surfaces yet

Get some knee pad cushions before you try kneeling on the floor. They were pretty cheap on Amazon and really help.

 

[JusticeRider]

@EalingGran can you share which knee pads you got? Thanks!

 

[EalingGran]

I can't find the exact one I got on Amazon any more but there are a lot of different ones. Just Google yoga knee pads.
Mine was a pack of two- each just over an inch thick foam with a washable cover.
There are also single longer ones. The separate ones are a bit more flexible.
There are also gel ones. I would try to get slightly thicker ones. Not sure the really thin ones would work. Mine were about £10 ( 12 dollars). There are some really thick ones which are more expensive but I would try the cheap ones first.

 

[WFD]

If you are talking about separate pads, not the ones you wear, then the pads sold for kneeling in the garden are nice and thick. In the US Home Depot has a super thick one, carrying the Husky Brand, which I bought for $14.88 to sit on but it would be great for kneeling.

 

[JusticeRider]

@EalingGran and @WFD , how about wearing the yoga knee pads and kneeling on the Husky pad?? That oughta take care of it
But seriously, these are both great suggestions and I may try both (though probably not at the same time!)

 

[EalingGran]

That Husky pad looks great and the thickness would be perfect. I haven’t seen that brand in the UK.

 

[WFD]

Husky is a store brand for Home Depot so it is only found in stores belonging to that chain. I’m sure there are equivalents in th UK.

 

[EalingGran]

After Partial Knee Replacement, Patients Can Kneel, But They Need to Be Taught to Do So: A Single-Blind Randomized Controlled Trial
Cathy Jenkins, Karen L Barker, Hemant Pandit, Christopher AF Dodd, David W Murray Author Notes
Physical Therapy, Volume 88, Issue 9, 1 September 2008, Pages 1012–1021, https://doi.org/10.2522/ptj.20070374
Published: 01 September 2008

 

[EalingGran]

This paper actually gives quite detailed advice on how to kneel and it is fully available free. The patients were
all medial PKR. The interesting thing is that the group who were given one- off kneeling advice were much better at kneeling than the group that didn't- despite both the intervention and non- intervention groups having equal ROM. It suggests you need about 111° to kneel ( not sure why it says 111° and not 110°!!)

 

[beachy]

Just popped in to say HI!
Sounds like you're doing great!
All is well with Pia. I haven't been on BS much because....life LOL

 

[EalingGran]

Hello @beachy. Sounds like you are doing great too!

 

[JusticeRider]

Hi everyone! We have been spring cleaning. Yesterday was a marathon day that my knee could not have handled even a month ago. We moved everything out of the house and dusted and cleaned and washed every surface and nook and cranny. It was a ridiculous amount of work for one day. I can’t believe how well my knee did! It did started to tighten up by late afternoon and I put my compression sleeve on. By late evening, it felt quite tight, and a little swollen, but I pedaled a bit on the bike and put it up for a while and today it’s been good! On the other hand, every muscle in my body is sore.

@EalingGran , I have read that study you sent. I also find it interesting that kneeling can be made accessible by simply teaching people how. Sounds as if technique and just overcoming the mental barriers are key, doesn’t it? I do wish there were similar studies we could read that included lateral and patellofemoral PKR’s. I guess we will have to find our own way!

@beachy , hi!! Thanks for popping in to my thread I figured you must be out there living your best life! I’m so glad to hear you’re doing well. Do you still feel like you’re seeing big changes as time goes by or do you think the progression has slowed? Any big goals or plans coming up this summer? Cheering for you over here!

 

[Susie-Q]

I could put my hands flat on the floor with my legs straight.

I can do this too. I'll be interested in reading that article, thanks for posting......

 

[Susie-Q]

gastroesophageal reflux disease (GERD) are more common in people with hypermobility syndrome.

Wow..... I have this too. Don't you also, @sistersinhim? I thought it was from my overuse of Advil over the years (and maybe it still could be). I don't have a high Beighton score, I guess I'm a 3. I don't have the hyperflexibility in my hands or elbows but I can hyper extend my knees on both sides (my extension is -2 or -3) and I can still touch the floor with flat hands, although not as easily as I could when I was younger.

This article is a bit eye-opening for me as well........ I am identifying with many of the symptoms.......