Become an Insider

TKR One year kneeversary

keefsmom said:
The PTs at the practice I have been going to keep tells by me that they are focusing more on extension than flexion because you can always gain flexion later on but extension has to come in first 12 weeks.
I haven't told them they're misinformed in general about a limited window of opportunity, just wondering, though, if anyone else has heard this extension first flexion later philosophy?
Click to expand...
I've never heard this before and I think it's rubbish.

It's normal for extension to take longer to achieve than flexion, but it can continue to improve for well over a year.

Many times, to increase extension, you have to gradually stretch the muscles and tendons at the back of your leg, especially if your leg was a bit bent before surgery. Any soft tissues that have shortened need to be encouraged gently and not rushed. Trying to do too much, too soon with extension could result in tearing some of the fibres in those tendons and muscles. Slow and steady is the way to go.

Here's an article about extension, with some suggestions for exercise. Just choose one or two that you like, and do them gently. Don't use weights until at least 4 months after surgery.
Extension: how to estimate it and ways to improve it
 
keefsmom said:
The PTs at the practice I have been going to keep tells by me that they are focusing more on extension than flexion because you can always gain flexion later on but extension has to come in first 12 weeks.
I haven't told them they're misinformed in general about a limited window of opportunity, just wondering, though, if anyone else has heard this extension first flexion later philosophy?
Click to expand...

I think your PTs are dead wrong. Yes, it can take longer to gain extension, because it's not a matter of getting swelling to go down, it's a matter of stretching some big, tough tendons. Those tendons will stretch, but it takes lots of time and effort if the extension is bad. A few degrees can take weeks. My left knee started at 5 after surgery and is just now at 1, closing in on 0. Seven weeks. So an extension of 20 would take even longer, I would think. So slow and gentle, and consistent stretching is what's needed.
 
No @pheebs I'm in the 0 to 3 range...
Yes, Susie those tendons of mine are quite tight and, as you say, it's partly because I haven't had good extension on either knee for years.
I do the recommended exercises celle linked to, not much else, but I have started stretching my hamstrings, they're my nemesis!
 
https://www.nytimes.com/2017/07/03/...l_art=11&nlid=65605178&ref=headline&te=1&_r=0
Many of you likely aware of NY Times writer Jane Brody who has chronicled her knee journey that ended in a BTKR. Her latest story quotes some pretty damning evidence via a JAMA study on poor results from arthroscopic surgery as well as other things we try to forestall TKRs. Maybe as the false belief that one has to wait till 60s or later to undergo surgery dissipates, more folks will choose to go the TKR route sooner.
As for me...office expects me at desk for 8 hours Monday! I think I'm ready, but bringing my cryo cuff and planning on setting a timer so I remember to get up and move every hour. Wish me luck!
 
Very interesting article. So many of us have had numerous surgeries for these repairs and are still here facing or having had a tkr. We all just helped to make the HMOs rich!
 
I read that article when it was published and naturally, added my name to the list of those disenchanted with arthroscopic surgery. In my case, it was used to remove a large piece of my torn, medial meniscus, but also used as a diagnostic tool with no promises of a *happier* knee afterward. That said, it actually made everything far worse, because there was that much less cushioning for the bone-on-bone OA. I'd say it was instrumental in my realization a TKR was really needed, a concept I'd been floating down Da Nile for a few months.

Monday is *Back to work day*, eh? 8 hours sounds....long to me, but perhaps you feel differently, physically and mentally? I hope you do! I'd definitely bring the cryo-cuff and perhaps a small footstool. If you cna manage a small sofa, all the better.:sleep:
 
Good luck going back to work! I don't think I could face 8 hours yet, my ROM is not yet at 90, however I'm going to try for 3 hours on Monday and see how it works out.
 
I'll be sending vibes of strength your way @dvannie! I just realized that I have PT on Monday at 3 so I'll have to leave early! DRAT. :heehee:
I'm feeling pretty good, I just have a stiff knee. Oh and a right knee that's bone on bone but I'd been working 40 hrs a week with two of those for the past 5 years! I can always work from home part of the week but my 20-something employees need to see my stern visage!
 
@Pheebs52 i only had the synvisc injections but 2 series of 3 over two years and with the thickest needle i ever hope to see. Awful that you had to go through that surgery only to see your condition worsen there's something to what @sistersinhim says, huzzah for our wonderful medical system, huh?
 
Hah, hurray for the PT appointment! Saved by the exercise @keefsmom! Perhaps you could make a large, Kim Jong Un style poster of your stern visage to help keep those 20-somethings in line while you're working at home? Just a thought.:snork:

It's my understanding (limited though it may be) that arthroscopic surgery can work well for much younger people without severe, bone-on-bone OA. Obviously, I did not fall into that category, but the severity of my condition was unknown until that unwelcome arthroscopy was performed. The MRI and X-Rays showed OA, but failed to show the extent of damage; puzzling, but true. Without having gone through that and seeing the actual bone-on-bone deterioration, my insurance may not have covered a TKR. I'm not 100% certain about that, but am 99% certain.
 
My last meniscus repair let to tkr within 7 months. And it was with a different OS. The meniscus repair left me with more pain.
 
@sistersinhim, I doubt I'd ever do it again. I'd just ask for a new knee and hope the OS could somehow wangle it through the insurance company.
 
Joining the ODIC.
Yesterday my PT decided I wasn't working hard enough and added weights to the quad arcs, increased the height of the step box to the highest one they had, and made me walk laterally with the band around my knees. And now I know what everyone means when they say it feels like a rubber band is wrapped around their knee. Icing and elevating now but need to go to work for at least a half day...let's see how long I last. May need to cancel PT tomorrow. Grrrr.
 
Oh and @SusieShoes remember your "pimple" from the escaped stitch! I have one now too! And it is sore as heck! Did yours ever resolve? This is like 3 weeks after the PA snipped off the end of the stitch that was poking out.
 
Way too early for weights at less than 2 months post op. I hope you don't let that happen again. What is your ROM?
 
You must log in or register to reply here.
Corganics CBD

Members online

No members online now.
Total: 1,481 (members: 0, guests: 1,481)

Latest posts

Back
Top Bottom