Regaining Leg/Knee Extension Capability Following a Gym-Based Injury – A “Course Correction” After A 9 Month Delay/Detour

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Hi folks.

New member here from the United Kingdom – I am very happy to join the forum, which looks to be a great resource and community.

I just thought I’d make a thread all about regaining leg/knee extension capability, which has been lost, to a significant degree, following a gym-based injury, and where there has been a long delay (9 months) in getting the right investigation and treatment strategy in place.

I was fortunate to find this forum after Googling around on this topic, and finding a thread from this board (among a number of others online) – which indicates the process can be very difficult.

For easier reading, I have split-up this opening post into the following sections:

1. My Injury
2. My Understanding of the Relevant Broad Injury Types That May Apply
3. My UK NHS Journey – A 9 Month Delay (Detour) Before Starting the Right Recovery Process
4. My Hope for a Course Correction and a Full Recovery
5. My Current Home-Based Self-Led Physiotherapy Activities
6. Questions to Ask
7. Next Steps and Future Posts
8. A “TLDR Summary” of My Main Learning Outcomes So Far

I apologise for the long length of the post – it was my intention to be as thorough as I can, to better inform folks in a similar situation. Also, as an aside, and for the avoidance of doubt, this post is 100% hand-typed by me (in Microsoft Word, then copied-in), and did not utilise any AI!

Here we go…


PART 1. MY INJURY

I injured myself in the gym just under 9 months ago. The injury was sustained by doing intense work on the back extension apparatus (also known as the Roman Chair), followed by standing calf raises.

At the time, I noted a significant degree of pressure, tightness, and discomfort behind both of my knees.

The result of my injury was a gradual tightening of my legs (loss of leg/knee extension ability). Circa two days later, I could not stand-up or walk independently. I have been in that condition ever since. I have lost a considerable amount of leg/knee extension ability on both legs, in addition to a noticeable degree of muscle-mass. My on-crutches mobility is decreasing.

I believe my injury is musculoskeletal in nature, and that it mostly relates to my rear-of-the-leg muscles, tendons and ligaments.

If breaking-down the injury into its component parts, I believe that I may have incurred a combination dual-leg injury, which may span over the following areas:

1. Some key muscles of the calves (Gastrocnemius and Soleus) – particularly at the insertion points near to the rear of the knees.
2. Some key muscles of the hamstrings (Biceps Femoris, Semimembranosus, Semitendinosus) – again, particularly at the insertion points near to the rear of the knees.
3. Some lesser known supportive muscles (which support the rear of the knees), such as the Plantaris and Popliteus.
4. Perhaps the cruciate knee ligaments (either the Anterior Cruciate Ligament [ACL] or Posterior Cruciate Ligament [PCL]).
5. Perhaps the meniscus.

I recognise that I am being very imprecise at this stage.

The reason I cannot be more precise, is that I am pre-consultation (with an Orthopaedic specialist/consultant) and pre-imaging (via X-Ray, CT, and MRI).

I hope to post back later when I know more about what is actually injured in my legs/knees, following some consultations and imaging.


PART 2. MY UNDERSTANDING OF THE RELEVANT BROAD INJURY TYPES THAT MAY APPLY

So far, I have read quite far-and-wide about what broad category of condition that I might be dealing with. I believe my dual-leg tightening condition may fall under one of the following broad categories:

1. Locked Knees – True/Mechanical Type; or
2. Locked Knees – Pseudo Type; or
3. Fixed Flexion Deformity (FFD) / Fixed Flexion Contracture / Flexion Contracture Deformity of the knees.

Out of those, my instinct is that I have Fixed Flexion Deformity (FFD)/Contracture of the knees. Under that category, it looks like a difficult recovery journey is ahead. Some of the solutions (both conservative/non-surgical and surgical) look to be quite daunting. In regards to both problem-identification and solutions, I understand that I will need to get real-life advice from an expert (preferably an Orthopaedic surgeon, backed-up by adjunct services, such as Physiotherapy).

I might post back later (in a follow-up post) with a summary of my very rudimentary understanding of each broad category of condition, and my basic grasp of the various solutions for each. I’m wary of getting into “medical advice” territory however, as that, as far as I understand it, is against the rules of the forum. So, for the meantime, I have just posted the broad category names that I think may apply.


PART 3. MY UK NHS JOURNEY – A 9 MONTH DELAY (DETOUR) BEFORE STARTING THE RIGHT RECOVERY PROCESS

Sadly, my recovery trajectory is about 9 months behind schedule, due to an unfortunate UK NHS (National Health Service) investigation strategy, which placed me on a neurological investigation pathway (and not an orthopaedic pathway). They sought to investigate my spinal discs, and rule out any Sciatic nerve root/rootlet pressing/impingement issues first of all. I believe their logic was that a Sciatic nerve root/rootlet pressing/impingement issue (in the spine) may have been manifesting itself in the form of bilateral behind-the-leg tightness, bilateral leg/knee extension contraction and general bilateral leg weakness.

This took a very long time. Each step of the process (GP [General Practitioner] > Consultant > MRI > MRI results > Discuss MRI results with Consultant) has taken multiple months each.

Also, I was discouraged from seeking physiotherapy during this time, under a risk-averse approach.

My NHS whole-spine MRI has come back clean – there is actually no spinal disc-related injuries, and no Sciatic nerve root/rootlet pressing/impingement issues at all.

Of course, I am relieved that I don’t have a spinal disc injury, nor a Sciatic nerve root/rootlet pressing/impingement issue. However, I am also bitterly disappointed and frustrated (angry even) about the whole UK NHS process so far. 9 months later, I am back at where I started, and back to my original suspicion of an injury that is musculoskeletal in nature, and that mostly relates to my rear-of-the-leg muscles, tendons and ligaments. This is what I tried to suggest to the NHS professionals I interacted with (GP [General Practitioner], followed by locum Consultant Neurologist) in the first place.

So, I am definitely “behind” (arguably, “well behind”) in my journey to a recovery, and my legs/knees have tightened-up further over this lost time. It is a very disadvantageous situation.

In retrospect, I should have:

1. Been much more savvy by researching my injury more quickly, and perhaps reaching-out to the right online communities.
2. Investigated private healthcare options much sooner, and arguably immediately.
3. “Stuck to my guns” more resolutely during my NHS interactions, including advocating for my initial suspicion of a leg-based musculoskeletal injury.

That is easier said than done of course, as I put a lot of trust and faith in the medical professionals I interacted with, and had no prior experience of engaging with the UK NHS for a serious injury. I have learned some hard lessons on my journey so far.


PART 4. MY HOPE FOR A COURSE CORRECTION AND A FULL RECOVERY

I am now in the process of implementing a course correction, which will involve:

1. Consulting with a private Orthopaedic Consultant/Surgeon.
2. Undertaking private imaging (a combination of X-Ray, CT, and preferably MRI, under the private Orthopaedic consultant/surgeon’s guidance).
3. Undertaking private:
   1. Physiotherapy.
   2. Remedial/deep tissue/sports massage.
   3. Additional therapies, such as Shockwave Therapy (if I am recommended it, which is not always guaranteed, as sometimes it is unsuitable/contraindicated for certain situations).
4. Referral to an NHS Orthopaedic Consultant/Surgeon. (This will take months, so I am relying more on the private options above.)
5. Referral to an NHS physiotherapy service. (Again, this will take some time, and is known to be limited in scope, so I am relying more on the private options above.)

Looking ahead, I am hopeful that I can recover under conservative methods (i.e., without surgery). However, if it turns-out my prospects of a non-surgical recovery are bleak – and that surgery is the only solution – I will go for it.


PART 5. MY CURRENT HOME-BASED SELF-LED PHYSIOTHERAPY ACTIVITIES

After my whole spine MRI came back clean, I decided to set the previous “avoid physiotherapy” advice aside, and started doing some very rudimentary self-led physiotherapy type activities at home. I plan to continue with these while I am waiting for my upcoming appointments.

I do what I can – but I can’t do much.

Here is what I do at the moment, in the order set out below.

The whole run-though can take about 1 to 1.5 hours.


(1) Massage: [Every 2 days or so]

• Self-massage of my legs, and in particular, the calves, hamstrings, and carefully behind the knees. I use my hands, plus a lacrosse ball for this. In my view, this is not, by a long-shot, as good as a “proper” remedial or deep-tissue massage from a professional. But, I see it is “better than nothing”.
• I don’t do this every day. Every 2 days or so is my frequency.

(2) Very basic strength movements: [Every day]

• Legs:
  • Seated bodyweight Calf Raises, including static-holds/isometrics at the top position.
  • Bodyweight Glute Bridge (AKA: Laying-down Hip Raise) static/isometric-holds. I use a few different feet placement positions, to emphasise:
    • The quads.
    • The hamstrings.
    • The glutes.
  • A number of low-position Bodyweight Squat static-holds/isometrics (as anything involving a high-position squat static-hold/isometric is impossible for me). I move into the low-squat stance from my bed or a chair. I can only hold these for a short moment – 15 seconds or so is my record. One “hold” is one rep. I aim for circa 10 reps, but often only manage 8 or so, as fatigue sets in, and I don’t want to take unnecessary risks.
• Core:
  • Series of floor/mat-based Hollows (with bent-legs/knees), Curl-Ups, Deadbugs, or similar anterior (front) core orientated movements.

(3) Low-load, long-duration stretching for the rear of the legs: [Every 2 days]

• I do a very basic derivative of prone hangs, based on the floor / a mat. I get into a position on my stomach, and just let my legs “hang out behind me”, with the aim of the weight of my feet/lower-legs, plus tension applied in the hamstrings, slowly encouraging the legs/knees extend out.
  • Observations:
    • Low-load, long-duration stretching is very often recommended in articles about conservative recovery from a Fixed Flexion Deformity (FFD) (AKA: an inability to fully extend the knees and legs) situation.
    • My success with prone hangs has been very limited so far, but I will persevere with them.
    • Due to my level of flexion deformity/contracture, I am far away from the kind of generous extension often seen in online example images of prone hangs.
    • They can be quite unpleasant to do, and can feel “pretty nasty” behind-the-knees as the minutes tick by.
    • I notice only tiny amount of enhanced extension movement when I do these, such is the level of my flexion deformity/contracture.
    • I do these every 2 days or so (as they can be “very unpleasant” to do), but I should probably be doing these every day. I might start doing them every day, if instructed.

PART 6. QUESTIONS TO ASK

I’m seeing my private Orthopaedic Surgeon and private Physiotherapist soon, for initial appointments.


Questions for private Orthopaedic Surgeon

So far, I can only really think of the following questions to ask the private Orthopaedic Surgeon:

• What are my chances of a non-surgical (conservative care) recovery?
• If surgery is required:
  • What type of surgery would be best? (i.e., what type of surgery would be selected?)
  • What are the chances of a complete recovery?
  • What are the risks involved with the selected surgery?
  • How long would I be in hospital?
  • What would the post-surgery rehabilitation process be?

I suspect that I might have to wait until the post-imaging consultation for realistic answers.

Questions for private Physiotherapist

I could only think of a smaller number of questions to ask my private Physiotherapist:

• What are my chances of a non-surgical (conservative care) recovery?
• How far can a physiotherapy (and related therapies) approach take me towards a recovery?

If anyone thinks I should be asking anything else, please do post!


PART 7. NEXT STEPS AND FUTURE POSTS

The next few weeks involve a lot of important appointments (meetings with an Orthopaedic Consultant, meetings with Physiotherapists, plus undertaking imaging).

I’ll try to post back with the process as it unfolds, to give others in similar situations an insight into what a recovery from this type of injury will entail.


PART 8. A “TLDR SUMMARY” OF MY MAIN LEARNING OUTCOMES SO FAR

1. If you get a serious knee injury in the United Kingdom, and you can afford it, take-up good-quality private healthcare (private consultation with an Orthopaedic Consultant/Surgeon, private imaging, private post-imaging consultation, private physiotherapy, potential private surgery) as soon as you can. If you are fortunate to have some resources for this available, the time-and-speed advantages are clear.
   
   
2. If you are only able to undertake an NHS pathway for a serious bilateral knee injury, be prepared to:
   • Advocate for yourself generally, and “stick to your guns” if you are sure the issue is a knee/leg issue, and not a back issue.
   • Give a full, true and accurate account of your injury, and do not underplay it.
   • Ask for a referral for a consultation with an Orthopaedic Consultant.
   • Ask for a good-quality knee/leg orientated MRI.
   • Ask for referral to an NHS physiotherapist (but be aware that NHS physiotherapy can be very basic).
   • Wait a very long time for initial appointments, and then in-between appointments.
3. Start a careful (non-injurious/non-exacerbating) physiotherapy/rehabilitation process as soon as you can, preferably under the guidance of a professional (a qualified physiotherapist).

Thanks for reading my long post.

I hope the post was informative in some way (especially for folks in the UK).

I look forwards to posting back with updates, and all the best!

I want to suggest that you try to find a clinic that can do an MSK ultrasound to investigate your idea of damaged soft tissue. I had one recently and it allowed the radiologist to determine damage swelling and scaring.

 

[ExtensionSeeker]

Thanks for that tip -- very much appreciated.

Interestingly, my physiotherapy clinic does do MSK ultrasound. I'll raise the possibility of looking into that the next time I see them.

All the best.

 

[ExtensionSeeker]

Hi folks.

Hope everyone is well.

Just another quick update.

I had my private MRI at the end of August, and am now awaiting the results.

I plan to wait a little bit (about 5 days after the scan), then book an appointment with my private Orthopaedic Knee Surgeon to discuss the results, hopefully some time next week.

Upsides

For the most part, my private (and fairly challenging) physiotherapy (both guided, and at home) has been going really great. Over the course of a mere 6-7 weeks, I have come from lacking circa 50+ degrees of full knee/leg extension (and mobilising on crutches on my 'tip-toes'), to now being, by my very rough estimate, perhaps around 10 (positive estimate) or 15 (cautious estimate) degrees away.

Some great progress indicators are:

1. Being able to lay down on my back, and 'nearly' have my legs straight when I extend them. There is still a slight bend (as noted above) however.
2. Being able to undertake the double-knee MRI scan (one knee at a time), with an almost straight leg on each leg (as fortuitously, the MRI day was the day after a good guided physiotherapy session).
3. Being able to sleep on my front, with my legs almost fully extended, albeit with a very slight bend to the left or right for comfort.
4. Being able to walk short distances in the house in my socks, albeit with quite an unsteady gait, and with a single cane/walking stick.
5. Being able to walk longer distances outside, albeit with quite an unsteady gait, with a single cane/walking stick, and using 3/4 of an inch heel lifts in my shoes/trainers. (The heel lifts are 1/4 of an inch down from a full inch, which is what I was using the previous week.)

I no longer use any of the following, which has been a massive boost, both physically and mentally:

1. Construction worker's knee-pads to crawl around the house. (That was really awful, and was my condition for circa 10 months.)
2. Elbow crutches to mobilise outside.

Downsides

I feel that I may have developed an injury on my right knee. Something feels 'off' inside the knee, and I am in pain on that knee when I do my cane-assisted walking (hence the need for a cane). I need to walk very carefully with the cane/walking stick. The worst case scenario is that I have a slight feeling it could be a meniscus issue. Hopefully, it is just a passing injury, perhaps due to walking too much recently (and loving being 'almost' able to walk). The MRI may reveal an issue here.

I still feel very tight behind both knees when standing-up. I am hopeful that I can continue to make progress with this however.

Other

My private physiotherapist has recommended I add a new exercise to my regimen.

It is 'band-resisted TKEs' (band-resisted Terminal Knee Extensions). A band is looped around, say, a bannister and the back of the knee, and the knee is brought backwards against the resistance of the band. The aim, I believe, is to further target/work the quadriceps and the VMO (Vastus Medialis Obliquus). I feel that I already achieved a fair amount of weekly quad activation from my Glute Bridges, but this will certainly add to that.


All the best folks, take care, and I will post back when I get my MRI results and/or make further progress.

 

[EalingGran]

The aim, I believe, is to further target/work the quadriceps and the VMO (Vastus Medialis Obliquus)

The VMO is a tricky muscle to engage as it only really comes into action in the last 10-15 degrees of extension, according to my pilates teacher. I need to work on it, because I have a chronically overstretched medial collateral ligament and the VMO keeps it as tight as it will go.
The exercise I have been taught is to lie on my back with my good leg bent and the bad leg resting on a stack of a couple of cushions, topped by a small pilates ball. You then elevate and straighten the leg, then turn the toes outwards and gradually try to bring the straight leg medially. Then reverse the movements, relax and repeat a few times.
If you are doing it right, you can feel the medial quad engaging.
I will be interested to hear what your physio suggests.

 

[ExtensionSeeker]

Hi there EalingGran -- thanks very much for that alternative VMO option.

I was not aware of the trickiness of engaging the VMO!

By my very rough 'guesstimate', I am hopeful that I am now in that last '10-15 degrees off full extension' range, but I think I will ask for a goniometer (a tool with two extending arms, which can measure a joint's range of motion in degrees) measurement when I see my physio this week.

I'll also ask about alternative methods to the banded TKE for VMO activation, and see what he says.

Thanks again and all the best.

 

[ExtensionSeeker]

Hi folks.

I hope everyone is well.

I had my post dual-knee MRI consultation with my private Orthopaedic Knee Surgeon last week.

He very kindly talked me through my dual-knee MRI results, and gave me a printed letter of the Consultant Radiologist’s report for each knee.

The Consultant Radiologist’s report was extremely dense – it was absolutely packed with complex information and terminology.

It has taken me a long to time to interpret and understand a lot of it. The following interpretation (below) only scratches the surface of the depth and clarity of the actual report, but still presents the main points.

I have split the post up into the following sections for easier reading:

• Part 1. The Good News – Most ‘Key Structures’ Intact
• Part 2. The Not So Good News – Right Knee
• Part 3. The Not So Good News – Left Knee
• Part 4. Some Very Basic Definitions/Vocabulary (To Quickly Explain Some Aspects of Parts 2 And 3)
• Part 5. The Consultation
• Part 6. My Own Conclusions

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PART 1. THE GOOD NEWS – MOST ‘KEY STRUCTURES’ INTACT

The good news was that no significant mechanical blockages (impinging against full knee extension) were found on either knee.

The dual-knee MRI report description indicated that:

For my left knee: All the following were fully intact:

1. Medial meniscus (‘inner side’ meniscus).
2. Lateral meniscus (‘outer side’ meniscus).
3. ACL (Anterior Cruciate Ligament).
4. PCL (Posterior Cruciate Ligament).
5. MCL (Medial Collateral Ligament).
6. LCL (Lateral Collateral Ligament).
7. Posterolateral corner structures. (These are a group of ligaments, tendons, and capsule tissue at the back-outer corner of the knee (the popliteus tendon among them, plus the LCL and several smaller stabilisers) that work together to resist the knee twisting and hinging outward.)
8. Extensor mechanism. (This is a ‘chain’ that straightens the knee: the quadriceps muscle, the quadriceps tendon, the kneecap itself, and the patellar tendon [connecting the kneecap to the shin]).

This was great news

For my right knee: All the following were fully intact:

1. Lateral meniscus (‘outer side’ meniscus).
2. ACL (Anterior Cruciate Ligament).
3. PCL (Posterior Cruciate Ligament).
4. MCL (Medial Collateral Ligament).
5. LCL (Lateral Collateral Ligament).
6. Posterolateral corner structures. (As noted above, these are a group of ligaments, tendons, and capsule tissue at the back-outer corner of the knee (the popliteus tendon among them, plus the LCL and several smaller stabilisers) that work together to resist the knee twisting and hinging outward.)
7. Extensor mechanism (quadriceps tendon, kneecap, patellar tendon). (As noted above, this is a ‘chain’ that straightens the knee: the quadriceps muscle, the quadriceps tendon, the kneecap itself, and the patellar tendon [connecting the kneecap to the shin]).

Again, this was mostly all great news (barring the medial meniscus [the meniscus on the ‘inner side’] which I will detail below).


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PART 2. THE NOT SO GOOD NEWS – RIGHT KNEE

The report describes insufficiency fractures in the bone just under the cartilage on both the inner (medial) and outer (lateral) femoral condyles, with the surrounding bone swelling, joint fluid, and soft tissue swelling that would typically accompany that.

Separately, there are two areas where cartilage has worn or peeled through its full-thickness (full depth): (1) at the back of the outer tibial plateau, and (2), on the inner facet of the kneecap, each with reactive bone swelling underneath. Regrettably, the cartilage patch ‘peeling off’ issues appear to be permanent (unfortunately). As far as I am aware, they do not heal/recover. However, assuming I can get back to full knee/leg extension, I can live with this.

There’s also a suspected small (5mm) flap tear in the medial (inner-side) meniscus, near the back of the knee. My basic understanding is that the meniscus is a crescent-shaped (and key) shock-absorbing cartilage pad in the joint, and a “flap” tear on it means a small piece has partially detached (and can fold or displace). However, I feel this was likely a historical injury (well before my October 2025 Back-Extension apparatus [AKA: Roman Chair] ‘behind-the-knees’ injury, detailed in my opening post). I believe I can live with the small meniscus imperfection for the foreseeable future. My private Orthopaedic Surgeon mentioned that it may begin to pose me problems later-on in life, but my hope is that I can avoid needing to address that for many years.

Also noted were mild changes in the popliteus tendon and LCL, which were presented as being reactive — irritated by the nearby bone injury rather than damaged themselves. Additionally, another minor finding was small amounts of fluid tracking around the popliteus and gastrocnemius muscles.


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PART 3. THE NOT SO GOOD NEWS – LEFT KNEE

The same insufficiency fractures of both femoral condyles with bone swelling, effusion, and surrounding soft tissue swelling, and the same full-thickness cartilage loss at the back of the outer tibial plateau. There were also some minor reactive tendon changes noted.

Thankfully, there was no meniscus issue on the left knee however.


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PART 4. SOME VERY BASIC DEFINITIONS/VOCABULARY (TO QUICKLY EXPLAIN SOME ASPECTS OF PARTS 2 AND 3)

The following definitions – which are my own limited understanding – only ‘scratch the surface’ of a true understanding of the ‘problem issues’ apparent (detailed in Parts 2 and 3). Nonetheless, I am presenting them for slightly easier reading.

An “insufficiency fracture” is a particular kind of stress fracture: rather than healthy bone breaking under abnormal force, it’s bone that has become weakened, breaking under relatively normal, everyday loads.

“Chondral” refers to cartilage.
“Full-thickness” refers to damage that goes ‘all the way through’ a cartilage layer down to bone, rather than just ‘roughening the surface’.

The “femoral condyles” are the two rounded knuckles at the bottom of the thigh bone.
The “tibial plateau” is the flat top of the shin bone they rest on.
The “patellar facets” are the cartilage surfaces on the underside of the kneecap.
The “inner patellar facets” are the cartilage surfaces on the inner side of the underside of the kneecap.


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PART 5. THE CONSULTATION

During my consultation, I received the main good news first, and then very concise/brief information about the various ‘problems/issues’, as outlined above.

The consultant’s final recommendation was to proceed with physiotherapy and massage only, and that no surgery required was required at this time. Given that I live in a low-sun environment, a supplement of high-strength Vitamin D (in addition to my intermittent multivitamin) was recommended. Interestingly, a Calcium supplement was not recommended – nonetheless, I have already added that to my supplement regimen, to complement the Vitamin D. (Outside this, I feel that I eat a very healthy diet.)

If I run into problems in the future, I am to get back in contact with my surgeon on an ‘as needed’ basis. No follow-up appointment was deemed necessary at this stage.

I was very relieved that it looks like I can avoid surgery at this time, and at least for the foreseeable future.


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PART 6. MY OWN CONCLUSIONS

I feel that my problem areas (barring the right-knee meniscus issue) correlate strongly with not being able to extend my knees/legs for a very long time. My lack of extension capability has put severe pressure on the front of my knees for a significant length of time (circa 10 months). This was because, over this time, I mobilised (moved) via crutches, on my ‘tip-toes’, with my legs/knees heavily bent, which put great stress and pressure on my knees, and in my view, led to the problem areas identified (which are now in addition to my original muscle/tendon injuries, at the back the knees).

Nonetheless, I feel that my problem areas (barring the right-knee meniscus problem) are not intractable, and will improve as I achieve better (and hopefully full) knee/leg extension on each knee/leg. Achieving full knee/leg extension on each knee/leg will allow an opportunity for healing, so it is very important that I keep making weekly/monthly ‘knee extension gains’.

In particular, a recommendation to proceed with physiotherapy and massage only (with ‘no surgery’) makes a lot of sense to me, under my general interpretation of the future-outcomes stemming from report, which in my view, are as follows:

1. The insufficiency fractures are the kind that heal with protection and time, rather than hardware.
2. The cartilage patch ‘peeling off’ issues, while permanent (unfortunately), can be seen as ‘discrete’ and not something that surgeons rush to operate on when a knee is otherwise improving.
3. The reactive tendon changes and fluid issues should settle as the bones (on each leg) heal-up.
4. The ‘meniscal flap’ problem was small (~5mm), merely ‘suspected’, and these are often routinely left alone when ‘quiet’.

I will post back, hopefully with more news of greater knee/leg extension, and healthier/healing knees.

All the best folks, and take care.

 

[EalingGran]

Glad to hear you have got answers to your problems- albeit not ones that can be solved by surgery.

Nonetheless, I feel that my problem areas (barring the right-knee meniscus problem) are not intractable, and will improve as I achieve better (and hopefully full) knee/leg extension on eac

It's great that you feel positive about the way forward.
Given the insufficiency fractures, I wonder if it is worth getting checked for osteoporosis?
A Dexa scan may be available on the NHS or it is not that expensive privately.
Have a look at my pilates teacher's free classes on YouTube for safe gentle but effective exercises and stretches. Google Katja pilates and they come up.
Good luck for your future rehab and recovery.

 

[ExtensionSeeker]

Hey there EalingGran.

Thanks so much for your kind words -- very much appreciated.

That's a very good suggestion there about getting checked for any potential Osteoporosis. I have my NHS physiotherapy appointment coming up reasonably soon I think, and I will ask about getting that checked out then. (The NHS physio had a massively long waiting list, and I requested to get on it ages ago -- so it should maybe be coming up in the next month or so I think.)

Thanks so much also for the tip on the Pilates -- I have heard this is an excellent, safe, very restorative means of stretching and exercise. I will have a look at the channel for sure.

Take care.

 

[EalingGran]

The NHS physio had a massively long waiting list, and I requested to get on it ages ago -- so it should maybe be coming up in the next month or so I think.)

I wouldn't necessarily wait for the physio appointment. You could just take the radiology reports to your GP and see if they will refer you for a DEXA.

 

[ExtensionSeeker]

Ah, that's a nice idea.

I think I will try that and see if a referral is possible.

Thanks again and all the best.

 

[ExtensionSeeker]

Hi folks.

Hope everyone is well, and is doing well with their respective knee journeys.


UPDATE

Just another update.

I have been continuing with the following (in-line with my Orthopaedic Surgeon's recommendation):

1. Physiotherapy (mobilisations, combined with fairly intense assisted stretching techniques, both guided [once weekly] and unguided/self-led [most 'off days']), plus
2. Professional massage sessions (once weekly).

I'm happy to report that I have continued to make great progress.

I am now very near to standing and 'walking normally' now, without any of the following:

1. Crutches. I ditched these some time ago.
2. Single walking stick (or 'cane'). I ditched the cane this week.
3. Heel-lifts in my shoes. I went from 1-inch lifts, to 3/4's-of-an-inch lifts, to half-an-inch lifts, to a quarter-of-an-inch lifts, and then stopped using them completely. The heel-lifts were a great method to getting me started with moving 'better' (or 'more normally') for trips outside the house, combined with using the single walking stick/cane.

It's been a long time since I have 'walked' in a manner resembling a normal walking style, and I am enjoying it very much. By my very rough estimate, I'd say I am about 5-10 degrees away from full leg extension now. Despite the slight 'bend' in both of my legs, I can now walk in a manner that is close-ish to normal, albeit with a little way to go, and with some pain if I walk too far or fast. After nearly 9-10 months of practically zero progress, getting about 8 weeks of 'solid extension gains' is quite incredible, and I am extremely grateful to my Physiotherapist and Massage Therapist for helping me 'unlock' those gains, plus for the solid advice I have received on this thread.


DAILY REGIMEN UPDATE -- SEEKING THE FINAL 5-10 DEGREES

Lastly, for anyone interested, my full 'daily regimen' has been slowly modified and adapted as the weeks pass, and is now as follows. I do the regimen on 'off days' from my guided physiotherapy and professional massage sessions, with some extra days off here-and-there if other things come up and/or get in the way.

The following is just to give anyone who stumbles on this thread (via, say, Google) some ideas on how to construct a late-stage daily regimen to work towards full leg/knee extension. However, that said, if anyone out there has found themselves in a similar position to myself, I would not recommend 'jumping in' to this late-stage regimen. Rather, and in particular, I'd recommend following the guidance of an experienced Physiotherapist and Orthopaedic Surgeon, first and foremost. That way, you can take yourself from a very bad position (like I was in), to a better position, over a number of weeks and months.

I should also provide the caveat that I have quite a lot of free time, which makes performing the below much easier.

Without further ado, here is my current 'off days' regimen:


PART 1. MORNING ‘MEGA SESSION’ (SLOW/LEISURELY PACE; DURATION IS 'AS LONG AS IT TAKES')

1A. MASSAGE

• Knuckles and thumbs. ((1) Around crease of knees, (2) Just above creases, (3) Just below creases, (4) Down the calves.) (Best results.)
• Lacrosse Ball. ((1) Calves, (2) Hamstrings, (3) Glutes.)
• Massage Stick. ((1) Quads, (2) Crease of knees, (3) Calves, (4) Hamstrings. Take care not to pull too intensively on massage stick with arms, as this can lead to injury of the biceps crease, biceps, hands and fingers.).

1B. STRENGTH

1. Calves: Seated Calf Raises. (Focus on quality reps to get blood-flow into calves.) (100 reps.)
2. Hamstrings/Rear-of-Knees: Laying-Down Dual Feet-Pulls. (Pull feet backwards along mat to buttocks.) (12 reps.)
3. Hip-Flexors: Laying-Down Hip-Flexor band work. (2 sets of 5 reps, for each leg.)
4. Glutes/Quads/Hamstrings: Glute Bridge variations. (20 reps.)
5. Glutes/Quads/Adductors: Low-Squat Isometric Holds. (~3 slow reps/holds.)
6. Quads: TKEs (Terminal Knee Extensions). (Using band looped around banister and back of knee.) (10 reps, each leg.)
7. Quads: Sitting Banded Leg Extensions. (Using a small (12”) band, looped around front-foot and back-foot. Extend working leg fully and fully activate/tense quad.) (2 sets of 5 slow reps, for each leg.)
8. Core: Varied Core Work. ('Freestyle' of varied holds and reps.)

1C. STRETCHING

• Hamstring plus Back-of-Knees Focus: Laying-Down (On Back) Leg ‘Extend Outs’ using Fitness/Stability Ball. (55cm diameter ball used.)
• Top-of-Calves plus Back-of-Knees Focus: ‘Simple’ Stand-Ups. (Stand-up from out of chair or from bed; focus on gently moving knees fully back; plus hips fully forward.)
• Top-of-Calves Focus: Wall-Supported Calf Stretches. (Focus on ‘very top area’ of calf. Take care.)

PART 2. LATE EVENING SESSION (QUICKER PACE; LESS TIME TAKEN; REPETITION OF SELECTED WORK FROM '1B' AND '1C')

2A. STRENGTH

• Quads: TKEs (Terminal Knee Extensions). (Using band looped around banister and back of knee.) (10 reps, each leg.)
• Quads: Sitting Banded Leg Extensions. (Using a small (12”) band, looped around front-foot and back-foot. Extend working leg fully and fully activate/tense quad.) (2 sets of 5 reps, for each leg.)

2B. STRETCHING

• Hamstring plus Back-of-Knees Focus: Laying-Down (On Back) Leg ‘Extend Outs’ using Fitness/Stability Ball. (55cm diameter ball used.)
• Top-of-Calves plus Back-of-Knees Focus: ‘Simple’ Stand-Ups. (Stand-up from out of chair or from bed; focus on gently moving knees fully back; plus hips fully forward.)
• Top-of-Calves Focus: Wall-Supported Calf Stretches. (Focus on ‘very top area’ of calf. Take care.)

PART 3. AD-HOC / ONGOING

3A. STRENGTH AND STRETCHING

• Always ‘walk freely’ when moving around – in the house, and outside. (Assistance items no longer required: (1) crutches, (2), single walking stick, (3) heel lifts).

3B. STRETCHING

• Always sit with legs extended/straightened as much as possible (say, at computer or at dinner table).
• Always extend/straighten legs as much as possible when sleeping.

CONCLUSION

As far as I am aware, the final 5-10 degrees of full extension are the hardest to get. I do feel that the rate of my progress has slowed down over the past 2 weeks or so. Nonetheless, I also feel that I am still, albeit slowly, finding extra degrees of extension, plus lesser 'behind-the-knees' muscular and tendon tightness.

Thanks for reading folks, hope everyone is doing well with their knee journeys, and take care.

I hope to post back with further progress if/when I make it.

 

[Legseleven]

The one exercise I do daily for the last stubborn degrees of extension is to rest my the edge of my heel on a firmly rolled up towel, allowing the fully stretched leg to simply hang there with gravity doing all the work. That’s all you do. You can do this sitting on a bed or on a chair with a footstool. If I use the footstool I’m make sure to use cushion(s) to make it the correct height. The leg needs to be straight. You can even do both legs at once if it’s more comfortable.
I have been doing this daily since my op, 3 x day whenever I can. I rest like this until it’s too painful, then I stop and I can still do this one exercise despite my current tendonitis.
Good luck.

 

[ExtensionSeeker]

Hey there Legseleven.

Hope you are well, and thank you very much for that tip -- very much appreciated.

That sounds like an effective technique, and I hope it is working well for you.

I think I may have seen that method recommended on a few YouTube videos that I watched when I was at the start of my 'knee extension seeking' journey. Sadly though, I was so far away from being able to do that at that time, that it didn't seem realistic for me.

Now though, I think I could try adding this to my regimen, as part of the 'Stretching' segments.

Thanks again and all the best.

 

[Jamie]

I’m just now catching up with your progress and I’m thrilled to see how far you’ve come. Congratulations! You’ve put in the time and effort and you are now reaping the rewards. I’m especially happy to read how you were able to use the lifts in a positive way to help you stretch and strengthen to the point where you no longer needed them. So many times people just use a lift as a coping mechanism that doesn’t allow them to progress to a point where the lift is not needed. I experienced a similar situation about a year ago when my spine had twisted slightly following my hip replacement. With the help of a great therapist, I was able to transition from a 1 inch lift to no lift at all which is where I am today. She was able to get my body back into proper alignment so that I was able to strengthen the muscles that had weakened and caused the twist.

Thank you so much for all the details you put into your posts. It’s great information and a good learning tool for others. I’ve learned things from following your progress. Here’s hoping your knees hold out for a long time without surgery!

 

[ExtensionSeeker]

Hey there Jamie.

Thanks so much for your kind words -- I am very grateful for those!

For sure, to come from a situation of barely being able to walk (and barely moving around on 'tip toes' on crutches, with my legs alarmingly bent), to now being 'almost' walking with no inhibitions is pretty amazing.

After crawling about my house for about 9 odd months, I am pretty ecstatic about it. I'm even considering getting back to the gym. At one stage in my life I was a 'gym addict', and the thought of getting back to that seemed a million miles away, especially at the darkest times.

I am extremely grateful to my physiotherapist, my massage therapist, my Consultant Orthopaedic Knee Surgeon, the MRI team, plus for the very kind and helpful guidance I have received on here.

I'm hopeful of getting those final stubborn degrees of extension over the next month or two, and hope to post back with continued progress.

 

[Jamie]

I hope so too. I think there is a good chance you will see that happen.