Will,
First, let me say that you are in a frustrating time with your knee---it is a time of hey, I have been so good for a whole month, what is with this knee--I want to do stuff!! Unfortunately, this is a long recovery and there is absolutely no way to rush things. You are starting to move, but at four weeks, I probably spent 50% of my time lying in bed, with my knee on three pillows making sure that the swelling in my knee went down.
I had lots of fights with my OS too--and he asked me at least twice when i got my MD!! My husband is a doc (not an OS) so I AM a doctor's wife!! but seriously, you cannot expect compassion from a surgeon--that is just not going to happen. However, they DO know something about knees!
I am also an "informed patient" I see myself as part of a team--and my pt also saw himself as part of the team, which did help a lot. I wonder if your pt is really the right one for you. Ben is a Phd in pt and is both gentle and compassionate--plus, he was 100% behind my idea of getting fit for skiing.
In fact, you are correct in that you need your quads to get full extension--and the VMO is often very weak after knee surgery. My doc was always rather uninterested in my rom, he never measured--just "eyeballed " my knee. He did jump out of his chair and get a measurement however at my six month check up when he realized that my rom was 150---he did share the credit with me--that I had done the work after his brilliant surgery to get this wonderful success.
Seriously though, my rom was about 110 at four weeks--but and this is a very big but, I was in bed about 90% of my day in the first two weeks and then about 70% in the next two weeks and at four weeks about 50% of the time. I feel (this is my opinion here) that you have to keep the swelling down as much as possible in the beginning sothat it does not become "chronic". If you do too much--walking, standing, cooking, cleaning, checking out the garage or the stores---your knee will swell. When the knee is swollen, the rom drops.
So, here are some thoughts. 1. talk to your pt and get his take on what is happening. Does he think the lack of rom is from swelling or mechanical--scar tissue? What does he suggest? I would never allow anyone to push on my leg until it hurts---if that is happening, you do need a new pt--a professional who works with you. Be honest about your activities to him/her and find out what he thinks? Too much? too hard? Does your pt massage your swelling? mine did and it helped a lot. Also they used ultrasound to get the swelling down. I am amazed that some pts just look at a leg and decide it needs to be pushed. Maybe it needs to be in a whirlpool bath or massaged or iced.
I found lots of fun at pt--my pt helped with the swelling. He helped me with specific exercises that worked my muscles. We made sure that all the quads were working. idid lots of leg lifts and biking. I liked the interaction with the other patients too--we did a lot of laughing and there was support for the blue days too.
So, I would not walk away--plenty of pts do really know a lot about knees--and they are useful and helpful during your recovery. Maybe you have the wrong type of pt right now? Get a new one. I am six months out and feeling pretty strong. I hiked up Big Mountain--2.5 miles and 2000 vertical feet carrying my skis and boots and then skied down--it was fun! and once was quite enough. But, don't loose track of the big picture here---right now, you need to rest so that you can be running around at six months. Kelly