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TKR ROM issues

Hooray! New success. I pedaled my Peloton all the way around with no discomfort. I have been coaxing it by going back and forth through the difficult zone until I could do it freely, but today my foot went all the way around and it kind of woke me up. What happened? Something was missing. Oh, there was NO discomfort. My foot went all the way around around easily.

Today is my 6 months anniversary of TKA surgery.
 
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skiforever said:
Happily my knee works well for all kinds of skiing - downhill, backcountry, skate skiing, and classic. After 8 days of skiing this month it still feels fine!
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I LOVE that you are skate skiing! It’s my passion and I really want to get back on skis. I feel like it would be almost easier than classic as it loads the patellofemoral joint differently (assuming on intermediate/race gear using proper technique).
Did you still have patellofemoral pain at 3 months? Any advice of what kind of tests I could do on land to test if I’m ready to try it? I’m still very weak on surgical leg and can only single leg squat about 30-40 degrees before it hurts but it might be enough to skate ski on the flats. I’m going stir crazy because I can’t walk fast enough and long enough to get any cardio and can’t go up stairs normally yet…but hoping I could do some easy Nordic on flat, even if just double poling. I have 135 flexion. I’d way rather do rehab functionally on a pair of skis than on a therapy “step to nowhere” indoors.
 
I have not experienced patellofemoral pain. I have had pain on the medial side of the knee, but it is gone. I read that weak quads can give you patellofemoral pain. I think I would try wall sits in different positions, changing position each time I did them.

XC skiing does not require much flexion. Double poling would seem to he a good idea for cardio and proprioception. Biking and squats along with wall sits could help dynamic and static strength.

I did not lose much strength because I just walked normally and used both legs going up and down stairs through the entire recovery.

If you are doing physical therapy you might consider dropping that and doing what you need. It is useless to work on ROM. You are fine now. I find PT to be excessive work that is not helpful, just generates pain. Go ski instead and see what happens. Best is not to fall in a way to hurt the knee unless you have strong bones.
 
Thank you! :) I am feeling like that is what I need to do - just ski and forget about the PT exercises. I stopped working on ROM at 7 weeks and turned attention to strength, which isn’t going so well.
I look forward to your future inspiring updates!
 
@Fluttershy, thank you so much for sharing the stretch you do that doesn't require an ankle bend. Much like @skiforever, my ankle kills me when doing my flexion exercises. That being said, I am having a hard time picturing the way you do this stretch. I can picture the laying on back with your thigh pulled toward you, but I am not sure where you grab your upper calf to do the stretch. Any clarification you can give would be much appreciated, as I am needing about 12 more degrees to make it to an easy 130 degree bend (I can get there currently, but it HURTS!).
Thanks!
 
Inspired by @Tentcamper I decided to try again on ROM. I did a bit of flexion on the stairs, for maybe 3 minutes. My knee hurt during the night and still hurts today. Unbelievable. I fail to understand what is going on with this. My first knee could be pushed a lot, but it settled down as soon as the pushing stopped. Note that I can hike, bike, and ski with no issues.
 
Bummer. Could it be that lower load, longer duration stretching in a position (eg on back) with more relaxed quads might be better for you? I never liked the stair stretch because the partial weight bearing seemed to add too much stress on front of knee. I now like putting foot on chair behind me to target the quad tendon area better as it’s so tight.

Hey guess what? I tried a short classic ski on flat tracks! You inspired me to try. No worse for wear the next day and nature therapy was healing.
 
skiforever said:
Inspired by @Tentcamper I decided to try again on ROM. I did a bit of flexion on the stairs, for maybe 3 minutes. My knee hurt during the night and still hurts today. Unbelievable
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Sorry to hear that. It must be hard when you are so fit and the knee is so string otherwise.
Have a look at my teacher's pilates videos on YouTube ( Google Katja pilates). She has a huge range of free classes. I think you might find something that gently extends your ROM without aggressive irritation.
I found pilates the best exercise for rehabilitation as it really focuses on listening to your body. Katja was really good at looking at my body and seeing even very subtle imbalances that were holding me back.
 
Thanks! I will look at that. It seems strange that such a tiny effort causes the knee distress.

I think my ROM is improving. In the shower straightening my knee does not stick out as much. Getting shoes and socks on is getting easier. The knee looks a lot like my other one, not so obviously bigger. I need to try measuring size and angles.
 
dotski said:
Hey guess what? I tried a short classic ski on flat tracks! You inspired me to try. No worse for wear the next day and nature therapy was healing.
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Great news! I think XC sling is helpful for muscle recovery, fitness, and fun! I am XC skiing 7.5 miles a day with 1000 feet of climbing starting at 8000 feet ASL. Classic yesterday, skating today. Really challenging!
 
You are amazing!

I’m struggling with getting full extension also. But getting a bit closer the past couple weeks. I hate prone hangs (on tummy hanging foot off bed with quad supported on towel roll to protect knee), but they are the only thing that get me results. It’s because I feel the pull where I know I have the restriction (posterior joint capsule). But I think they make me hurt and swell. Trying to stretch while sitting up with leg in front of me with foot on towel roll ends up hurting front of knee. My hamstrings and gastrocs (muscles crossing the knee) aren’t the limiting factor (I’m flexible), so a lot of the other stuff (eg heel toe walk, etc) to work on extension doesn’t do anything for my extension. I still do it though as it doesn’t hurt and is good for the muscles.
 
Backcountry skiing on very rough snow worked! The new knee is good!

ROM is improving without working at it. I measured the circumference of the knee and it is down 1 1/4 inches. ROM is about 3 to 112 degrees. It is still almost an inch bigger than my other knee. When it shrinks I hope for 0 to 120.
 
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