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sistersinhim

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Ok, the very first thing I see is swelling. That can restrict my extension, also. You should try icing and elevating more to get that fluid out of there.

What helped me most with my extension, which lagged behind my bend, was to walk with a longer stride with a heel-to-toe gait. As you stretch out that leg to step forward with a long stride it helps to stretch out those large muscles and tendons in the back of your leg. It worked for me, but it took a while. Those are some large soft tissues to lengthen but they will!
 
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agsmom

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@sistersinhim thanks! There is some swelling but the new knee is quite a bit larger than my actual joint. I think that makes it look even more swollen but I’m not arguing, it’s definitely puffy. I haven’t been icing at all and I’m not elevating as much as I should. I’ll make an effort to do that. I appreciate the tips. I see the surgeon in a few weeks so I’ll be sure to ask him about it, too.
 
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sistersinhim

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You are very welcome. Hopefully, your doctor will give your some more tips. Don't let him push down on your knee to try and straighten it up. That would just cause more swelling and not be helpful at all. We have found the same for MUAs to straighten the leg. It just doesn't work.
 
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agsmom

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@sistersinhim it goes flat if I have it stretched out on the floor or sofa. It gets to around 2°, not all the way flat but almost. I just can’t get it straight when I’m using my muscles to straighten it as in the picture.
 

sistersinhim

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It sounds like you might need to strengthen your quads. If your knee is flat against the floor but you can't lift it up more, then it must be muscle related. Is this causing you any problems?
 
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agsmom

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It’s only causing issues in the sense that my stride is off a bit. The quad muscles around the knee are still very sore. When I try to extend it straight, as in the picture, it is painful.
 

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It took me two years to be able to do that with one of mine, the lower end of the quads just above the knee was painful and felt as if there was a lump of something inside. It still feels odd and uncomfortable, but I do have a maltracking patella on that side so the quad tendons are fighting unnaturally to pull the patella over the top of the implant instead of along it’s groove.
As your new knee is larger than the old one, maybe your tendons need time to settle to pulling your patella over it.
 
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agsmom

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@Ghostpipe thank you so much for responding! I was beginning to think I was the only person who had this issue. @sistersinhim has been very helpful and encouraging but I don’t think she has this issue.

Did you do anything special to get the range of motion back or did it just eventually happen?
 
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Ghostpipe

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It just happened, slowly! My quads were pretty good before surgery, it wasn’t lack of strength, just the op., and the other leg (I had bilateral) could get there much sooner, but maybe not for a year. It hurt!
 

EalingGran

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Just wondering if you tried pilates to strengthen the quads?
I now put a 1/2 kg ankle weight just on my operated ankle for some exercises to develop the muscles on that side and rebalance my legs.
My pilates teacher also gets me sometimes to do exercises twice on the operated leg and just once on my unoperated side.
My gait is now pretty balanced but I still notice if I am standing for any length of time that I mainly use my good leg.
I consciously try to put more weight on my operated leg or even momentarily stand on one leg to strengthen the operated side.
 
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agsmom

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@Ghostpipe thanks for all of the info. My vmo was shot before the surgery; hadn’t been activating/firing/working for years. It’s activating now but still very weak. It hurts, too, especially when I try really hard to straighten it. I hope it will just take patience and working to strengthen it.

@EalingGran no, I haven’t tried Pilates yet. I have the best of intentions but never seem to get around to it. I will look up the Pilates YouTube channel you recommended soon and give it a try. My leg is very strong overall. I have no problem standing on it and I get a lot of walking in most days. It’s just the lag that I can’t seem to push through. It does still get tired but overall it’s doing very well. I’m headed to Disney next week so I’ll set a goal of starting Pilates when I return home. Thanks for the info and letting me know what has worked for you!
 
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agsmom

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Hi everyone, I just got home from a trip to Disney World and did miles upon miles of walking. I did it! There was a time I was doubtful that walking would be something I was able to do easily. So happy!

Question for the experts out there: how do you measure ROM yourself? I have no idea what mine is since I’m no longer going to PT.
 

sistersinhim

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Your ROM isn't important, your function is. What you just did shows that your knee is recovering nicely.
 
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agsmom

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@sistersinhim I know it’s not but I keep seeing people who say they’re not going to PT giving ROM #s and I’m curious. And I agree, this trip was a huge test of the new knee and I passed!:yay:
 

EalingGran

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keep seeing people who say they’re not going to PT giving ROM #s and I’m curious.
There is a picture on BoneSmart which shows the angles and I guesstimate from that. I can now bring my operated heel almost as far back as my good side in heel slides. In standing poses like standing quad stretches it is not so good.
 

sistersinhim

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knee-rom-small-jpg.61505

Here's the image to help you estimate it. You could also buy a goniometer to measure it yourself. I found it difficult to use because it needs to be placed the extra same way every time. That's why PT's numbers aren't really accurate. It's almost impossible to place it the exact same way each time. Different therapists almost always get different numbers, also.
 
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agsmom

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I saw the surgeon last week for an early one year follow up; June 27 is actually one year. I asked the question about extension and the answer wasn’t great but did make me feel better. He said my knee has been through a lot of trauma because of the surgeries being so close together. The quadriceps tendon and muscles are all very weak. He said the motion may not ever come all the way back. He recommended that I start doing strengthening exercises to get the muscles stronger. Anyone out there have good quad strengthening recommendations? Since it’s still a little painful at times, I want to start very easy. I haven’t gone to PT for about six months and have only been doing ADLs and walking. The quad muscles are still somewhat atrophied. TIA!
 

EalingGran

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Try putting a soft yoga/pilates ball behind your back and the wall and slide gently into a squat with your feet placed out from the wall.
I built up to squats from the side lying glute strengthening pilates video I recommended to you. At first I found squats painful and I couldn't go far. I still find it helps to push my knees out.
I find it is important that my knee doesn't turn inwards when it is bent with weight on it.
 
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agsmom

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@EalingGran thank you. Surgeon did recommend squats but I was having a hard time figuring out a safe way to do them. I can’t go far into a traditional squat at the moment.
 

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