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Help please with leg extension

Posted , 11 users are following.

angela52217
angela52217

I am nearly nine weeks post TKR.   I have been going to knee gym with physios at local hospital.   Last Tuesday they gave me an assessment before going for check up with surgeon on Friday and bend was 117 but extension -3.   The OT discharged me saying if surgeon was not happy she would reinstate me to group.

At hospital on Friday surgeon delighted with bend but not happy with extension which he says will give me a lot of trouble later if I do not get down to 100.  I think this is because I have spinal stenosis and he is trying to give me the best possible result.   Phoned local hospital who have changed their minds and will not reinstate me because she thinks he is being unreasonable.  She says their surgeons would have accepted.    She says go it alone and then she will review in a fortnight.

I am not very happy about this because I have to  be careful because of my spine.   Have been doing the lying on the bed exercise pressing backs of legs into mattress which I have in fact been doing since well before op.  Surgeon told me to press down on area above knee with both hands till it hurts.  He demonstrated and it did hurt!   But I discover I cannot get that sort of pressure because of arthritis in hands, or perhaps more scarily I am pressing wrong bit.  Last night my leg was very, very painful and I got no sleep at all so am unsure of my exercise.  I have also tried lying on tummy on bed with knee and lower leg hanging over edge.

Has anyone any good suggestions.

Angela

 

1 like, 21 replies

21 Replies

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  • Django
    Django angela52217

    Posted

    Hi there, not sure I can help as didn't have this problem, but would massage help before and after doing the exercises.  It did for me when trying to get th e bend which I know is opposite to your problem. I also sat with foot only on a stool to encourage the knee to go flat. Im  sure someone will come along with some help.  Good luck.

     

  • chrishappy
    chrishappy angela52217

    Posted

    Don't know what country your in,I'm in UK and if it was me I would be contacting my surgeon and telling him that his request has been refused. Your health and outcome is the most important factor here and I'm sure your surgeon will sort it . good luck
  • deborah90838
    deborah90838 angela52217

    Posted

    Angela, my therapist had me do the same exercise where you push into the mattress except that she put a rolled up towel under my ankle so there was air under my knee when I was doing it. That way not only does gravity help with the effort you also don't have any resistance (the mattress) when you push down with your hands.

    Best of luck with your continued recovery.

  • irish_linda
    irish_linda angela52217

    Posted

    angela he is right you will have problem later if its not straight mine is not straight at 17mths post revision  ,im doing pretty hard excersises to straighten it .if you dont get it right now you walk will be effected you will start carrying the leg because of the bend now you are lucky its only -3 most physios would say thats acceptable but as you say your spine is a problem i would put in the effort to get it straight now .!!!. to get it straight you can look up utube for ideas some are really good a doctor jo on utube is good .what i do is sit on a chair and have another chair in front of you place your foot on the chair in front leaving your knee between the chairs without support so that the joint is forced to straighten to make it abit harder place a weight just above the knee to push the leg straighter you can use maybe a bag of suger or two i made sand bags it dose work but you have to persist with it at first you will only be able to do a minuite or two but as you do it more often you will increase the lenght of time you do at first little but often if it gets easier either increase the weight or the time you do it .i find using my mobile to time it is best god im counting the seconds to put the leg down .make sure you bend the leg after and use ice everytime after you do it plus if you like use heat to warm it up before you do the excersie it will help to warm up the joint
  • terri59470
    terri59470 angela52217

    Posted

    Hi Angela, how frustrating that your Physios and Surgeons have different views, and you're stuck in the middle!

    I'm also struggling to get my 2nd knee straight, the last time it was measured it was about -4 and the physios seemed to happy with that (they discharged me!!) But I can feel it's not right. I do an exercise similar to Irish Kinds - I put my foot up on a chair or stool in front of me and then I drape an oven glove (the kind with 2 gloves joined together by a band of fabric) with a tin of baked beans in each glove! Same principle as the bag of sugar, but no balancing involved. As the exercise gets easier, you can replace the cans of beans with bottles of water - or anything that will fit into the gloves and gives you the weight you need.

    I also lie on the bed, and put my foot up on several cushions - but I put a long strip of wood underneath the length of my leg so the mattress isn't doing the hard work! It HURTS but it's effective. Try one or two minutes to start with and build up from there.

    Good luck with getting straight, I know how hard it is!!

    • irish_linda
      irish_linda terri59470

      Posted

      the strip of wood is a good idea terri !! i should have said put the sugar/flour in a bag and hang it juse above knee  . as i do . its a very boring job to get it straight never mind the pain we give ourselves .redface i went out for a walk today thank god no rain well i was practicing my walking !! you think i learned that before but my huusband keeps telling me that im carrying the leg so i went down to the shopping centre it has a long wall of mirrored glass so i walked up and down and yes he was right (hate when he is right) i do it very subtle so now im having to consentrate on walking properly its what happens when your leg dose not straighten properly
  • Oldfatguy1
    Oldfatguy1 angela52217

    Posted

    Are you doing this excercise. Roll a small towel to go under the back of your ankle. While laying on you back with your head slightly elevated. Tighten the quads which will in turn force the leg straight. The rolled up towel should have your foot elevated about 3" off the bed or at a 10-12% angle. Do this 10 times holding to count of 10 each rep. Do a set of 3. After a few days add a couple of counts until you get to a count of 15. Be sure and tighten the quads as tight as you can as this will force the leg straight.

    When you walk.....go slow, very slow. With each stride, step out as far as you can, touch down with your heel, then your toe, then bend as far as you can. You'll look a little goofy but the point is you are doing it right. Be sure and hydrate. Plenty of water all day. Dehydrated soft tissue will not streatch properly like hydrated. This will go slowly so don't be discouraged

  • john44470
    john44470 angela52217

    Posted

    If there is a moderator reading this please note I've sent Angela a reply twice - NOTHING HAPPENED. I keep getting a text inspect element. Means nothing to me. Absolute rubbish!
    • Oldfatguy1
      Oldfatguy1 john44470

      Posted

      John. This site doesn't let certain things go through such as links to questionable treatments and medications until they are checked out. Also it is very concerned about certain products that get pushed by contributors. It is just a built in protection. While you may have found something helpful to you it may have the potential of be dangerous to another. I wouldnt take it personal, they are just following the printed guidelines that you agree to when you register with the site.
    • john44470
      john44470 Oldfatguy1

      Posted

       Hi Oldfatguy,

      ​Thanks for your two comments and advice. Yeah, I'm understanding what you say but I had not included anything that might have led to the problem. WhatI did get when typing the text, Hi Oldfatguy,

      ​Thanks for your two comments and advice. Yeah, I'm understanding what you say but I had not included anything that might have led to the problem. WhatI did get when typing the text, and it kept appearing was - the phrase "inspect element".

      ​That to me is computer and/or programming speak and so I think the moderators should investigate with their IT department. (There it did it again with the word investigate, took me 4 attempts to type it and then that phrase popped up).and it kept appearing was - the phrase "inspect element".

      ​That to me is computer and/or programming speak and so I think the moderators should investigate with their IT department. (There it did it again with the word investigate, took me 4 attempts to type it and then that phrase popped up). Either that or I've a problem with Win 10 which I've just put on my laptop. I'll use the envelope tonight and see how it goes, haven't time now as have to leave for work.​ This is now the 2nd try at sending this. Useless!

    • Oldfatguy1
      Oldfatguy1 john44470

      Posted

      I agree....does look like a triggering word of some sort. I've been on here awhile and never seen that type messag. Technology and knees.....2 great mysteries.......great when they work and a mess when they are screwed up
  • john44470
    john44470 angela52217

    Posted

    Sorry angela, thats it - this technology behind thios website is crap - can't get my message through to you. Moderator, suggest someone gets this sorted. I've just given up and angela is missing out.
    • Oldfatguy1
      Oldfatguy1 john44470

      Posted

      BTW....you can use the envelope on the upper right hand side of her comment and send her a private email if she hasn't requested this not be allowed
  • angela52217
    angela52217

    Posted

    Thanks everyone for your helpful advice.  Going to try the towel method today and also buy a different sort of over cloth when I go out - currently I have oven gloves.   OFG I am walking heel to toe and my surgeon very pleased with this when he made me walk the corridor!!!!

    Terri what did your surgeon say about the -4?

    Angela

    • terri59470
      terri59470 angela52217

      Posted

      Angela, Im SOOOO sorry I missed this message! 

      When I saw my Surgeon I was just under 6 weeks Post Op, and struggling with superficial skin infections on my wound, but all in all he seemed pretty well pleased at that early stage. It was mostly as the weeks passed by that I started to worry that things werent moving.

      Since this big discussion about inadequate straightening (and, to be fair, inadequate information/forewarning about it from the health professionals!), Ive started doing a few things diligently. I wont let myself get out of bed until Ive done my morning exercises (this is on both legs) Straight Leg Lifts x 20, Inner Quad Lifts x 20, Leg Slides x 20, and then I lift one knee at a time towards my chest, and when its as far as I can get it I clasp my hands around the knee and gently pull it closer towards me(I dont know what this is called, but it flipping well hurts!). After all that its a relief to get out of bed! And I am VERY strict with myself - a couple of times the Postman has interrupted me, but Ive made myself go back and finish them off!

      Throughout the day I have a set of static exercise pedals set up, and if the TV is on and theres a programme Im watching, I use the Advert breaks as a timer, pedalling until the programme restarts. I also have an Ottoman (Thanks Cheryl, it works great!) and I use that for passive extention BUT.....I set a timer on my phone, 2 minutes at a time. By the time the first 2 mins is up, if its too painful then stop. I was surprised how quickly I saw an improvement when doing this, and can now manage 5 x 2 minutes (the air is usually pretty blue during the final 2 minutes though redface) Ive found that breaking it down like that really makes it less daunting as Ive always really REALLY hated that one! 

      If the TV isnt on, but the radio is, when a song comes on with a good beat then Ill do step-ups for the duration of the song. 

      Im sure that my house sounds like a bit of a funny-farm, but Ive been at this lark for so long now, including pre op exercises its been a full year, and Im really jaded by it all, so Ive had to rethink things and come up with little mechanisms to "trick" my mind into thinking that Im doing something new and fun! 

      Ive also returned to the Physio/OT group - not the structured Knee Group, but the sessions called Next Step. Have you been going to these at all (Im just wondering if we've been there at the same time and not realised! Im going every Tueday at the moment, and its good as I can use the Sci Fit, Leg Press etc which massively helps with strengthening.

      Well if youve made it and managed to read this far, you deserve a medal! 

      Let me know how youre getting on, and Ill talk again soon xx

    • angela52217
      angela52217 terri59470

      Posted

      Hi Terri, Good to hear from you.  Is the next step from 1-2pm on Tues and Thurs and you pay £3 a session.   If so after my assessment last Tuesday I suggested this to OT.  I had not known about it before but a man I had become friendly with came over and pointed it out to me.   My reassessment was OK but still not in agreement.  OT adamant that my surgeon wrong and I will harm back more if I continue and that -5 and below acceptable.  I am now down to -2 and determined to continue.  I said I would join that group and she said OK but not until you have had an assessment by a PT specialising in backs.  After that you can join if she agrees.  It might be quite useful but means I won't be there this week as appointment 2 pm.  Actually I won't be there the following Tuesday either as we are going away for a couple of days as husband working in Leeds on the Tuesday.

      However, if it is that group stick your head in to say hello in the waiting room tomorrow.  I get there about 1.45 pm - traffic and parking - and I think your group comes out about 1.55 presumably to clear way for knee group.  I sit near the door and have dark hair and will be wearing dreadful bright flowered trousers - only thing I have that gives them easy access to knee.    Otherwise I will see you in a fortnight.

      Angela

    • terri59470
      terri59470 angela52217

      Posted

      Hi again, and once again SORRY for not picking this message up, for some reason I'm not getting notifications!

      How did you get on today? Well, I hope!

      I braved going into the City centre when I left the hospital, had a good walk round, first time in months I've been anywhere on my own apart from Physio, Doctors or my daily walk in the village! Made me feel more human, just pottering around the shops. Can feel it now through, I'm really tired. But hopefully that will lead to a good night's sleep, so its all good!

      See you in a couple of weeks, same time same place!

    • angela52217
      angela52217 terri59470

      Posted

      Hi there.   Good to meet you yesterday.  I did not mean you to interrupt your session and come straight out however, so sorry for that.

      It went really well.   I liked the physio very much - very friendly and thorough.  She actually gave me an hour not the half hour booked and it felt really good to have my back assessed so thoroughly.  She also gave me a lot of hints on my back to ease the pain of the neurogenic claudication.   She also thought my leg was doing well.  She agrees I can join the group and wants to reassess back and leg mid April.

      So see you a week on Tuesday.   Your trip to town seems to have done you good.  We are going over to Chester tomorrow to an exhibition there.  I will have to do quite a lot of walking.  Tossing up at the moment whether to use wheelchair or stick/stool.  Trouble is I can only walk about 50 yards with my back problem before pain up in the 8-9 level and I have to stop and rest and go on like that. 

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