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Zero Degrees!!!

Posted , 6 users are following.

CHICO_MARX
CHICO_MARX

After a TKR, you've gotta do the physical therapy...seriously!!!  Your PT will take two measurements in "degrees" or angle: how straight the leg is (a negative number; zero is straight) and how far back it can bend towards your butt (positive number; more that 120 is the goal).  When I started, my leg was -14 and + 84.  After 9 weeks of PT twice a week plus work at home, I'm -1 and +128...virtually back to normal.  If you want full range of motion on your knee again, your goals are 0 and +120 or better.  Your therapist should be keeping track of the numbers.

The other goal is to rebuild your quadricep.  Leg presses and lifts in the gym...squats at home.  Make the quad stronger to take the pressure off the knee.  Start slow with light weights and more reps.  Build endurance before you build strength.  I'm very lucky to have a daughter who is an ACSM and ACE certified personal trainer.  She's brutal but effective.  Completely rehab'd a total hip replacement in six weeks (5 hours a day, six days a week in a therapy pool and gym).  Gotta do the work to get the result you want: A year from surgery, it should feel like the operation never happened.

CAUTION: For the knee, don't push it too hard.  Swelling will be the result if you do.  Then you have to back off until it returns to normal.  Slow and easy for the knee.  The hip can be pushed and rehab'd quickly...the knee takes time and patience.  Swelling?  Back off.

1 like, 13 replies

13 Replies

  • Ingrid54
    Ingrid54 CHICO_MARX

    Posted

    I am trying hard to do exercises but pain in thigh is unbearable coupled with swelling of leg. I am trying a little bit but wishing had not had op.
    • CHICO_MARX
      CHICO_MARX Ingrid54

      Posted

      I started the same way.  Lots of pain because the meds don't work on me.  Remember that the cut the quad so your thigh is very weak and has to be rebuilt with leg presses and squats. The normal sweilling and stiffness can take up to a year to go away but lots of swelling means that you're overtaxing the joint.  Back off and try again.  Light weights...more reps.  Slow and steady...this will take time.

      Yout therapist will lie you down and push down on your knee.  This is torturous but the knee starts to straighten out little by little.  At home, I would lie in bed with a 2 pound ankle weight on my knee to help force it down to zero degrees.  Take your meds; lots of ice for the inflamed area. This takes patience and time.  The pain will definitely go away if you don't push it.  Pain and swelling mean your forcing the knee too much.  Back off.  I did PT twice a week plus home stuff...took 2 1/2 months to go from -14 to -1 on the knee.  Working on that last freaking degree!!!

      Remember: pain and swelling are normal post op but not normal 3+ months out.  The first 90 days are really, really hard but you should feel a lot better after that time.

    • Ingrid54
      Ingrid54 CHICO_MARX

      Posted

      My straight leg is very good the bend is however not so good only at 77 I think the thigh pain and swelling is stopping me from getting a better bend.
    • CHICO_MARX
      CHICO_MARX Ingrid54

      Posted

      Are you still working with a PT?  If not, get to the gym and do leg presses and curls.  At home, hold onto a chair and just do deep squats.  It doesn't happen overnight.  Just stay with it.  I doubt that my heel will ever touch my butt again but I keep trying.  Getting that to happen would be the ultimate goal.  Don't give up!!!  Gotta get maximum flexion back or you'll have that limitation for the rest of your life.  Don't let that happen.  Good luck.
    • Ingrid54
      Ingrid54 CHICO_MARX

      Posted

      Thanks for advice. Unfortunately the pain is so bad it is stopping me from doing much. Not for the want of trying. Really wish I'd never had op as pain in thigh so bad. I have always been fairly active so find it very frustrating.
    • CHICO_MARX
      CHICO_MARX Ingrid54

      Posted

      I know the feeling. Told people that I'd rather have another kidney stone!.  I was also very active...44 years of hockey.  Then 4 knee scopes, hip replacement, back fusion and now the LTKR.  The right knee is on order...  I've got 4 1/2 pounds of titanium in me with more to come.  Docs are turning me into a Terminator...and I hate airports!!!  Just know that the pain will subside...takes time.  Just gotta build up the quad when you're ready.  Slow and easy...
    • eileen15268
      eileen15268 CHICO_MARX

      Posted

      Your comment terminater made me laugh out loud. A sense of humour does help can't STAY down or mis. I haven't slept a night, or even a couple of hours in a row for 5 weeks, but there IS light at the end of the tunnel !! & as you say Rico we just have to work at the exercises. I really appreciate you sharing your knowledge & experience makes me feel it's not just me !!

    • ruifeng
      ruifeng eileen15268

      Posted

      I HAD MY b/l tkr in FEB 2016, I was not able to sleep for four months. Every person body reacts differently, until you have pain while walking everything is fine. It's just matter how week are your muscles, how is your body responding to the implant, major muscles are cut during the procedure and every body healing is different. It is rightly said don't exert to much. Slow and steady win the race, keep doing your exercise and try to involve yourself in other activities.

      Now I m one year plus, my sleepless nights are over, Not yet recovered fully but still far better

    • eileen15268
      eileen15268 ruifeng

      Posted

      That's encouraging to learn

       ruifeng    that you can at last get a nights sleep, I'm looking forward to that. Yes I must be patient I know TKR is major surgery ,this past 5 weeks has been unreal. Will press on though with exercises 

    • CHICO_MARX
      CHICO_MARX eileen15268

      Posted

      At 5 weeks, you're a "Kneebie".  Unless you are one of the very, very lucky ones, this takes a long time...but it all starts with taking your meds and getting your ROM back.  There will be times that you want to give up or get depressed. Don't do that!  Yes, it's a long recovery but it does get better.  Promise...

    • eileen15268
      eileen15268 CHICO_MARX

      Posted

      Thanks for encouraging text Chico. I must say I had a little more sleep last night, but scar area still really sore. I'm now using the Bio Oil with vit E & feeling positive xxx

  • rhonda58211
    rhonda58211 CHICO_MARX

    Posted

    Hi Chico , I am five weeks out  total knee reeplacement on right knee .. I can bend it 122. bu a little more to go on the straight part ... but last week in therapy I was told that we were just doing maintaining exercises and then the PT knelt down and bent over and put all his weight on my knee,, I couldn't walk for about 3 days with shooting pains down my leg .. now my knee doesn't seem right , it is really really hot and feels like something is sticking me inside my knee .. I haven't been going to therapy . but I am doing my exercises at home .. any suggestions ?

    • CHICO_MARX
      CHICO_MARX rhonda58211

      Posted

      What that PT did sounded extreme but I don't know their protocols.  I know that when I was on the table, he put a block of wood under my heel and leaned over and down on my knee...about 6-8 times.  Then he had me flip over onto my stomach and down the table so that my knee was on the table but my leg just dangled in mid-air.  Gravity's a bitch...  After a few sessions, he put a 2-pound ankle weight on the leg...  It wasn't pretty.

      Again, I don't know about different PTs and their methods.  The goal is to break down all the scar tissue forming.  It's not easy...it IS very painful.  Five weeks is very early in a year-long recovery.  There will be advances, setbacks and plateaus...the worst...I was stuck at -4 for weeks...  If you think something's really, really wrong inside, see your ortho for an x-ray.  I do know that your knee will feel very different on occasions as you walk this path.  Meanwhile, ice, elevate and sleep.  Talk to your PT the next time about what you feel...and see the doc if you suspect an issue.

      In fact, you should be seeing the ortho for your six-week alignment check.  They do an x-ray at that time to make sure everything is lined up correctly between hip, knee and ankle.  Good time to talk to the ortho and get that x-ray. 

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