Posted , 7 users are following.
Not sure how to explain this but when I do heel slides I do both legs at same time so I can compare how far I have to go to get the injured leg the same as the other one. I get my feet in the same position but my knees are not even. The uninjured leg is higher than the injured one. Is this because of the bend? What I mean is they are together side by side but the height is not the same. Any suggestions?
0 likes, 14 replies
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missmagwumps linda88757
Posted
Hi Linda,
I am told we all have on thing or another larger than the other - some people have feet slightly different sizes some people have one leg slight shorter than the other....
I thought my new knee had made my leg longer than the other as I felt I was raising sllghtly higher on that step....but think it was just the stiffness making it feel that way. But staying with friends the other weekend he made me bend my knees to a normal sitting stance and put a spirit level on top of my knees to see if they were level - they weren't but we can't be sure why not or if they were like that before but the difference was only minimal.......will check it out when I go for my 6 months follow up in July! Not much help to you though.....but food for thought....x
CHICO_MARX linda88757
Posted
The anatomy of your knee has changed. The comparison is invalid. And at seven weeks, you are barely at the beginning of your one-year recovery.
Do heel slides on the TKR knee only. Keep pulling that extra tiny bit even when you think you can't go any further. This whole thing happens gradually over months. Depending on what the ROM of the good knee is, you may never achieve the same ROM on the TKR side...nor should you try. Why?
For a fully functioning TKR device, the minimum recommended flexion is +120. This is enough to restore normal life functions. As you progress from ROM work to gym work, you will gain more flexion. Mine went from +123 at the end of PT to +133 now. Very many people report the same.
Problem: +140 is the lower limit for "athlete" range and "+161" is heel touching butt. These ranges are: 1. completely unnecessary for a TRK knee; and 2. may exceed the device's physical capability resulting in potential failure or decreased lifespan. The problem is that no one has any data on this...it's just conjecture. However, with a ROM in the upper 120's to lower 130's, you should have a fully functioning knee within whatever limits there might be. No one recommends taking chances on excessive flexion exercises for a TKR knee.
We hear of some new "high flexion" devices out now but there is zero data on their maximums or longevity. To play it safe, stay within a reasonable range. Once you start the muscle rebuilding part of the program...
https://patient.info/forums/discuss/post-tkr-exercising-565527
...you can then start working both knees together (like a leg press) to balance both ROM and strength across both knees and legs.
One other thing...leg length. So many people who get "diagnosed" with legs of unequal length immediately blame the surgeon and run out to buy expensive orthotics. While this is a possibility, it is very unlikely. The more common cause is that we shift our gait unconsciously to avoid pain and throw our hips out of alignment. I've done this many times through four knee scopes, a hip replacement, four spine surgeries and the TKR. Lots of hip and lower back pain, locked SI joints, sciatica, etc. I see my chiropractor who tells me that I'm a half-inch off (or more). After some realignment sessions, all the pain is gone and I have two equal leg lengths again. I would seriously consider this as a solution to that problem. Putting an orthotic in a shoe does not solve the underlying problem of hip alignment.
Dcweather CHICO_MARX
Posted
Hi Chico, you keep quoting these ROM amounts but you really should qualify them. My research and experience of my own knee and discussion with Physios and the surgeon indicate that is rare to get much more movement than you had before the operation if you had limited movement for some time before hand. Age is also a factor but of course every case will be different. i agree for a "normal" lifestyle 120 deg would be great but i think you are raising expectations above what may be possible in many cases. People, in my opinion, should be working to get back to the range of motion they had before the op and then hope to get a few degrees more, especially if they are relatively young and have flexible ligaments and tendons but in some cases no amount of hard work will get you beyond your personal maximum (90 deg, in the case of my first knee).
Dave
CHICO_MARX Dcweather
Posted
I have never heard of anyone who knew their pre-op ROM. That may be true for a very, very minute number of people who have had multiple leg/knee injuries in their past and their docs will give them their own ROM goals. However, the absolute TKR standard for any healthy individual with no previous knee issues is 0 / + 120. As a side note, I was a hockey goalie for 45 years so my doc, for the heck of it, did test my other knee at +145, which is in the +140 "athlete" range. However, I have no intention of pushing the new knee to that level.
However, I did ask my PT what they did with elderly people in their 80's and was informed that yes, they do relax the standards in cases where that group of people just cannot get the exercises in. He said for those patients, they concentrate more on getting them active enough to have a reasonable quality of life without worrying about numbers.
martha08360 CHICO_MARX
Posted
CHICO_MARX martha08360
Posted
Your pain is caused by both the swelling and the fact that you have to break down the scar tissue forming inside. That's a painful process that can take a number of weeks. Most people have achieved 0 / +120...or close to it...by 12 weeks (mine was -1 / +123). That number is NOT chiseled in stone!!! Some do it sooner; some later. But the 0 / +120 goal is the standard measurement used worldwide to tell you that you should be able to walk, do stairs and lead a normal life from that point on. With the muscle rebuild program, lots of people reach the upper 120's to low 130's. That's more than sufficient to forget the metal even exists (except when kneeling on concrete) in daily life but does NOT give you the ability to run, jog, play single tennis or get involved in competitive sports again. There is a rather extensive list of prohibited activities if you want the knee to last 25 years.
Dcweather CHICO_MARX
Posted
CHICO_MARX Dcweather
Posted
What you're saying is probably true for people with existing knee issues so their docs track them. I've read over 4,000 posts on here and I've never really seen anyone discuss their PRE-TKR ROM numbers. 0 / +120 is the standard but obviously doesn't apply to people with existing conditions that make the goal impossible to achieve. Those cases are one-offs and reasonable goals should be agreed to between the surgeon, patient and therapist.
martha08360 linda88757
Posted
Just do your injured leg. BTW, I like it when ppl say injured leg. And, why are TKR's a replacement and a liver or heart is a transplant? just wondering. Oh how I wish I had my old Knee back. I told the ortho other day at hospital, after he put a rod in my 98 yr old aunt's femur, if he could put my old knee back in. He laughed and did look at my knee an asked me where I had it done. He's also a knee replacement doc. I told him. He had heard of my ortho. Yeah, so what>>>>>>>>>>>>
missmagwumps martha08360
Posted
shan99257 martha08360
Posted
Oh Martha! I feel exactly the same way!! I wish I could turn back the clock and have my old knee back!! I hate this new knee! I had it done over 2 years ago now and it is still not working right. They want to put a patella button in but I'm not game to let them touch me again!! :-(
martha08360
Posted
martha08360 shan99257
Posted
I can't promise this left TKR won't ever be touched again Hid forbid, but you can bet huge bottom dollar no surgeon will be touching my right knee. And on that you can count on. And take that to the bank! Like my analogies? I'm loopy sleepy😜
jenny80029 linda88757
Posted