Range of motion...

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8 weeks post TKR and range of motion is not progressing. Bend at 100, (105 if PT pushing), extension at 8, (6 if PT pushing). I am frustrated and concerned -as I do my exercises, and PT pushes till my pain limit reached. I don't want a manipulation. I have read that ROM will continue to improve over the next few months. True? My husband is making the knee extension board so I can use it at home (pain!). Can I get some experienced comments...? Will I never bend adequately again? This is the most frustrating surgical experience -and I was unprepared for rehab....Help! Hate being a wimp -but was hopeful things would improve, not stall... Thanks everyone for all the helpful info each and everyone contributes to this blog.

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29 Replies

  • Posted

    Still early, plenty of time..... don't panic....😊

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  • Posted

    Hi Carol

    U prob sounds v similar to mine. I have 110 bend but -10 extension that has not moved from week 9 and I am now week 13.

    Ike you I feel frustrated and I tried to improve but my mobility and discomfort has regressed. So mau booked for 24th. Just have to think positive. When walking no prob with knee most of my discomfort is calf, back of thigh n shin bone. So unfortunately I can't say yes go for it as I don't know what outcome for me will be but my worry was how long do u wait to see if things will improve. Good luck in your decision making.

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    • Posted

      Good luck good on your mau. I have a concern with ROM regression following mau -as I can't tolerate natcotics and have come this far on Advil only. I think my 2-6 weeks of no pain meds caused me not to push myself like I should have pushed. Reading these blogs has been encouraging- that PT pain isn't always a good thing. I hope to hear you have had a good response w mau; thanks for your response.

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  • Posted

    Hi Carol -

    It is early in your journey - hang in there a bit - i'm 8 mos post TKR and am still having issues (long story) with my extension.  Don't fret, you'll get there - your numbers are pretty good!  Hang in there!

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    • Posted

      Thank you, I appreciate your wisdom after 8 months. I will keep plodding away. Seems like this surgery has me so focused on my inabilities... I need to keep a positive attitude and just keep moving... You hang in there too!
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  • Posted

    Yeah, at 8 weeks there is time for improvement.

    ?I have been much worse at only 60 degrees 10 weeks out an had an MUA to break up scars, still only getting 85 degrees, not the 95 they got under anaeasthetic.

    For me it has been a journey of excess swelling , pain, stiffness, frustration. I am sorry I had this surgery so far but hope I will think differently one day. It was painful before but I had some control, which is now not the case.

    ?I'm think your flexion could improve from where you are. Follow all the advice given and keep mobile, stretching is more important than too much walking at this stage. Rest, ice and elevate as they tell us. I'm just one of the minority of people who struggle with TKR, most do fine, though I doubt anyone would say it ever easy. Some do very well though by comparison. It is best not to compare with the super recoveries though. We are unique and fare differently.

    Best of luck!

     

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    • Posted

      You are so right, certainly not an easy surgery- and everyone is different. I m sorry to hear of your difficulties. I will keep u in my prayers n remember your advice. I will keep working hard and hope to avoid mau. Hope to hear you are doing better soon.
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    • Posted

      Thank you Carol. But if you do need and MUA eventually, I meant to add that it was not all that bad - I was scared of having it done in case the level of post op pain came back, but it was not as bad as thought.  I struggle with pain meds, too so that has been one of my issues, plus my GP just wanted me to manage on paracetamol and ibuprofen when I asked for something stronger to get me through physio. I dont't think they realised how hard TKR is  and they must think it is like some other surgeries where you can get of the heavy meds in a short time. Take care.

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  • Posted

    MUA was easy. They knock you out for all of 10 minutes. Got me to 135. I am at 125 now but released from therapy. I'll get more as all the swelling leaves. Good luck to you. You just hang in there. Every day that goes by you are improving. I never had trouble with extension so I can't speak to that. But manipulation helps so much. Just get to therapy right away. Think positive. This won't last forever.

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  • Posted

    At 8 weeks you are still very early in the recovery process, so please don't worry. You will get there as the swelling goes down & you are able to do more.

    Please don't measure yourself by anyone else, you are an individual & your recovery also is individual to you.

    Don't forget to ice regularly & also take your pain meds regularly, you need to not be in pain esp when exercising. I found it best to take pain meds an hour before exercise & to warm the joint before exercise & ice after.

    You aren't a wimp, you are a TKR survivor!!

    Good luck with your rehab, you WILL smash it.

    Marilyn

    XX

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  • Posted

    Hi Carol, im only 7 weeks and have 120 bend but when i was at a 110 bend my PT said that even if i stayed at 110 that would be fine and enough, he said anything more than that was a bonus.

    I hope things improve for you. Take care.

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  • Posted

    "Can I get some experienced comments...?"  Sure, just send your check to "wewereallfrustratedwimps dot com".  No problem...

    "Will I never bend adequately again?"  Absolutely yes.  I started PT three weeks post-op at -14 / +82; finished 10 weeks later at -1 / +123.  It just takes a lot of time and work.  Painful?  You betcha.  I'm now at 15 months with 0 / +133.  

    "This is the most frustrating surgical experience..."  Absolutely.  Pain management, PT from the middle ages, advances, setbacks, plateaus (the worst)...all of it.  Deep breath...

     

    "... and I was unprepared for rehab..."  LOL...NONE OF US WERE PREPARED!!  Docs told us zero, zippo, nada, zilch.  We all ran face first into the brick wall.

    "Hate being a wimp -but was hopeful things would improve, not stall... "  Remember plateaus?  I got stuck at -4 for weeks...felt like "eating the gun".  Finally broke through.  We all have experienced the same.  And "wimpitude" is soooo normal.

    Got 18+ posts out there to help you.  Click my picture and then Discussions (see all).

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    • Posted

      Thanks Mr Chico!

      needed to hear your wisdom n loved your posts. I will get back to work n understand plateaus are part of the process.

      my PT is now out of pocket so will need to work extra hard at home.

      appreciate everyone's responses.

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    • Posted

      I don't know of any other way to break down the scar tissue other than having a therapist lean on the knee.  Others have tried massage, oils, machines, etc.  There's really no escaping the pain that goes with this.  Yes, there are the lucky few who do this in a heartbeat...very, very few.  The rest of us have to go through PT hell.  It's the damn scar tissue.

      Once you get your ROM back...or damn close to it...get to a gym and follow the exercise program I posted.  Lots cheaper than PT sessions.

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    • Posted

      What is most important, the bending or the straightening?

      since I am pretty much opposed to a manipulation I am working harder than I ever thought I could, but frustrated with this plateau. Thank you for your advice.

       

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    • Posted

      Carol, why the opposition to manipulation? It's nothing and you get to move ahead. I am so glad I had it done. I really did well after that. You won't be able to get there on your own. Scar tissue can be stubborn. It didn't cause me any more pain! Just do it. Don't fret about it. Many of us have had it done.

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    • Posted

      Thank you for your positive response. I have heard many horror stories regarding the pain and slower progress after manipulation -as well as those who suffered infection and broken prosthesis from incorrect manipulation. I don't tolerate pain meds so would not be able to control that pain, and also my PT insurance is done. My MD informed me I would need daily PT for 2 weeks after manipulation. Quite an expense. I know those stories are probably the exception and not the rule, but I am about at the end of myself with this TKR experience. I return to see surgeon in July when they will see where my ROM is, and determine if I need manipulation. I will certainly take your positive experience into consideration because I really don't want to be incapacitated by this surgery the rest of my life.   It is good to get as much info as possible and I really appreciate hearing about your positive experience. These next few weeks will see me working hard. Thank u Karen.

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    • Posted

      Carol, I see where you are coming from, I cried my eyes out when told I needed MUA. I was so scared it would make things worse but I had no hope of regaining a meaningful bend without it seems.

      ?It is actually only the same as being pushed and pulled by the physio but with the benefit of being put out so free of the pain and stops us resisting the process and, importantly, in the hands of a skilled surgeon who should be able to manipulate the knee safely.

      ?The after pain was not nearly as bad as post op, though it has been a return to some of the earlier soreness and stiffenss, swelling, only to be expected, but I imagined all manner of things while it was no way as bad.

      ?I have only had 3 PT sessions (I'm in the UK so only get so many) but have to find the mental strength to do the exercises at home. I am going to try some in water as I feel this may help now.

      ?I hope your efforts will pay off, clearly if you can do without an MUA, then it is better not to have interventions and extra anaesthetics if you can avoid them. The morphine they gave me after made me very sick and I was on the CPM machine overnight after so had little sleep. But otherwise I was glad of the extra degrees of flexion to work with.

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    • Posted

      Carol I think a lot of what you are worrying about you don't need to! If you have reached 100 to 105 on your flex at 8 weeks, you will get to 110 to 120 eventually, if not more.

      You do need to work on the extension as without a straight leg you will limp, so work on both flex & extension but maybe concentrate more on the extension. OFG has suggested an exercise for that in his past replies. Maybe you can look back & find it??

      I was given an exercise where you sit in a chair & put the heel of your operated leg onto a stool or something, with NO support under the knee & let gravity do its job. My exercise sheet says to sit like that for 10 mins! It kills!! Maybe try 5 mins or less & build up. I was lucky in that my extension was just there (1st time in years!), but to make sure I still did the exercise as, in my probably wrong, opinion if it hurt it needed work!!??

      Where are you in U.K? I'm in Hertfordshire.

      Marilyn

      XX

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    • Posted

      It is so good to read everyone's replies and get information and encouragement! My husband built a knee extension board for me, and already in past week, I have gained extension with use of board at home. 

      I live in Indiana, USA. I have some friends in London tho, and my sister lived there for 9 years. It's beautiful there.

      I will review those exercises for extension and start them immediately. Thank you, Karen and Cynthia, for your wisdom and kind responses. I always feel less anxious after reading these posts.

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    • Posted

      Looks like this.  Search for "knee flex" or something like it.  Google images should have a selection.  WORKS GRRRRREAT in bed, on the floor, at the beach, back of a flatbed truck, etc.  No so good in space on the ISS.

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    • Posted

      I did the same without a board on my hardwood floor. I wear socks and just alternate legs pulling them up as far as I can and pushing my legs flat on the floor. No need for a board. With socks your legs glide smoothly on the hardwood.
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    • Posted

      Google- full knee extension board.

      This should pop up with a picture.

      DME. Direct .com

      after my husband put this together at home I have had good results with extension. Good luck!

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