TKR ROM Work At Home

Edited , 25 users are following.

This is for everyone but especially for those who can't afford PT or are too far away to travel to one.  Remember: The goal is to break up the forming scar tissue.  Screw the pain...do the work!!!  You want to walk with a limp the rest of your life?

#0... Warmup:

Nothing beats a stationary bike to get the blood moving and to warm up the knee.  This is usually a given.  Virtually all PT sessions start out by warming up the knee.  Do this...  No bike?  Take a 10-minute walk...and walk correctly...

https://patient.info/forums/discuss/walking-after-a-tkr-593409?

#1...  Heel Slides:

https://patient.info/forums/discuss/tkr-heel-slide-exercises-526213

When you use a belt to PULL your foot toward your butt, you will be increasing your bend to +120 and beyond.  There is also a medical device to help with this (see picture).

#2... Squats:

Hold onto a chair and do squats.  Deep as you can...hold...stand up...repeat.  Start with three sets of 5 once a day.  Increase to three sets of 10-15 multiple times a day over the course of weeks.  Want more?  Put some weight on your shoulders or hold onto some dumbells to pull you down.

Both the above home exercises will help with your bend.  Do them diligently multiple times a day.  When you see your doc again, he can measure your progress, although when doing the heel slides in the same location all the time, you can have a piece of masking tape on the floor; mark your progress with a pen and date it.

Now for straightening your leg...

#3... Gravity:  

Lie on your bed face down with your knees just on the edge of the bed...NOT OVER IT.  Lower your TKR leg (or both) and just let it hang...gravity will do the rest.  This is one hell of a difficult thing to do.  Count "x" seconds...bend the leg back up to vertical...repeat.  You can do as many reps as you can handle for how many seconds you can endure multiple times a day.  As you progress, increase the number of seconds and the number of reps.

The big thing to remember with this is that you CANNOT use your muscles to support the leg.  You have to relax and just let it hang!!!  When you get adventurous, strap on a 2-pound ankle weight.  That will be INTENSE!!!! ...but worth it.

#4... The Gym

Once you get your ROM going pretty well, you'll need to hit the gym anyway to regain all the strength in your atrophied quads, glutes and core.  Doing more leg presses and squats with increasing weight and reps will help finish off your ROM work to 0 / +120...probably beyond.  You can also do this at home with a good set of exercise bands of increasing resistance to do the leg work.

Conclusion:

These are only some of the exercises you can do but, for me, they formed the core of my recovery.  Do some research on the web, especially YouTube, for more ROM exercises.  So, yes, a PT can be of immense help to you but if money or distance are issues, you can do this recovery at home, on your own, if you stay focused and diligent about the ROM work.  You will NOT have a PT pushing down on your knee to break up the scar tissue but you can come close if you do the work!!!

Have fun...

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  • Posted

    THank you.  My main problems right now are: 1. Very often,  my leg jerks forward as I walk. 2. I feel the leg unsteady, I can’t do one leg stand on it. 3. I still walk with a crutch and though I can climb the stairs without the crutch I cannot go downstairs with out it. 

    Background: I had double partial knees replacements. My right leg was first it’s now 16. My left knee was in February of this year and it’s the one with all the issues.  

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    • Posted

      Many people who have both knees done report very different experiences between the two operations...some #2 better...some #1.  Can never tell in advance.  I'm 20 months and I still feel unsteady on uneven pavement.  I avoid grass when possible because divots, rabbit holes, etc. can throw me completely off balance.  It's both a balance and strength issue.  Takes time for all of it to get back to normal.

      On stairs...

      https://patient.info/forums/discuss/mastering-post-tkr-stairs-552728

      A controversial topic as people have been taught doing stairs in different ways.  I still stick to my stated premise.  Stairs are the last big hurdle for knee replacement patients.  Have to rebuild all the lost strength in your atrophied quads, glutes and core.  You have to do the exercise to expect to do stairs WITHOUT holding onto anything...that's the goal.  I'm 20-months and almost 70...I can climb stairs with no railing TWO AT A TIME!!!  Gotta do the work to get there.

      The jerking?  No idea.  I'd ask my doc or PT.

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  • Posted

    Thanks for the info, "TKR ROM Work at Home."

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  • Posted

    I wish it was that easy. I’ve working at trying to bend my knee but I’m still at 50% 

    what’s the difference between a PT specialist helping me or doing it at home? what am i to expect with a PT specialist? 

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    • Posted

      Easy?  NO ONE said this would be easy.  It's hard, painful, necessary work or you will never walk normally ever again. 

      Doing it at home requires dedication without anyone pushing you.  You have to be highly self-motivated.  The exercises described, plus others, really rely on your strength to pull your foot to your butt and gravity to straighten it out to zero degrees. 

      Going to a PT is waaaay preferable.  To straighten the knee, the PT will put your heel on a 4" block and then literally PUSH DOWN on your knee to break up the scar tissue.  Remember the chest-waxing scene from Steve Carell's The 40-Year-Old Virgin?  Yeah...like that....and more.  An hour at PT is a GREAT way to get to 0 / +120 fast.  Took me 10 weeks to go from -14 / +84 to -1 / +123.  Absolutely worth the pain and effort.  PS: Most of us take a pain med before a session and get driven to PT.

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  • Posted

    Many thanks for this! I am printing it out for reference. Thanks again.
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    • Posted

      #3 is the killer...just gravity...that's it.  Very, very effective!!!  Make sure you have a pillow to scream into.  Start for just a few seconds but the key is to let the leg just hang...no muscle resistance...just hang.  Build up time and reps as you go along.  When you can handle it, add ankle weights or similar.  This will get you to zero straight...guaranteed...

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  • Posted

    Thanks.. almost everyone on patient told me to get your advice. I will try all and be very careful..

    I like to know fir how long will i aspect my knee cap area to be swelling.

    Thanks fir your health

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    • Posted

      Swelling is so very common in two ways...

      1. The knee will be naturally swollen for even as far out as a year.  As you get along the path, there wont be a lot (or any) pain but the knee will just look a bit "bigger".  Sat down one day a year out and noticed it.  Then the light bulb moment: "Dummy...  You have a 2 1/2 pound hunk of metal implanted in your knee!  What do you expect?"  It's 2+ years now and I don't even notice a difference.

      2. The knee will ALWAYS swell when you push it too far on any given day...period.  Get a fit bit and track your steps.  Know your limit...increase gradually.  I did 8,200+ steps at 5 weeks and paid for it with a "balloon knee" for three days.  Never made that mistake again.  By 8 months, I was doing 11,000+ steps (~ 5 miles) with no swelling or pain.  Gradual slow improvement.

      Click on my name and then "See All Discussions"...lots of stuff out there on all sorts of TKR topics.

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  • Posted

    Funnily enough I find #3 the easiest. A stationary bike is  great but is impossible for me and probably many so may need other ways of warming up. We know you got great ROM but is essential for people to realise that it is physically impossible in some cases to achieve more than say 90 deg due to previous conditions etc. In fact forcing it is impossible anyway but could do serious damage. As you say every person is  different and I wish I was as lucky as you with the rom and I appreciate this is all good advice for many but won't apply to everybody.

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  • Posted

    Thanks for the advise will work on it
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  • Posted

    Thanks for the regimen. My wife's going in for TKR in about a week so we'll try follow that afterward.

    Just checking on #3 (Gravity). It's difficult to imagine lying face down wouldn't seem to allow the knee to hang down very well as knees don't usually bend backwards. But maybe this is to get the leg to straighten?

    Thanks for the help!

    Robert

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    • Posted

      Yup...#3 is all about getting that leg to zero degrees straight. Remember that the knees stay on the bed...just the legs hang over it. Don't underestimate the power of gravity. My PT taught me this one and at the beginning I could let it hang just for a few seconds. It is NOT easy...it is, however, very, very effective. The difficulty is in just letting it hang there vs. trying to use your muscles to compensate. As time goes on, you increase the number of seconds and the reps. Really helped me break through from a -4 plateau to -1. At 2 1/2 years, I'm 0 / +133.

      If your wife is still pre-op, you might want to read this...

      https://patient.info/forums/discuss/tkr-pre-op-expectations-622045

      The more you know the better..and the docs usually tell you little or nothing. I've had lots of ops plus 4 1/2 pounds of meal in me. The knee was the toughest and longest recovery of them all. I went in with expectations of skating through it...then got slammed. Having her understand the possible amount of pain early on plus the usual full length of time to recover is critical. Pain management will be very important; work with your doc if adjustments are needed.

      Click on my name, "Discussions" and then "See All". Lots of topics out there that can be of help...especially post-op depression, sleeping, etc. The Post-TKR Exercise will be critical to a full recovery. Oh...prepare your house!!! Get rid of any rugs that can be tripped over, set up something near near the bed with food, meds and lots of water, staying on the med schedule is very important. Your support of her will also be a game-changer for her. Time, work and patience are your tools.

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