2nd Total Knee Replacement is near

Discussion in 'Masters (50+ years old)' started by wags, Jun 7, 2017.

  1. Rif

    Rif More than 500 posts Master Certified Instructor

    way to go but do whatever you can to get that full flexion . you need 110 degrees just to go down stairs! the closer you get to 150 ( if your device flexes that far) the easier things will be in my experience.
    I did tons of supported squat holds to get that stretch reflex to let go and give me more depth; using gravity.
    One thing most therapists I see miss is the importance of the calf, specifically the soleus, in allowing knee flexion.
    I worked that bad boy hard, in every angle imaginable. soft tissue work as well as stretching and toe squats.

    swings always helped me stay strong and resilient with very little stress on the knee.
     
    LoriLifts, Steve Freides and wags like this.
  2. wags

    wags Double-Digit Post Count

    Today is week 11 after my total knee replacement. Finished up 5 weeks of out patient PT 2 weeks ago. Everyday is better than yesterday. Was released by surgeon to return to work next week on a light duty basis. Honestly, feeling pretty good about myself and progress I've made since surgery in June. I have only one issue, my Range of Motion (ROM) is not where I want or need it to be. Not quite the 120 degrees I'm shooting for. The swelling around the knee I still have could be hindering me. Was told to keep doing my quad bending stretches which should improve the movement I'm shooting for.

    I've been diligent and motivated doing all my exercises as prescribed since day one. It's on me to make sure I can keep bending for that matter. And I've been doing swings, goblet squats and press's to strengthen myself and of course my right leg/knee 4-5 days a week for a couple weeks now. I'm not sure if this is correct or just a old wife's tale, but I heard if I don't have the ROM of motion by week 12 it's not going increase? I could of swore my ROM improved over time with my other TKR 4 years ago, way beyond the 12 week mark.

    I'm looking into Rif's Heel to Butt stretches. Even brought into the house knee pads since my new knee is still extremely sensitive to being knelt on. Going to try and see if this helps. Rif: Did your ROM improve PAST the 12 week mark by doing this particular stretch? I'm serious on getting over the 120 degree mark soon. Thanks again.
     
  3. Rif

    Rif More than 500 posts Master Certified Instructor

    More ( much more) later but for now YES your ROM can increase for years. I didn't get my heel to butt until almost 3 years post TKR.

    there are many ways to increase knee flexion and most are stretching, massage and SMR related. ALso the calves play a huge part in knee flexion as well
     
  4. Rif

    Rif More than 500 posts Master Certified Instructor

    Not sure which exercises you are doing to increase ROM but one thing became clear to me very early on, working too hard on strength exercises before my flexion was solid was not helping. One of the best exercises for me was a static supported squat where I held onto a post, lowered into a squat and held it until the stretch reflex gave out and I dropped lower. I repeated that many times.
    I also sat in seiza with a foam roller between calves and hammies for as long as I could stand, numerous times er day, every day.

    I also used a variety of stance widths as well as did the same thing in a lunge stance.
    LOTS of foam rolling as well as percussion massaging while the knee was in a flexed state also helped.

    I think they tell you you won't( can't) get more knee ROM after _____ # of days ( fill in the blank,I've heard many time lengths) is to motivate people to get to work as fast as possible

    I got to 120 fairly quickly but it was a slog to 140 and I still can only hit 150 on really good days. The thing to remember is that the limiting factor is muscular NOT the device ( which should go to 150 if it's a newer appliance.)
     
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  5. wags

    wags Double-Digit Post Count

    Thanks for the feedback Rif. I will concentrate more on flexion than strength the next few months. My current KB exercises are swings, goblet squats and presses. Nothing crazy weight wise. Just building a base keeping my muscle memory alive while gaining a slow strength comeback. Does that make sense? Swings are the best exercise I know since they are easy on my new knee's, and give a total body workout.

    Your range of motion is insane at 150 degrees! For sure my right knee replaced 4 years ago is 125-130 degrees. I'm pleased. But need to have the new left one moving a lot more than where I'm currently at. I'll get there, I know. Just takes time. But boy is it a drag bending this puppy to the point of major discomfort, then holding that position until you can't take any longer then repeating. Lol. Will keep you posted on progress in the following weeks.
     
    Rif likes this.
  6. Rif

    Rif More than 500 posts Master Certified Instructor

    It takes time for sure but only if you are moving towards full flexion specifically. When I meant not focused on strength I meant not worrying about using progressive weights in the knee flexion exercises ( squats,lunges, etc) and focusing there more on flexibility, tissue quality and ROM. For swings and presses focus on strength all you like.
    I 'wake up' at 140 degrees now and can get to 145-150 with a serious stretch but I'm still working towards waking up at 150. that's my goal.
    DO NOT stretch towards major discomfort imo. Pain creates tightness and that inhibits stretching and release. MY mantra here is from Pavel: "relax into stretch'. that's the key in all your mobility exercises.
    I was holding the static position BUT constantly adjusting, BREATHING THROUGH, and 'making space' during that hold
    Plus make sure in your squat/ lunge work you are allowing the knee to move over the ankle. that's a very important part of regaining the flexion.

    Hows your extension as well?
     
    wags likes this.
  7. wags

    wags Double-Digit Post Count

    Funny you asked about extension. I was at the negative degree requirement/goal early into my out patient PT. I'll keep working on my ROM and report back in a few weeks. Wish I had one of the medical protractors my PT therapist used to measure ROM. Appreciate all the positive input, Rif! You should be listening to me instead since I'm on my 2nd TKR. ;)
     
  8. wags

    wags Double-Digit Post Count

    It's been 14 weeks now since my 2nd Total Knee Replacement (TKR), and 3 weeks since I last checked in. Working like heck to improve my Range of Motion (ROM) which has had me concerned since being cut from physical therapy. I've been doing plenty of step ups, and step downs at 14" of height. Wall squats with a large ball in lower back while I squat as low as I can, then holding that position. Also sitting in a chair tucking my left leg as far back as I can, then scooting my hips forward for more bending motion of the knee. Overall these exercises have improved my ROM tremendously! Where I'm at degree wise is unknown, but at the rate I'm going in a year or more no telling where I'll be.

    I'm doing two handed 100 swings with my 24kg bell 4-5 days a week with no discomfort to my knee's. Period. I'm not quite ready to go to one handed yet at this weight but I do with a 20kg just fine. Plenty of goblet squats and two/one handed press's since it may be a while before I can back to TGU's. My knee is still in that "funny feeling" stage and kneeling on it is VERY UNCOMFORTABLE. If I have a knee pad on I can kneel on it if needed, but not a good idea, yet.

    Hopefully by spring I'll be 90% of better so I can attend a Strong First KB course. There are a few qualified instructors in a 75 mile radius of me. I'd like to get some professional input and keep improving. Maybe do a video in the future showing what you can still do with double knee replacements and KB's. It isn't the end of the world believe me. Just another bump in the road to over come. Appreciate the help given to me the last 14 weeks of my recovery (RIF). Stay strong!
     
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  9. Rif

    Rif More than 500 posts Master Certified Instructor

    Pretty much the only thing you can't, or shouldn't do, is run or jump. That's what my surgeon told me. Everything else is ok Haven't found any of the basic kb movements I can't do , should be the same for you. Keep strong!
     
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