4/27/2011

what more can i do to rehab from total knee replacement?


what more can i do to rehab from total knee replacement?i'm 40 and had a total knee replacement at the end of sept. i'm not getting my range of motion back, and cannot walk still because my knee is bent to far still. i can walk with one crutch, but some days with 2 because it's at 45degrees...NOT GOOD! i'm doing rehab and home-rehab religiously. i do the prone leg hang with a weight to try and pull my leg straight too. I've had 8 prior surgeries, and have never, EVER had this much trouble coming back!


it's hard to go into all the details, but has anyone had similar problems, and what did you do? my doctor is talking the possibility of putting me to sleep and forcing my knee, but wants to try and avoid that because there's a chance of damaging tissue around the joint. i know i have about a 6 month period before the scar tissue starts to harden beyond repair without surgery.
thanks for your help!!!

- mlgable
Call your doc and ask for a referral to physical therapy.

- summerfest_01
That sounds horrible to me. I have no idea but good luck with that. Maybe exercise? Don't listen to me, though. I know nothing about the subject and am no doctor. I hope you get some answers, and good luck!

- justbeingher
I use a technique of sports rehab massage called Muscle Energy Technique.

You activate the muscle against resistance, hold for 7 seconds, and have the therapist start increasing the opening of the joint gradually after each 7-second activation. You do 2 sets of 7 reps each session. Very effective. But you have to find some PT that knows MET.

- twocoolinc
You might try cold compression therapy to get the swelling down. Your symptoms seem similar to a sprain or strain albeit it is post surgical.

Strains are injuries that affect muscles or tendons, thick bands that attach muscles to bones. They occur in response to a quick tear, twist, or pull of the muscle. Strains are an acute type of injury that results from overstretching or over contraction. Pain, weakness, and muscle spasms are common symptoms experienced after a strain occurs.

Sprains are injuries that affect ligaments, thick bands of cartilage that attach bone to bone. They occur in response to a stretch or tear of a ligament. Sprains are an acute type of injury that results from trauma such as a fall or outside force that displaces the surrounding joint from its normal alignment. Sprains can range from a mild ligamentous stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs.

RICE is the acronym used for Rest, Ice, Compression, and Elevation. It is used as the best initial treatment of soft tissue injuries such as sprains, strains, and contusions. The combination of RICE helps reduce inflammation that occurs after acute injury. It is important to remember that the earlier this treatment is put into place, the more effective it is.

Rest: Rest and protect the injured area. If it hurts to bear weight on the injury, use crutches, or a cane.

Ice: Apply ice to the injury. The cold will reduce swelling and pain at the injured site. This step should be done as soon as possible. Apply the frozen object to the area for 20 minutes three times a day for the first 48 hours.

Compression: Compress the injured site. This will decreases swelling of the injured region. Although the wrap should be snug, make sure it is not too tight as this can cause numbness, tingling, or increased pain.

Elevation: Elevate the injured area above the level of the heart as much as possible. This technique will also assist in reducing the amount of swelling to the injured site.

Once the pain and swelling are eliminated, you should start gradual range of motion exercises but not to the point of pain. Each day your range of motion will increase slightly. Continue until you have complete range of motion. Than start gentle strengthening exercises to re-build the strength in the knee.

The stiffness will go away over time.

Good Luck

- mistify
The MET technique is a good idea...I use it frequently, but it is probably too little too late.

Regaining ROM after the 8th week is very difficult as scar tissue has had a chance to adhere. Therefore, a manipulation may be unavoidable...in fact, it may actually take arthroscopic manipulation to release the scar tissue.

Yet, before trying that, I would look into progressive static spliting such as one by JAS. It is a device that allows one to progress a stretch for 30 minutes at a time. It is equipped with a little "crank" on the side of the brace that progresses the stretch every five minutes. The patient is in complete control of the stretch. Talk to your therapist or surgeon about obtaining one of these devices.

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