Question about Extension

[Amy29]

Just a quick question - how long did it take everyone to get full extension after surgery and what surgery did you have?

Thanks
Amy
 

[LindaM]

Hi Amy,

Every surgery is different.  After my meniscus surgery I had it back immediately, the first PKR took about 3 weeks because I had been limping and not straightening my knee before surgery.  My PT had to give it quite a jolt to break up some scar tissue(and he didn't warn me ahead!). The second PKR I had it back in about 2 weeks (this time it was mainly the swelling that kept me from straightening it).

If you are currently working on gaining full extension, one thing my PT had me do was put a rolled towel under my heels when I was sitting with legs extended so the knee gently is stretched to straight.  He recommended 2-3minutes at a time several times a day and it really helps.

Linda

[Amy29]

Thanks Linda;

I know every surgery is different after having had 2 other ops on my knee already - I was really just curious of other people's experiences.

Physio's have given me a few exercises to do inc one where I just lie on my front and let my leg hang over the edge of the bed.  I haven't been told to use a towel under my ankle. 

I just feel as though in some aspects of straightening I'm moving forward but in the one where you have to tighten your quad and press your knee down to the bed, I'm going backwards - it seems to be worse than it was and I don't know why

[LindaM]

Hi Amy,
Now that you are stretching it over the side of the bed, your knee might be aggravated and tightening up to protect itself from pain- just like when you overuse any muscle and pay for it the next day with stiffness and pain.  You might want to shorten the period you let your legs hang for a few days and add a few extra times doing the exercise to make up the difference.  The towel under the heel is very gentle too, you might want to try it when you are seated with your legs up icing.  I've also found that doing seated straight leg toe touches and holding them helps to stretch out the hamstrings and makes the extension exercises easier.

Have a beautiful day.

Linda

[Amy29]

Thanks again - the knee over the side of the bed I repeat 5 times and only hold for 6 seconds each time but have been told to do them every hour.  I have been told not to ice my knee but put a heat pad/hot water bottle on back of thighs whilst doing it.  How do you do that toe touch one you mentioned?

Thanks

[LindaM]

The heating pad before or while stretching is a great idea.  I was talking about elevating and icing your knee after doing your exercises to help take down the swelling.  The toe touch is simple.  Just sit on your bed with your legs straight out in front of you and lean forward stretching your arms as far to your toes as you can go. Hold for 10, then relax.  Repeat, extending your arms a little further each time. I usually do 4-5 repeats.  Try to lean forward from the hips more than just curling your back as if you were closing up a jack knife.  It feels great on the back as well as a good hamstring stretch.

Hope it helps you get to that full extension sooner.

Linda

[Amy29]

Thanks again Linda - I will try that toe touch one.  He told me not to Ice my knee at all and tbh it doesn't really swell up after I have done the exercises - it just seems locked in a bent position.  It probably doesn't help that I sleep with my legs bent and to the side but I have always slept like this (in the foetal position) and can't sleep on my back with my legs straight - find it way too uncomfortable

[The KNEEguru]

You may want to read these notes, especially the LLPS stuff - http://www.kneeguru.co.uk/KNEEnotes/node/634

[Amy29]

Thanks for that but I don't have arthrofibrosis - have had microfracture surgery.  Don't think I'm allowed to wear any braces as I got told to not even wear my tubigrip.  Also, still got 3 weeks of not weight bearing on it

[LindaM]

Hi Amy,

I think the article was suggested because down at the end of it were some gentle passive extension exercises.  I don't think it was meant to say that you had arthrofibrosis.  I'm really glad to hear that swelling isn't an issue for you.  I think you are right that side sleeping isn't helping the situation.  You might want to consider trying to fall asleep on your back.  Of course you will roll over and curl up eventually, but it might cut a little time from your bent-knee sleeping.  Side benefit-sleeping on your back helps delay facial wrinkles!

Take care

Linda

[Amy29]

Thanks but even when I sleep on my back - the only way I can sleep is to have my knee bent out to the side which then hurts my hip and groin.  Also when I sleep on my back - I wake up in the morning with lower back pains and breathlessness - think this may be because I have a big chest lol.  Thanks for all your advice though 

[seerobinbike]

Hi Amy,

It's been 14 weeks since my PKR surgery and I still haven't got full extension.  Last time they checked, I was about 5 degrees short. I did the passive stretch that Linda M. suggests when I first started rehabbing.  My PT told me not to worry about it too much and that it would come as long as I continued to build my quad mms. I believe this particular PT gave me bad advise!  I saw someone new recently who was shocked that my extension hadn't normalized yet and told me to to the hang your leg over the table with a one pound weight on it twice a day.  I have been doing this one on a regular basis but it's still not right although I'm not sure if I was at zero degrees prior to surgery.

Where are you at extension wise?  How long since you had surgery Amy?  If you mentioned it, I'm sorry if I missed it.  Have only had one cuppa coffee so far.   

Robin

[Amy29]

Hi Robin;

I have a deficit of 30 degrees (they want me to try and have it down to 20 today) and I am 3 weeks post-op.  I had Microfracture surgery so am still on crutches and will be for another 3 weeks with only toe-touch weight bearing.  I know I wasn't at 0 degrees before the surgery as I didn't gain full extension after my ACL recon 8 yrs ago (although I am hypermobile in my right knee and so wouldn't get my left to have as much extension as my right anyway)

[seerobinbike]

Hi Amy,

Oh you poor thing.  Microfracture surgery has quite a long rehab.  I'm not totally surprised that you are at -30 degrees at only 3 weeks post-op.  I *might* have been -20 degrees 3 weeks after my partial.  It seemed like it has taken me forever to get to -5 degrees!  I do believe that the passive stretch with a rolled towel under the ankle worked the best for me.  It was a gentle stretch although I seriously couldn't do the stretch for more than a minute at a time for the first several weeks after surgery.  It was definately the most painful thing I had to do as part of rehabbing. 

Fast forward 14 weeks and it's almost normal.  I still do the towel stretch but not as often. 

Good luck to you Amy.  Keep in touch!

[Amy29]

Thanks Robin;

No one has really told me how long rehab should be after Microfracture surgery.  I had my 2nd Physio appt today - 90 degrees flexion and still -30 extension.  He said I was guarding and not relaxing my muscles so they are sending me for Hydrotherapy to see if that helps.

Hmmm may have to try that - normally I wouldn't mind if it took 14 weeks to get better but I have a holiday on June 16th - 2 weeks in Turkey - that I have to be able to at least swim on (wanted to do White Water Rafting again this yr there but don't see that happening now)

[LindaM]

Hi Amy,

Of course you're guarding, that knee has gone through a lot!!  Glad to hear that they are trying the hydrotherapy.  That sounds a lot gentler than my one PT who just forced my knee to straighten.  Hopefully working in the water will do the trick.

Linda

[LindaM]

Hi Amy,

Of course you're guarding, that knee has gone through a lot!!  Glad to hear that they are trying the hydrotherapy.  That sounds a lot gentler than my one PT who just forced my knee to straighten.  Hopefully working in the water will do the trick.

Linda

[Amy29]

Oooh that sounds painful Linda

It's funny because after my ACL reconstruction years ago I had exactly the opposite problem - my quad muscles weren't working and I had to have a machine to help me!!! Lol.

Yeah hopefully hydro should help