tibial plateau fracture - just started ROM but feels tight at 30 degrees

[linac eng]

Hi Ive just been allowed some movement after 0 dgrees for three weeks. Theyve given me 45 dgrees on the brace but my knee feels very tight at 30 degrees.
By gradually persisting and pushing into the tight bit will it get easier and allow more movement? Not much pain just very very weird and tight!
ThANKS FOR THE ADVICE!

[rye_70]

Welcome to the land of TP fractures. I think we all know, no matter how bad are fracture is, about ROM issues. From first getting out of the cast, to trying the stationary bike for the first time, I think back to what I have been through.

Yes it does suck. Your leg atrophies, losing muscle and creating scar tissue. My pain went away quickly also, but ROM has been a struggle. I did not have a PT (physical therapist) so I did it all on my own. I suggest you have PT, they can guide you the best, but I will tell you some exercises my OS told me.

When I first got my stationary brace off my OS told me I needed a Bledsoe brace. He told me to ROM exercises, by lying on my back, bring my leg up and let gravity pull it down. The other one is sitting up on a high ledge and put your good leg over your bad and pullback slowly. Another one is to lay on your back a try to contract your leg with you foot flat on the floor. Once you can bend enough the stationary bike is probably the best. If you surf this site there is a section on early non-weight bearing exercises.

Well good luck to you. ROM is slow going. So slow you don’t realize how much better your doing unless you pay attention. You found this site and I think just reading about others with the same misfortune as me has really helped in my recovery. Share and keep us posted.

[linac eng]

Thanks for your info. Could you clarify - Is it normal then that the knee is "tight" and that the exercices push into the tight area and that the tight limit gradually get further away. I really had no idea what to expect?? I even though maybe I wouldbe able to move my knee fully after the op but the brace was there to limit the movement to a bit at a time.

Hoe much do you push it - until it get too uncomfortable I suppose?

It really is such a horrible feeling the best description i can think of is like have a rusty siezed hinge for a knee - gradually, using WD40, you can get more movement out of it.

[rye_70]

I like your analogy. Basically everything is locked up. Yes pain or discomfort is a good stop point. A PT might push you a little harder, but they know what is damaging, and what pain is good and what is bad. My OS said that I could not damage anything by bending the knee. Only compressing the break, by putting weight on the leg, was bad. I am no expert so don’t take what I say as anything other than my own experiences. I would bend my leg until I felt discomfort, hold and then relax it. Also working on extension is important. I found that getting to 90deg came fairly quickly, but it has been slow after that.

Here is a good web site about TP fractures:http://www.wheelessonline.com/ortho/tibial_plateau_fractures

[Suzbean]

linac- my knee has and still does feel "tight" when I bend it to stretch the muscles.  I can bend it just so far and it feels like my knee is swollen and very tight when it isn't swollen at all.  That is the best way I can describe it.  I do push a bit furthur everyday even with the tightness.  Each degree I get back is another degree that doesn't have that "tight" feeling.  I hope that made sense.   

[cah7]

linac - Keep working on it........your ROM will gradually improve.  I used all of the exercises mentioned in the other replies.  I also used heel slides to help with ROM - sitting on the floor, bending my leg, and then actually pulling on my sock to bring my heel closer to my butt and bend the knee more.  I found I would improve, then seem to plateau, then improve some more, etc.  I would take it to the point of discomfort.  My PT would push farther, but I felt more comfortable letting them do that.  It took awhile, but I eventually regained full ROM and can touch my heel to my butt.  The knee does still feel slightly tighter than the uninjured one as it bends, but it does bend fully now.

Cathy

[JAZZY]

Linac, ROM is my enemy. After 14 wks. I can only bend 88, and my knee still feels like I am trying to bend a painful block of wood when I, or the PT really push it. The stationary bike has really helped me more this week. My PT said that the adhesions (I think everyone has them after a TPF) would stretch or break with movement. But for me it has been painfully slow. You are getting to move before I did so your knee will probably improve quickly. Hang in there. PT isn't fun, but they really know what they are doing and will help you although it may not be pleasant. Just ask lots of questions and be really specific about how much your knee hurts or feels stiff. Pain is relative so listen to your body. Doing what the PT and OS tell you to do every day is the key. This fracture requires you to really work to get everything back, but only at the speed you are healing. Rye70 is right about extension. Muscle strength is really important. The PT can push my knee and straighten my leg to 0, and it is not even really uncomfortable. I can only push it to 8 from straight. PT said that was because I had lost too much muscle strength and would have to continue to rebuild it. So sorry you have joined our little club. We may not have all the answers, but we sure as heck know exactly how you feel. 

[rye_70]

We may not have all the answers, but we sure as heck know exactly how you feel.

What she said!