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Author Topic: passive extension vs active extension  (Read 4068 times)

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Offline demiago

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passive extension vs active extension
« on: February 20, 2014, 01:03:09 AM »
Is it possible if your passive extension is greater than your active to gain active six months after surgery?. 
demiago, siderotic synovitis of unknown cause, misdiagnosed with pvns,

Offline Kaputt_Knee

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Re: passive extension vs active extension
« Reply #1 on: February 20, 2014, 07:45:35 AM »
I would think so because the extension is there. If you have greater extension passively, i.e. when letting your knee hang while supporting the ankle and foot, then it is possibly a lack of confidence in the knee causing you not to actively achieve it.

I had this problem with my first knee injury as I was in plaster and a wheelchair for a long time. The muscles wasted to nothing and I had no confidence in my leg at all. I regained full extension quite quickly as I remember but continued to walk with a limp for a long time as I did not have either the strength or confidence in my leg. My physio basically taught me to walk again by using parallel bars and slowing me right down. I supported myself on the bars while I walked in slow-motion deliberately striking the heel first, then using my arms to assist the full extension of the leg through the flat part of a step, followed by pushing off the toes into the next step. Slowly but surely I regained confidence and relied less and less on the bars but I was glad they were there.

Good luck.

1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline demiago

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Re: passive extension vs active extension
« Reply #2 on: February 20, 2014, 11:21:20 AM »
thank you
demiago, siderotic synovitis of unknown cause, misdiagnosed with pvns,

Offline missmyknee

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Re: passive extension vs active extension
« Reply #3 on: February 20, 2014, 08:32:13 PM »
I would think that would depend on the individual, the type of surgery that was done and whether there were any complications, such as infection or arthrofibrosis, causing setbacks. People who have arthrofibrosis would have a harder time making gains after 6 mos because usually by 4 mos post-op, scar tissue in an AF patient becomes very stiff, fibrotic and has very little elasticity.

I had to do gait training too after each surgery just like Kaputt knee. We did not use the parallel bars like Kaputt knee, but placed coffee sized styrofoam drink cups staggered in front of each leg. Then did the same same walking sequence as Kaputt Knee described. We did this in front of a full length mirror, so we could watch to make sure we were using correct technique. We did this several times a day. It makes a difference to follow and execute correct gait.

We also walked backwards on the treadmill ( holding on rails) using slowest speed, to work on extension by contracting quad, lift, step back, striking toe first, and following thru to the heel, working on extending that leg, then repeat.

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions

Offline Kaputt_Knee

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Re: passive extension vs active extension
« Reply #4 on: February 20, 2014, 10:20:53 PM »
Good point about the walking backwards Pam - did loads of that, usually to the Monty Python song as well! It was fun having a PT with a sense of humour who was also a bit of a comedian in her spare time! We did not have a treadmill machine in that facility but I walked backwards around the gym and along corridors in the hospital when she thought I was getting too cocky!  ;D ;D

Sue
1989 big trauma R. knee - sorted
1990-2004 3ACL recons and 20+ arthroscopies -RK
3/06 LK ACL torn!
4/06 ACL recon, kneecap broken
09 &10/06- 2x meniscus trims
3/07 - Notch Plastic & Lateral Release
14/8/08 complete revision ACL plus LCL/PLC recon
6/2/09 returned to skiing! Whoopee

Offline demiago

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Re: passive extension vs active extension
« Reply #5 on: February 21, 2014, 12:54:22 PM »
thanks everyone for the info.  i never did gait training or walk backwards, but i can start trying walking backwards, cant hurt,  i do feel after reading these posts and Pam's pms, that my rehab was not as good as it could have been,
demiago, siderotic synovitis of unknown cause, misdiagnosed with pvns,

Offline missmyknee

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Re: passive extension vs active extension
« Reply #6 on: February 22, 2014, 09:43:58 AM »
Hi Demiago

Just in case you did not see this in the AF info section. Here is a link to a rehab tutorial for AF, by Dirk Kokemeyer, who is head PT at the Steadman clinic in Vail.

http://www.kneeguru.co.uk/KNEEnotes/courses/arthrofibrosis-rehab-tutorials-dirk-kokmeyer-pt-scs-comt

This gives a good understanding of rehab protocol for AF. Every person will have some sort of variation of this program, to suit their individual needs.

Pam
4Fx Clsd red
IMrod fib plate
derotate osteotmy tibfib
AF
IPCS patbaja
DeLeeOsteotmy,LOA,LR Zplasty,bongrf,chondrplty
chondrplty,LOA,fatpad remvd
TKR
openLOA,neurectmy,ITB Zplasty,fabela
PLC recon,revison,LOA,synovec
MCL,revison LOA
openLOA,prox Zplasty
openLOA, 6 neuromas excised,synov
3 Fusions