Increasing Knee Flexion After A Tkr
Many individuals who undergo Total Knee Replacements struggle to gain maximum flexion of 130-135 degrees. Many just are unable to go through the window of pain that is in front of them when they undergo Physical Therapy . I talked to many people who are unable to ride a bicycle at all after 6 months post-op.
The video above is of me at Method Strength & Fitness, Seminole, FL, working on the Octane r6000 Recumbent Elliptical at 10 weeks post-op after my TKA on the right knee. This is my primary technique to improve and increase the bend angle.
I have been steadily increasing the maximum flexion at the top of the pedal stroke over the month. There is no doubt that one must endure a level of pain to keep increasing the flexion angle without revision surgery which only increases the rehab time. Riding a bicycle comfortably and safely requires a minimum of 120-125 degrees of knee flexion.
It is also important to have a well-designed stretching program that is performed a minimum of two times per day once the edema has receded to a level that allows for both SMR and proper stretching of the muscle groups of the leg.
In this video, I have achieved a flexion angle of 130. One must dance with lady pain utilizing your will and determination. If you really want it. The only way is Through.
You can call, text, or email me anytime. I will get back to you.
As the Romans used to say, Carpe Diem! Each day is the best gift.
Will I Experience Pain And What Medicines Are Available
Pain after knee replacement surgery is normal. Most of my patients have some level of pain and swelling for several weeks.
At TRIA, well work with you to create a plan to help manage your pain. Plans commonly include a combination of:
- Home remedies such as applying a cold compress or elevation to reduce swelling in your knee
- Hands-on care to reduce inflammation and swelling
- Prescription strength nonsteroidal anti-inflammatory drugs
- Movement strategies
Sitting Unsupported Knee Bends
- While sitting at bedside or in a chair with your thigh supported, bend your knee as far as you can until your foot rests on the floor.
- With your foot lightly resting on the floor, slide your upper body forward in the chair to increase your knee bend. Hold for 5 to 10 seconds.
- Straighten your knee fully.
- Repeat several times until your leg feels fatigued or until you can completely bend your knee.
- This exercise should take 3 minutes.
Sitting unsupported knee bend
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Make Your Rehabilitation Plan With Proactive Physical Therapy
The expert team at ProActive Physical Therapy offers convenient locations, skilled therapists, and multiple specialties that compliment your recovery process.
ProActive Physical Therapys offices throughout the Tucson, AZ, area provide patients with pre- and post-surgical physical therapy to experience the relief of a strong, stable new knee.
Call or book an online appointment to learn more about knee replacement physical therapy with ProActive Physical Therapy.
Stair Climbing And Descending
Stair climbing is an excellent strengthening and endurance activity that also requires flexibility.
- At first, you will need a handrail for support and will be able to go only one step at a time.
- Always lead up the stairs with your good knee and down the stairs with your operated knee. Remember, “up with the good” and “down with the bad.”
- You may want to have someone help you negotiate stairs until you have regained most of your strength and mobility.
- Do not try to climb steps higher than the standard height and always use a handrail for balance.
- As you become stronger and more mobile, you can begin to climb stairs foot over foot.
Stair climbing and descending using a crutch
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Top 3 Secrets For Increasing Knee Bend: Total Knee Arthroplasty
After your total knee replacement, or total knee arthroplasty, you will naturally experience some limitations as you recover. However, to ensure total recovery, its so important to focus on physical therapy and exercises that will help rebuild the tissues, strength, and flexibility in your knee.
Thats why were going to share our 3 secrets to increase your knee bend!
Lifetime Precautions After Hip Replacement
Aside from ultra long-distance running, there isnt necessarily any activity that is completely out of bounds after a hip replacement. It all depends on your level of fitness and activity before and after surgery and the advice of your doctor.
As you can see by our advice for cycling after a knee replacement, there are plenty of ways to remain active and healthy with your new hip or knee.
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Whats The Maximum Bend
My doctor was very encouraging and told me that after knee replacement surgery I might improve the range of motion in my knee. He said that one of the best indicators of your range of motion after TKR surgery would be your range of motion before surgery.
Ask yourself, what is/was my maximum bend before surgery? Focus on attaining that level first, then as you recover you can try to improve upon it.
My surgeon encouraged me to strengthen my knee and work on range of motion exercises before my knee replacement. He told me a good goal was to aim for a minimum of 110 degrees of flexion six weeks after TKR.
How Does A Hf
There are mixed reviews in terms of comparing HF-knee replacement to standard knee replacements. On one hand, HF-knee replacements have been shown to improve knee flexion range of motion by 15-25 degrees compared to a standard knee replacement. HF-knee replacement has also been shown to have greater improvements in general health, physical functioning and overall quality of life compared to standard knee replacement. However, other research has shown that there has been no difference in overall knee flexion compared to standard knee replacement. This could be due to the many factors that determine knee flexion after surgery. When comparing the survival rate , HF-knee replacement and standard knee replacement last approximately 20 years with a standard knee replacement slightly outperforming the HF-knee replacement.
Image by RapidEye via Canva. A high-flexion knee replacement may allow you to continue activities that require alot of knee flexion.
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Climbing Stairs After Bilateral Knee Replacement
You will be able to climb the stairs using crutches after surgery. You will be able to climb without crutches as you work on the extension of the new knee. Stair climbing will be easier with the help of physical therapy and building up the quadriceps muscles.
The recovery time will depend on many factors, including the type of surgery, the length of time you have had the injury, and the severity of your injury. In general, it will take about 6-8 weeks for your muscles to fully recover. After that, your body will need time to adjust to your new position and strength.
You may experience some pain during this time, but you should not be concerned about it. It is important that you continue to work with your physical therapist to build up your strength and flexibility, as well as to strengthen the muscles that support your knee. If you experience any pain or discomfort while you are climbing, stop climbing immediately and seek immediate medical attention.
Once Your Total Knee Arthroplasty Has Recovered Enough Its Time To Do Stairs
Stairs are a difficult part of recovery for many people, but especially for those who avoid their strength-building exercises. About 3-4 weeks post-op , use the banister or the help of a relative/friend to hold yourself up by the first step in your home.
Start by lifting your arthroplasty knee to the first step and stretch forward enough to feel a little weight on it. It will stretch and hurt a little bit, but dont go too far. Remember, this is an exercise best done at physical therapy the first time so that you know your limits.
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How Long Will I Need Physical Therapy After Knee Replacement Surgery
Physical therapy is one of the key parts of your recovery. Physical therapists like myself use a combination of exercises, education and hands-on care to strengthen your body, teach you how to avoid injury and help you learn how to use your new knees.
Youll start regularly working with physical therapists within the first week after surgery. At TRIA, well work with you to develop a personalized therapy plan, which usually involves about three months of meeting with your physical therapist.
These first three months of physical therapy after knee replacement surgery are critical to setting you up for a successful recovery. And many of the moves you learn will be useful long-term to keep your joint feeling good.
Treatment plans are unique to each patient, but heres what you can expect:
Knee Replacement Range Of Motion Timeline: Where You Should Be After Surgery
Not only do people have different ROM potential to begin with, people also heal at different rates. With that in mind, here are the flexion goals our team of medical advisors look for in their total knee replacement patients.
- Stage 1 65-90° flexion. This amount of flexion allows for walking without assistance, standing, and some stair climbing . Before you leave the hospital, your doctor will be looking for flexion as close to the 90° as possible.
- Stage 2 115° flexion. At this point, you should have made noticeable improvements from your early recovery days. This means moving around normally, bending to the ground, sitting down, and even tying shoelaces!
- Stage 3 A goal to hit 115°or greater should be the aim. The timeframe for this varies, but should be consistently work towards. A flexion of 125° is great and 135° is excellent .
Throughout each stage, its important that you keep working your surgical knee and artificial knee prosthesis. The first 3 months of your recovery are critical for working out your new knee to gain back flexibility, bending, extension, and movement. If you stay idle, inconsistent or not fully committed to gaining back range of motion, your knee may become stiff. If your knee becomes stiff, you risk the need for revision surgery and a joint that will cause lifelong issues.
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What To Expect After Knee Replacement Surgery
by Andre Porterfield Andre received his doctorate in physical therapy from A.T. Still University. He believes he has a unique opportunity to actively attend to his patient’s needs in any way that helps them reach their goals. Green Valley Clinic
There are a few key signs that you are ready for knee replacement surgery. Those indicators include constant knee pain and an inability to perform everyday activities such as walking, climbing stairs, or even lying down without pain. Knee replacement surgery allows patients to resume their favorite activities without pain. For those who put off their surgery too long, a successful knee replacement surgery means they can finally resume their favorite activities they gave up on years ago. However, a strong recovery and rehabilitation plan is key to a successful outcome after knee replacement surgery. At ProActive Physical Therapy, our Tucson, AZ offices support your rehabilitation, providing you with the knee treatments and exercises you need to get back in action as soon as possible.
Advanced Exercises And Activities:
Knee replacement muscles of your affected leg become weak due to lack of activity before and after surgery. These exercise well help you recover faster.
- Standing knee bends: Standing erect with the aid of a walker or crutches, lift your thigh and bend your knee as much as you can. Hold for 5 to 10 seconds. Then straighten your knee, touching the floor with your heel first. Repeat several times until fatigued.
- Assisted knee bends: Lying on your back, place a folded towel over your operated knee and drop the towel to your foot. Bend your knee and apply gentle pressure through the towel to increase the bend. Hold for 5 to 10 seconds repeat several times until fatigued.
- Knee exercise with resistance: You can place light weights around your ankle and repeat any of the above exercises. These resistance exercises usually can begin four to six weeks after your surgery. Use one- to two-pound weights at first gradually increase the weight as your strength returns.
- Exercycling: Exercycling is an excellent activity to help you regain muscle strength and knee mobility. At first, adjust the seat height so that the bottom of your foot just touches the pedal with your knee almost straight. Peddle backward at first. Ride forward only after a comfortable cycling motion is possible backwards.
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Expected Range Of Motion
After knee replacement surgery, it is important to work with a physical therapist to restore as much range of motion as possible. Typically, the range of motion will progress quickly during the first three months. It can continue to increase for up to two years following surgery.
Normal motion after knee replacement is defined as the ability to get within 5 degrees of a straight knee and the ability to bend the knee back to 90 degrees. Most knee replacements have movement ranging from zero degrees to 110 degrees or more.
The range of motion of the replaced knee can be improved with a combination of stretches, exercises, and gradual resumption of normal activities. Some surgeons will recommend the use of a machine to bend the knee, called a CPM .
Exercises To Increase Your Rom
If you worked at a PreHab program before joint replacement surgery, youll already be leaps and bounds ahead for achieving optimal range of motion. If youre reading this before your joint replacement surgery, great! In the weeks leading up to surgery, we strongly encourage you to start a daily PreHab program of exercises and everyday movements that will help build strength and movement in your joint.
If youre newly into recovery, you will likely be setup with a physical therapist or occupational therapist. Taking advantage of as many sessions as possible is key. However, strictly relying on in-class sessions to optimize your ROM isnt enough. Its absolutely, positively imperative that you supplement classes with an at-home guided ReHab program.
A great at-home program will include early exercises that will help get you mobile after surgery, functional exercises that will help bring back regular movements, advanced exercises that aim to build strength and push you further, and later stage maintenance exercises after the 12+ week mark where you engage in low-impact exercises to keep fit and keep moving.
Havent had surgery yet? Get matched to a top surgeon who has the tools to improve your ROM before surgery. The better your movement before surgery, the easier it will be to gain ROM in recovery.
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Taking Care Of Your New Knee Joint
After you have knee replacement surgery, you will need to be careful about how you move your knee, especially for the first few months after surgery.
In time, you should be able to return to your previous level of activity. But even then, you will need to move carefully so that you do not injure your new knee replacement. Be sure to get your home ready for when you return, so you can move more easily and prevent falls.
Upper Limit Of Rom After Knee Replacement
I went to my PT group yesterday for a hip issue, and the therapist measured my knee flex while I was there. After 3 days of backbreaking yard work I was really stiff and sore, and she still measured it at 132 degrees, and warned me not to push it much further. On the other hand, my Ortho seems pretty much unconcerned as to how much I will/can bend the artificial knee. Whats the consensus here? Is there such a thing as too much flex for the TKR joint? Surgery was 9/13 of last year.
Interested in more discussions like this? Go to the Joint Replacements group.
My surgeon and PT said 135 is the absolute max. I fluctuate between 125 and 132. The 132 is passive .
My surgeon and PT said 135 is the absolute max. I fluctuate between 125 and 132. The 132 is passive .
@melcpa86 : thanks for the warning. good to know. The 132 degree flex was active, and very easy to achieve. If my muscles had not been so overworked and on the verge of cramping, it would have been higher. Guess I can stop with my heel slides now!!
I am 8 weeks post tkr and my knee flexion is 134 1/2. My guess is your PT was telling you not to push it because you were so stiff and sore after you did yard work. I have been told to keep stretching to your limit whatever that might be.
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What To Expect After Knee Replacement Surgery: The First 24 Hours
Not all patients require an overnight stay in the hospital after knee replacement surgery. However, if you need to stay in the hospital, it will likely be for only one night.
Continuous passive motion devices have diminished over the years. Although once considered effective, many surgeons are now opting for other methods for early ROM in the first 24 hours after TKA surgery. Per the Clinical Practice Guidelines provided by the American Physical Therapy Association for management of total knee arthroplasty, the usage of continuous passive motion devices for an uncomplicated TKA surgery is not indicated. Early ambulation of the patients tolerance and early ROM activities progress as the patients tolerance level improves the current best practice for managing TKA within the first 24 hours.
If your pain is under control, a physical therapist will help you stand up and take a few steps, possibly with an assistive device like a walker or cane. Patients who begin moving and bearing a little weight on their new knee tend to recover from their joint replacement sooner than those who dont.
Youll also receive instructions on performing specific tasks like bathing, dressing, and using the bathroom post-surgery. In addition, most physicians prescribe medications that will reduce swelling and side effects while managing pain.