Increasing Range Of Motion after total knee replacement

Recovery and rehab can be a frustrating experience. Using your knee flexing machine quickly brings you to your upper limit beyond which each additional degree may be very painful to achieve.
Here is a fast track method that just involves how you set your knee machine differential. For me it meant gains of several degrees more each time, where previously my progress was slow with gains of one degree at a time. I am twenty days post op now and I am flexing 120 deg in the knee machine.
Having just finished my second TKA three weeks after the first I can pass on some more tips that were helpful to me.
Having set the range on your knee flexing machine to 15 deg, now set the speed down with the speed control. That helped me push the pain limit further.
Next, when the pain is really at it's max with the machine , use your fingers to firmly press around the knee area. I think this is kind of a smoke and mirror trick by giving your brain too much to process so it eases up on the pain.
Another little trick I just found was to take a sanitized bristle hair brush and brush near (but not within 5" of the sutures) the knee joint...to the side...above....below. That distracts the pain of your knee machine flexion (which should now be set on the slowest speed). This is not easy and I grimace each time I try to reach my goal....but just do it.

It's been just over four weeks and I have both knees reaching 120 deg. (but honestly, some days you just can't get that but then you can the next time....don't give up and I do the machine about four times per day...I see the doc tomorrow).
UPDATE (3/11/2010)
I must admit that getting 120 deg. flex on the machine is easier than getting it at the gym. It dropped to 110 deg the day after they took the knee machine back. I exercise at the gym 3 times a week for 1.5 hrs each time. Today my flexion was averaging about 122 deg. Hurray!
I think what helped me the most was doing flex exercises at home and during the night when I would wake up. Sometimes I would fasten an elastic theraband loop around my foot and upper thigh and try to sleep in that position. Another valuable tool for me to force flex was the stationary bicycle which allowed me to slide the seat closer to the pedels until the pain was too much. If you want to have more than 90 deg flex then there is no shortcuts...just work at it often...learn to love the pain (ha)...and keep it up.

I think it's important to keep exercising for a few months so that my knee will not take a permanent stiff limited flex.

I did get back on my inline skates last week (wearing an umpire's shin and knee pad for protection). No problem but need more conditioning for the hills.

UPDATE: April 2010
I am 3+ months post op. / My range of motion is 125 deg on one knee and 130 deg. on the other knee.

For me I think the two most important points that have helped me are:
1) I do my knee flexes on a stationary bike and when I reach the position that hurts the most....I hold that position for at least 20 seconds. Holding the event (flexion) seems to allow for a better and longer lasting change.
2) I find it makes a big difference for me to "reflex" my knees at least once every 4 hours if possible...especially at nite.

UPDATE: April 21,2010
I am 4 months post op./My range of motion is 130 deg.on one knee and 135 deg. on the other.
That is the maximum range under all the stress I can tolerate.
My normal range of motion (after I get out of bed) is about 112 deg on each knee.
My goal is to have my normal waking ROM to be 120 deg or better. Right now I feel I have hit a plateau...very frustrating.

I will continue to try new approaches but if anyone has some good ideas please send them.

UPDATE: MAY 28TH, 2010***BLOOD CLOT*****
I can't seem to get my blood clot update to 'stick' with YouTube. It keeps disappearing.
Does anybody want to know about a possible TKA related Femoral vein blood clot? How to recognize it and what not to do? It's definitely something to fear.I spent a week in the hospital. I could make a separate video clip if anybody is interested. Let me know. (I have talked with several other TKA patient whom also have had clots).

Category:

Education

Tags:

• Ben Ben Blyton
• TKA range of motion

[32f3245f4]

I am sure the saran will work but vary with other tecniques like the leg cast,etc.

The pebble has nothing to do with night pain. The pebble is for ligament pain,usually when exercising. It's an acute type of pain below the knee. Runners get this often.Anyway you place a flexible strap around the leg below the knee and place a pebble, marble, etc between the strap and the exact location of pain. This puts pressure against that area for support. Remove strap after exercising.

[32f3245f4]

Hi,

I am so glad the saran wrap helped you (and many others). And thank You Tube for making the sharing of ideas so easy to do.

The Best To YOU!

[shallforesthill]

Dear Ben, Thank you for the tip on the elastic band and the marble trick. I will try anything. I really appreciate your tips and ideas. This is really a project and that is why I dreaded getting it done, but my knee hurt so badly, I had to. GOd bless you.

Love, Sandy

I eaded getting it done so much but my knee hurt so badly, I had to get it done.

[32f3245f4]

@shallforesthill

The marble/stone thing should work for you also. The trick is making sure you find the exact location to place it. I understand about having to get the TKA done...mine was at that point too. Funny how the doc's always seem to overlook telling us about the fun of recovery. Your real fun still lies ahead...trying to forcefully flex the joint to breakdown the daily scar tissue that forms.

[shallforesthill]

I had it done 4 weeks ago. It is so stiff especially in the morning. I keep putting ice on it and wrapping it in saran wrap at nite. God bless you for that tip. I was ready to shoot myself being up all nite in pain. How is your blood clot? I hope it is better. Does this nitemare ever end? GOd bless you. Sandy

[32f3245f4]

@shallforesthill

My blood clot was more painful and more frustrating than having both my knees done. Be sure you continue some kind of anti-clotting treatment for at least four months post op. would be my advice. I understand about morning stiffness. I liked trying anti-inflammatories for that. For example taking a couple of Aleve's an hour before I was going to get up (in addition to the percocet or lortabs for pain). That may not be appropriate for you however.

I also used DMSO gel.

[debstkr]

I am very anxious to try the saran wrap tonight. I am 17 days post op and the nights are the worst. But what is the pebble thing I see listed? I can not find that video.

[Gobbione]

I have used this recommendation the minute I saw it. I figured I had nothing to lose since i was so miserable. It helped me and I was thrilled. I am three months post op and sometimes I still do it. It helps keep my knee in the morning lose. Sometimes I wear the wrap during the day also. I t works for me and I thank you so much. There are still nights I have problems. If I have a long day and come home with pain I cream my leg and on goes the Saran Wrap. I even told my Doctor.

[metriks07]

Very informative video.

Metriks' FCE software allows the healthcare professional to objectively quantify and report on a person's functional abilities.

[32f3245f4]

@shallforesthill

Hi Sandy,

Yes, this is truly a journey. I will try to help you along the way as best as I can. Remember that what may work for me may not always work for someone else but I do understand the frustration. How is your range of motion? Did you finish with the automatic flexing machine? This is the time to really work on that painful item of flexing. Do you have a lot of pain from the knee inflammation when you get up? The Therabands can help that. Ben