Richard Haynes PTA/CPT - 3/25/2009

Question
I had a TKR 6 weeks ago.  I had in-patient therapy for 3 weeks and now out-patient therapy.  The entire time I have not been able to bend my knee past 95 degrees.  This therapy is excruciating.  I do not want to think of the pain of having it manipulated into bending.  Any suggestions?

Answer
Hi Joy,


Have you discussed this in detail with your Physical Therapist?
I do not mean to answer  with a basic question like this but after working with knee replacements for 14 years these are questions that your PT should be keeping you informed with.

Have you been told why the knee is not bending further? Has your surgeon or rehabilitation professionals kept you up on your progress and what your goals should be?

Joy, it also could be due to the condition of your knee prior to surgery. The surgeon may have had to complete extensive work inside which more bone may have been cut away then normal.
The type of prosthesis used will have a bearing on movement as well.

If you have had extensive adhesions developing in the quadricep muscles or thigh muscles before the surgery, it will take considerable time to work them out.
Sometimes gentle massage to the area along with heat can be used to manipulate the muscle fibers and soften the area allowing you to get some increased motion in the area as well.

I would try heating the area before you try to bend the knee and I suspect you have been through that portion already, then have someone or yourself try massaging the thigh muscles using what is called a transverse method where you massage against the fibers then, start and continue an aggressive exercise program to get the knee to bend.

let me know how you make out with this.