(1) Reason Your Knee Won't Bend After Knee Replacement Surgery
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- Опубліковано 27 вер 2024
- Reflexive muscle guarding may be one reason why your knee won't bend after total knee replacement surgery.
It can be conscious or unconscious, but it is very common for patients to reflexively tighten the muscles around the knee joint in anticipation of movement.
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About the author:
Hi, my name is Anthony (Tony) Maritato, PT. I am a licensed physical therapist and owner of Total Therapy Solutions. I have specialized in helping clients recover from total knee replacement surgery since 2002 and have created this video to help YOU.
Total Therapy Solutions
5900 Long Meadow Dr
Middletown, OH 45005
I got after my knee immediately after surgery! I’m talking as soon as I got to my bed. I pushed it as straight as I could stand then pushed a little more and held it for 10 seconds 10 times an hr then I’d put it on ground throw a towel around my ankle and bend it as far as I could stand it 10 times every hr and hold it 10 seconds. By next morning my therapist couldn’t believe my range on motion in one day. In two months I was at zero and 134 degrees. Everyone couldn’t believe I had that much range of motion as fast as I had it. You do have to push through the pain to get it better!
Thank you for your comment. I'll be have my new knee joint surgery in a few months .. I have good range of motion now. I realize I need to stretch every day. It might help me recover like you did. 🎉😊
I'm surprised you didn't open your incision stretching it so much so early on. Mine seeped for over a week.
You probably shouldn't give that order. Not everyone is from the same mold. Some of us have been abused in cult like situations that embed in our muscles. Please do not make sweeping statements like that again just because it worked out for you.
@c😂eceliapadgett570
@@rahbia5805 whaaaaat???
Hello Tony. Hello all my fellow TKR peeps. I had my TKR in Dec 2019. I was 48 years old and in great shape at the time. This was my 3rd surgery on this knee and the recovery was absolutely brutal. No trouble getting the knee straightened but it took me every bit of 5.5 weeks to get it to 90 degrees. I was a nervous wreck thinking i'd have to do manipulation but thank goodness i escaped that by a hair. My doctor told me multiple times that i probably would not bend more than 110-115 degrees because it had been so badly damaged. I could run a mile on the knee, drag 70 pounds of weight, but the knee would not bend. I would sit on the leg flex machine and allow the weights to pull my knee backwards, but still it would not budge. Dry needling helped a little each week. In all, it took me until September of 2020, thats right... 9 months to get my knee to bend to 120 degrees on my own strength but it hurt like hell. By october i was at 125-130 on my own. I can't even count how many older people started thier therapy adventure after me and left me there still trying to get bent. I cried like a baby SO many times. Recovery was a struggle but it was SO worth it! DON'T GIVE UP! IT WILL BEND WHEN ITS READY AND NOT BEFORE.
Thanks for sharing!
Thank you for sharing this. How did you manage to convince your knee and mind to start bending? I have a lot of scar tissue and I'm on my second surgery (same knee), the first 2 months were great and then the knee freezes so to say and the scar tissue starts growing and I'm stuck with inflammation/swelling and after a bit of a traumatic experience with a forced bend my brain tenses up my leg. I want to let it go but it doesn't seem to be working. 😅
This is super helpful, thank you for sharing your story! I’m 45 and 8.5 weeks out from my first knee replacement and I’m at 119-degrees flexion, but still fearful of falling, so still walking with a walker outside of the house (cane inside). I think the most frustrating part has been seeing so many people 20-30 years older than I am walking around without any mobility aid after 2 weeks! It’s been a lesson in patience, for sure, with many frustrated tears. But we all heal in our own time and I’m learning to try be kind to myself and just keep up the exercises and eventually I’ll be back to a more functional state. I hope by now you’re doing even better!
Hello. I was speaking with my mother today, and she was crying and feeling very sad because her therapist told her that they are unsure whether she will be able to reach 90 degrees. She's 66 years old and is now 3 months post surgery. Reading your story gives me hope about my mother's health state. I will definitely share your story with her. Thank you for sharing and I wish you all the best.
I cried Friday, but usually I swear and am pissed off 😊
THANK YOU SO VERY MUCH! Reflextiing, guarding, tightening, mistrusting of the hand on the heel 'that will not let go', anticipatory response... yes to all of these and the inability to bend from 70 deg to 90 deg! Deeply grateful for the empathy and for the message that it is wired into the CNS not something I can will. I feel so much better now that I know I am not alone in this.
Hi. I am in my 3 months post-op surgery. I thank you for this video. This is exactly what I've been going through. I have a new therapist, and she is great. I had 1 before her. Didn't realize I could switch therapist. 11 weeks post op, I finally went with a new therapist. I've been doing much better with my knee, and I feel like she really cares. Thanks Louise
You basically described my exact situation. I'm 63 years old, tall and very active before surgery. Struggling to get 90 degrees 10 weeks after surgery. The knee is always swollen and PT was painful at times. Hopefully, I can eventually get to 120-130 degrees. Thanks for the information.
Same. Exactly as you describe. Tried riding a stationary bike and the pain was unbearable
I'm 7 weeks post op and just got to 90⁰ bend. I think it's due to swelling and not guarding.
Have you tried taking a muscle relaxant? Game changer for me!
I took the generic form of flexeril. I think this particular muscle relaxant works differently on me than other muscle relaxants I’ve taken in the past. It also made it so I could NOT sleep so I only took it on my PT days.
Day 4 after surgery was my first day in PT and I was at 62 ROM and I stayed there until about 2.5 weeks. I moved up to 63. That was it with all that hard work!
Then I started flexeril (the genetic) and my progress was huge. I did do 1-1.5 hrs extra stretching at home after every PT day because I was making progress and knew my knee would really only stretch on the days I was on the muscle relaxant. Weird.
I went from 63 ROM at 2.5 weeks to 130 ROM and holding at 5 weeks!! WHAT?! I’m 9 weeks postop now and I haven’t taken the muscle relaxant since week 5. I didn’t lose any ground I gained while on the muscle relaxant but it was strange because the days I did not take the muscle relaxant, I could not add to my ROM.
Wow. Great idea. I'm sure that my muscle are tight and won't allow additional ROM. I have recently seen the surgeon and need to go through MUA for a second time. Fingers crossed.@@JohnOne12Thirteen
I would take the muscle relaxant before your procedure. You might not need it after all. And stretching naturally will give you a better result.
With my 2nd knee replacement, I started bending it immediately while the nerve block was still working. That helped tremendously!
Thank you for your comment I'm going to remember this.. I've had a total hip done so I know you got to move. 😊
I wish I would have seen this video before my surgery. I'm 4 and 1/2 weeks out and this would have been extremely useful 😮
I feel fortunate. 10 months post. Starting to do
Light running. 140 degrees of flexion. I worked hard to get here.
That's great. Congratulations.
Hi, I have just listened to all you have to say. I find your manner in which you deliver your analage very soothing and empathetic. This is me you are talking about. Had surgery they said 120 couldn't get past 80 on my own. Had mua 9 months later 120 on theatre bed hired machine for 6 was couldn't get past 80 degrees again. This was 3 years ago. It is improving as I challenge myself over going downstairs each day smallish ones can now do them. This led to me releasing a bit of fear it wouldn't bend. I am always trying to stop my guarding I am 68 and fit but struggle to get up and down off the floor etc. Peopletell me they don't beleive I have a new knee I walk incredibly well but park a car next to me and I cannot get out of the door. My knee will not bend. I am going to carry on and your words have inspired me. Thankyou so much.
This is me too ! Exactly ! Getting into and out of my car is torture ! But My flexion is good normally as is My extension of the knee ! I am 13mts post op and 66yrs old 11:43 and unless parking spaces are xtra wide or I use a disabled space I just cannot get in or out and there's a sharp pain down the outer part of the knee and below my kneecap ! It's horrendous 😫
Posting this to hopefully help someone. After knee surgery I could not bend or straighten my leg and what worked for me after months of trying to push through the pain to bend my knee and go to pt which got me nowhere in a 20 minute session was to do a prolonged stretch with no pain and focus on relaxing the leg. So for instance to straighten the knee I would sit on a chair, put my foot on another chair and put a weight on my leg to give it as much pressure down without causing any pain in the knee and sit there for an hour or two relaxing the knee and eventually I would feel a slight pop and gain a little movement. The keys are to stretch for a long time with as much pressure without pain and to relax the leg.
You have hit it exactly. I was stuck and all I started to hear from PT was "manipulation". 😮. Instead I needed encouragement and hope that I could do this and get there on my own. We stopped the "M" talk and I focussed on my breathing and knowledge of what was really happening and I jumped ahead on my ROM.
Ditto. The "M" word was from my first visit like a threat. It was a war of wills between the PT, MD, and my resistance. I had the MUA 2 days ago and it has set me back in function due to stiffness and pain. I did get to 90 yesterday with the PT saying "let it go" over and over but at home I can get my flexion 90. I am 7 weeks out and all around me say it will come just keep going. My sister wants me to try water aerobics but I will need the MD to approve this. I would like to hear from others if they found good relief in the water? And at what time frame did you feel safe getting into the water and out?
@@lindabrandt847 I think water aerobics is a good idea if not a whirlpool or a cold plunge after your scar has completely healed… That is when they gave me the green light to get into the water. Also do hot magnesium salt baths at home! Those are all pain relieving, however nothing seems to get rid of the swelling which limits my range of motion… And I had the MUA and it did help me go from 80° stuck to 90 to 100 at the PT sessions! water will be your friend. Igod luck!
I am in the Uk and have had two knee replacements in the past 3 years, both now doing great. Your videos have been the best I’ve seen while looking for advice about post surgery worries. Your advice is so relatable to the situation and the exercises are great. It is so easy to compare your own situation negatively to others recovery and this shouldn’t be so.. Thank you for the videos.
Hi Kay, thanks so much for sharing this. You are right, it is hard not to compare.
You are so comforting. I had knee surgery 8 weeks ago. I’m at 90. I’m working hard to get to 120. I’m doing all you say to do. I’m doing PT. But you have been so encouraging about not enough sleep and the tightness around my knee that I’m trying to work through but it gets tight. I ordered the little bike so I can get my knee all around. I went to PT and got on the bike. And I cried. I got my knee to go around. You made me brave. God bless you
A JAS joint active system will give you more ROM.
Very inspiring, at 90 u r able to do all these.God bless
Tony, I've watched so many of your videos since my TKR 6 weeks ago. I have a good PT helping me, but your videos have been so amazing with great tips and I always feel like you understand what I'm going through! So thank you for the videos, I know they are a lot of work to produce but please know that they have meant so much to me during this challenging recovery.
I have been struggling so much since full knee replacement 7 weeks ago. I only came across your Utube videos tonight. You are a gift to me. Thank you 😂 Catherine from Ireland
Very helpful and reassuring...I'm almost 6 months post RTKR, and still unhappy with my flexion. I've never gotten to more than 110°, before the area just above the knee completes tightens up. Zero trouble with flattening, bicycling, walking, even brief kneeling...just can't flex as well as I want, and need to work on my going down stairs (loved your video on that too!)
This is me! I'm 8 weeks out at 100 degrees with stress placed while measuring. My quad was dead after surgery for almost 3 weeks, now it's awake and limiting me. Thank you for giving me hope I can still progress.
Thank you Tony. I have watched quite a few of your videos, all of which are enormously helpful. This one is key for me. I am almost 51, and am 11 weeks post-bilateral TKR. I had an MUA about 10 days ago. My surgeon took photos. He got me from 90 to 130 degrees under anesthesia. In my PT sessions since I have only been able to get to about 100 degrees. I feel tightness and pain from my hips and lower back right down to my ankles all day and night. I have exercised all my life, so I know my body. It's constantly tight and achy such that I can't sit comfortably for long, nor lie down for long. It is very hard to get to sleep so I am now almost 3 months with no decent night's sleep. My PT keeps telling me that I have to push through the pain. I am tired, distressed, and sick of the pain and discomfort. This video summarizes everything that I thought was going on - on the basis of your other videos. My current PT focuses on bending my knee, and nothing else. I recently saw a massage therapist to help me with the rest of my lower body. I was walking better, had better flexion (she doesn't measure) and I felt more relaxed after just 1 session with her (1 hour). She didn't do anything around my knees. She focused on the 'knots' in my hips, behind my knees, and my around my ankles. I have decided to stop seeing my PT for a while and to work with my new massage therapist. I also really felt like she was listening to me, and hearing me. Once the knots are ironed out and I have relaxed - as you explained - once my central nervous system has relaxed, I will find another PT if I need to. I don't think, in my case, that's it the type of professional (ie PT vs massage therapist), rather it's the connection and the trust I have in her vs the anxiety I have developed with my PT. So in summary, your video has helped me to decide to get my mind (and emotions) and the rest of my legs in order (or least on their way) and then go back to worrying about how many degrees of flexion I get to. Thank you.
Hi there… I feel the same… my massage therapist has helped me a lot (my PT as well…is very patient and kind) How are you doing now?
Went to therapy for 2 weeks. My therapist made me cry every time. Did not go back. Decided to watch videos on UA-cam.
Mr Tony. That presentation was excellent. You were able to verbalize the ...extra ordinary ..response. Also in a very gentle way you insight into how to proceed or help such "" patient"" was very emphatic and "" right on "". Thank you for all the effort and thoughtfulness you put into these presentations. Amy e.
I had TKR 4 weeks ago. I have a very good therapist. My knee is already bending 126 degrees. My Dr is very pleased with my progress. My goal is to walk up and down stairs by myself. We have started working on stairs. Very challenging for me, but I will get there.
Hi 4 weeks post on a total right knee and I’m at 75 degrees at best… have had prior negative experiences with PT on my hand and prior extremely negative surgery experience on my left knee…
I’ve been working on trying to relax my thigh and leg muscles in general as some were hard as a rock 1st and 2nd week…better now, but still feeling emotionally guarded I think. Your video addressed this and I appreciate the insight! Very much appreciate validating my suspicions of an emotional response to this procedure. I’m taking a guided meditation course on healing to try to relax my mind on this and not be fearful. Also trying not to do too much! The laying on the floor with leg on the sofa is a GREAT idea! Thanks so much!
Thank you for making this video. I just had my first session with the therapist and I think this was the best time to hear this advice. It will make me more aware of the need to relax and trust the process. I did sense myself resisting a little today, but now with your advice I think I will do better from now on. A very valuable lesson to learn.
I had to have a total knee replacement. I feel it was very successful. I practice martial arts, 3 styles, and did not get hurt doing it. I stepped on a stick at night. It rolled, I did a weird split smashed my knee on the concrete, smashed the knee cap, tore the pcl ruptured the acl, tore the meniscus and some tendons. Range of motion at 3 weeks post of was 132 degrees. I watched several videos prior to the surgery and followed the advice of the doctor. Therapy started on the second day but I was up and walking the first day. Now I am at 4.5 weeks, no longer needing the cane but I do use it on uneven surfaces such as grass. Walking in the sand on the beach is good therapy for me. At 65 they said I am well ahead of where they expected me to be. Part of this is because I am working on the exercises up to 6 times a day. I am also able to go up and down stairs as I did before. The exercises hurt to do but I know the difference between the pain that causes injury and the pain that is to be expected. Some people don't know the difference and are afraid they are injuring themselves. I was very blessed to have a great medical team to see me through it all.
Thank you. I had a hip replacement 2017 .Its great 😊 at 56. Now I need Left knee replaced at 63. I know I need to work it. From the get go, so I ll have good range of motion and strength.😊👍👍👍👍
I had a total knee replacement on August 21, 2023 on my left leg. They took me off Eliquis 2 days prior to surgery, then back on after surgery. Big mistake, I feel. I'm now only taking baby aspirin twice a day in place of the 5mg of Eliquis twice a day. I developed a huge hematoma directly on my patella! My leg blew up to about twice it's normal size. The back of my leg was blood and dark red. It finally calmed down about 2 weeks ago. The hematoma is smaller but still there. The surgeon's PA tried to aspirate the hematoma 2 weeks ago, but could not get any blood out and said it's like grape jelly in there. I'm sure this is what is stopping me from getting past 65 degree of flexion? I do get almost 0 degrees, completely flat, on the extension. Now the PA says I need manipulation under anesthesia. However, I think that it might be harmful with the hematoma still there? What do you think? Note: My knee and lower leg gets hard as a rock most of the time.
I am experiencing your same symptoms. Agreed to have an MUA after 8 weeks, and blew up like you described. Went off of blood thinner before surgery, but not before MUA cause it was not a surgery. I fear I may never walk again. I will not have any further surgeries (I.e. to surgically remove scar tissue) or another MUA. Even tho cardiologist said blood thinner not a cause, I doubt that now. Not a good candidate for leg surgery. Trying very hard to progress with PT, but with the quadriceps hematoma, tight hamstrings and other bleeding factors in leg I am not making very fast progress. This channel gives one the realities of possible negative outcomes of TKR and how to find the will to go on. God bless. Listen to Tony and increase your faith.
I had a TKR on my left knee after 50+ years of the original tearing it up in high school. As an athlete back in the very early 60’s there was no such thing as rehab after you had surgery. My knee what was left of it became bone on bone and very painful. Had surgery in 2015, a very good surgeon fixed me. I was and still am a very avid golfer. He told me that if I did the rehab as prescribed I would play golf in 6 weeks. The initial pain I had I thought playing golf in 6 weeks was not feasible. The pain is bad, however I knew I did not want scar tissue as you would be just like before the surgery. So, I hit the rehab hard. I could completely straighten my leg in 10 days. I had a recumbent bike and it took me one month until I could make a complete revolution with the pedals. After that I was home free. I played 18 holes of golf 6 weeks later to the day. I rode in a cart but I met my goal. Having my knee replaced was a great decision.
Hi Tony ,I'm 7weeks after my knee replacement I'm still on sticks and only 90% motion range,I find when I sit down the back of my knee really hurts right up to my groin.Im paying my physio but he's not hands on he just tells me to stretch but I can't seem too.Your amazing and learn more from you...I wish i was nearer to you....
Hello my Name is Rita and I had my TKR May 29th 2024 it was so very hard on me I live alone and my support system was just not as helpful but through it all I’m off the Walker but yet need some help so I yet carry my Cane and today in physical therapy I only got to 95 in my range of motion got so discouraged but I go back Thursday and I’m praying I can get to 99 my therapist bend my knee just a little and did i scream 😃😃😃
I am 70 had a total left knee done 15 weeks ago. This sounds like me but it seems to be getting better. Great 👍 video thanks
Thanks for sharing. Glad to hear it is getting better. Stay patient.
I had my knee replacement 17 years ago, I am only 63 now. I have a 120 bend, This took me 8 weeks after surgery and i still have it now.
Excellent
This is exactly me. I am 1 year 3 months out from RTKR. I was very active before the surgery. Now I am struggling to walk. I do not have the stride. After seeing your video I know understand why I could tell that my doctor was and is hesitant to do anything invasive - like remove scar tissue. I do not have any pain. I have only gained 115 range of motion - 0 flexion. I have been in physical therapy 3 times. I have been working with a trainer at the gym. I use the exercise equipment and walk in the pool. Some days I feel at my wits end. I just don’t know what to do from here. Thinking back about the trainer and things she says and does - I think she believes it is exactly what you say Anthony.
It is hard to override your brain's natural protective response. If I bite a hot pepper there is nothing you can say to me to make me not feel my lips burning. But if you take the temperature of my lips they are not hot. It is a false perception of sensation.
Some things to try might include activities or positions that allow you to active the hamstring and muscles behind the knee once you get to 115 degrees. If you know your quad kicks in as you get close to the end range of motion, activating the hamstring could reflexively inhibit the quad from firing. Things that encourage you to use the muscle behind the leg work better than things that push the foot back.
Best of luck and thanks for sharing.
Thanks for posting. I could have written this! I'm at 14 months post TKR and having issues with walking although I was very active with great range prior to surgery. 100 degrees and +5 for my range of motion. I have inflammation after any walking over 10 mins, ugh. If you need help with stride also look for the YT channel the walking code.
❤@@totaltherapysolutions
I had a single knee replacement 5 years ago, at age 55, that got stiff within 48 hours after surgery and remained behind schedule and 'stalled' around 90 degrees of flection from maybe week 6 or 8 to week 12. (I was on the verge of scheduling a follow up appointment with my doctor to discus surgical solutions.) Then I tried a. little surfing for a couple days and seemingly gained over 5 degrees instantly and then another 5 degrees every week or two afterwards until full ROM.
This is the only video that seemingly describes my situation. 40 years of knee cap dislocations made me hyper-sensitive to knee instability and pain: whenever my knee would twist or become unstable, I would cry out and tighten my quads to straighten my leg, in anticipation of a dislocation - regardless of whether there was any eventual pain or injury. However, when I was surfing, I wasn't focused on my knee.
Note that my knee sensitivity to pain may have also contributed to my losing so much range of motion in the first 3-4 days after surgery - my doctor eventually told me that I should have worked my knee range of motion more regularly, e.g. every hour, and stayed on whatever drugs I needed to help me relax during those exercises.
I'm learning what I have to do after my knee surgery. To get back on my feet so I can do the things I use to do. Biking hiking , swimming.. thanks😊
I have a total hip replacement and left knee replacement and never had one problem with any of them. The day after surgery, the hospital physical therapist said it was going to hurt like hell but he pushed my whole lower leg back against my upper leg. He was right and just like my doctor told me, it would hurt for 48 hours and then the pain would be gone. He was right. So I see no reason why anyone should not have a totally functional knee surgery. And having a friend who owns several physical therapy places, I did 3 hours of PT 6 days a week for 3 weeks. I have not had one problem with any of my surgeries. However my one natural God Given knee should have been done as I am 79 and it is a problem and my townhouse is 4 levels. Most people who are not having a good outcome from knee or hip replacement is because they have not had sufficient PT. Most people want to go right home from the hospital which is the first mistake. Going to a rehab unit for a week or more will get you back in working order. For any replacement surgery, you need the best doctor and a fantastidally good rehab group and that is hard to find.
Hello I had a total knee replacement 4 weeks ago in January 8 th 2024. I have been I serious pain . My range of motion is 70 and I was listening to your video , stating that the muscles prevents me from bending my knee , because it hurts. I believe you right ! I do all the stretching every day and still have problems with my range . I had a partial knees replacement in 8/22 it didn’t work still had issues and this is my second surgery in less than 2years . I’m hoping this time it works and I want to live pain free .
How ironic… I had my surgery on one 824 as well and this is April 18 and I can reach 100° if I’m pushed but my knee seems to stay happy bent while sitting at 90 to 95! I had to have the manipulation done at Six weeks because it wasn’t going past 75°… The scar tissue did prevent me however I still have extreme bruising following that and pain in my thigh groin muscles of the thigh! And those keep me from bending… I do all my exercises ride my bike I’m a former dancer and fitness instructor so this is very annoying!I go up and downstairs like a zombie and it seems to swell overnight and get stiff but the days seem better! I guess we all have to just keep watching Tony’s videos and support one another!
I am at 9 weeks post surgery. The first knee was super easy to recover from. Knee 2 was much more limited, neither full straightening or bending well for 20 years. A complication is that the ankle on that side was always weak, rolling, for close to 50 years and would shut down my Quads. I can all but straighten with work now less 2-3⁰ without being pressed into position but when l try to bend passed 90 or 95⁰ my hip comes up. At 3 weeks l had close to 105⁰ and now get hip to knee to arch, sick feeling, and end up with body tremors. And spasms in my glutes and down the back and outside of my leg. I reduced the bending exercises trying to work on straightening and also trying to strengthen my ankles and release the tightness in my hips. My reasoning, the ankle if not in place affects the thigh which drives the knee. I also find the knee flexion drives the hip response. So many things to keep in my head. Is there a trick to reorder and make movement natural again?
I am 4 weeks out from TKR surgery and this video is 1000% representative of my situation. I am at 0° extension. No gap whatsoever under the knee. Have been since the beginning. But, the flexion has been very slow and frustrating. We talk about me being guarded. I can't seem to just let the leg go when in the hands of the PT. I am at 90° in some positions. And yesterday with his help and manipulation, I got to over 100°. To be clear it hurt. No question. From this video I understand it's a reflex. I know I don't want to tense up. I want to give it all over to the PT and allow him to help me. I believe I will get there. Four weeks is not time to panic. Although the surgeon at my followup appointment started right in with scar tissue and the potential for surgical intervention if I don't reach the expected milestones. Frankly he scared the crap out of me. And that was at 22 days! It was also going in cold and having the bandage removed and the surgeon taking measurements. It couldn't possibly be the right time for that. I haven't thought of anything else since and it's interfering with my ability to get past the fear and anxiety. I know the surgeon needs to set expectations and explain the risks. But it set me on a bad path way too early in my recovery. I trust my PT and he is trying new things (TENS yesterday and massage to get my knee and body to start thinking about something different). Yesterday felt like a breakthrough. It was also the first time I drove myself to PT. Very liberating. I am struggling with anxiety and post surgical depression (my own diagnosis). This video helps me understand it. Thank you.
I had a TRKR last September 2021 and it has hurt every day since. I am still limping and in a lot of pain when I use stairs. I have had four consults since a year after the surgery and all the doctors said, they couldn’t find an obvious reason for my pain. I had all but given up hope but in the last couple of weeks, I have noticed my ROM has improved and l am able to do the stairs a bit easier. I feel that perhaps I have broken through some sort of huge resistance. I had a bad experience in the operating room and had to get mental health therapy for that as soon as I returned home. I am thinking that perhaps that experience sat in my psyche and created a lot of fear. Thank you for this video. I am feeling even more hopeful now.
Ice is your friend.
Hi Tony, What would I do without your videos?! I am in the UK and I use your videos all the time and also pass the links on to my fellow UK knee warriors. Thank you for reinforcing the fact that we are all different and all recover at a different rate. With my first knee replacement I was still on two crutches at 6 weeks, with my 2nd (2weeks ago today) I have dumped the crutches and have a 95° bend. So even one person can have two completely different outcomes in different legs.
I’m 2 weeks post TKR Tony I think you are so correct about the physical response to fear and anxiety, I am not a fearful or anxious person normally but because of the pain experienced after my physio session I find it hard to repeat an exercise I used to do fine previously on my own because I’m waiting for that awful pain and burning to happen again. I’ve been told I have a good straight knee but I’m currently measured at 87 degrees bend and “need to work a little harder and push through” 😢, so I feel pressured even though I know it’s said with the very best intentions.
So Tony this video has been very helpful thank-you, I watched it yesterday and this morning whilst still in bed, I lay flat switched my brain off thought about something else and managed to lift my leg straight up to about 8 inches and hold it for approx 20 seconds, then slid it back to a good bend it burned it hurt but not as much as when I’m under “surveillance” 😁 there’s hope for me yet! 🥰😢🇬🇧
I am 10 weeks on and only 68 degrees bent, due to go for MUA in six weeks time (UK). Not looking forward to it but my knee just won’t bend and yes I do my exercises. This is my 4th operation. Reading these messages has given me hope
I am 4 days out an very discouraged. I can not bend my knee to sit on a raised toilet. I can only walk a few steps with a walker and with someone hanging on to me. It is agony.
Your pup seems to have limited range of motion in this video... and is perfectly comfortable with that! 😊
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Hi Tony, thanks for your comments. I am 64 year woman and 4 and half years PO on my right knee, during that time I was involved in car accident and the dashboard crushed my knee and fractured my patella ever since I had that operation to repair the damage with a patella button but now my leg is worse than ever. My surgeon said the x-ray looks normal and he can't see anything out of the ordinary. I have acquired a permanent limp and find it difficult to walk distances at all without the aid of a walking stick. I have also been left with a huge "orange" sized swelling on the inside and a golf ball sized swelling above the kneecap. My physio and surgeon say more exercise, more exercise.... I don't have anymore left to do any more exercise! I walk, I do my house work, hang washing, workout on my steps, with a ball, with ice packs, with heat packs!! I have had enough I have even asked him to amputate my leg above the knee as I am so damn depressed with the pain level and the amount of pain killers I have to take!!! What can you suggest :(
So sorry to hear this. I would encourage you to find a different therapist. There are therapists who specialize in persistent pain and conditions such as yours.
There is an absolutely limit to what exercise can do. You might need to find someone who can provide a different perspective or a new set of eyes.
I’m 9 weeks out and I’m still having a lot of stiffness and cannot get my leg straight. I’m 47 yrs old and have been pretty active since 3 weeks out yet my quad still seems weak. I had horrible osteoarthritis in there as well as a pcl tear and a meniscus tear. My surgeon said I had a lot of inflammation when he got in there. I’m so frustrated that I almost regret having it done. I walk on a treadmill and use the stationary bike twice a week and I do ankle pumps while sitting. I ice and elevate often as well. Any suggestions on what else I should try? Thank you
Thank you I think it’s exactly what I’m going through it makes sense I thought I was a failure I have new hope now
Absolutely brilliant explanation.I go in 13 days for TNR. I am very scared 😢as I’ve been told that I won’t be able bend my knee.
Seven weeks out from bilateral total knee replacement. My turning point came when my PT massaged out a knot in my right quadricep. Once that was gone, my knee flexion and strength exercises progressed very quickly. I do most of my exercises on the stairs because I can control the flexion and the amount of support. My right knee was damaged when I was 12 years old so it may not be perfect in a year. My knees are now at 116 and 110 and progressing. I have practiced hot yoga for 15 years so this whole process has been not so bad. I stretch my knees on the stairs. Every time I let the dog out. That way I don’t get mad at the dog and my knees get a very relaxing, comfortable stretch. Very little pain but a lot of work!
I have that same problem my knee will not been because it hurts so bad when I do the exercise 😢
May I ask what do you mean by a KNOT in your right quadricep. Was it painful and tight before?
Am still having pain been in physical therapy for 3 years an still having pain had 5 surgery s on by knee an still having knee pain what a girl to do
Thank you sooo much for this video Tony! This has made me finally understand what and why I deal with the lack of being able to get my full range of motion! 💖💖💖
3 months out. At 8 weeks I had a manual manipulation because my knee froze, my doctor said it was scar tissue. Less than 1 week after the manual knee manipulation My knee froze up again and I think it has been more with my muscles and my therapist has to be great to work with different ways of getting those muscles to move. I believe you're a 100% on with the soft tissue and my being apprehensive perhaps to let the leg relax. I will start to really pay attention to that and see if I can get that to move but I think your advice is absolutely spot on. I think that it is my soft tissue and I think that my therapist is amazing he assesses everything within anticipation of new things to work on. I will pay attention now to To the relaxation of my body now And do something more to pay attention to let those muscles go.
My PT person tried so hard and said you need a manipulation. Best thing I ever did! I also had cartilage removal in 1971 so the scar tissue took over fast. Now I’m doing great and pt helped me get here!
I just listened to your video I really appreciated it as I thought you were talking about me you’ve given me a lot of hope as I’m 6months since my op & can’t bend my knee back very far x
very helpful - just about to begin out of home PT
I'll be at northwestern medicine for my 1st tkr next month. I'm nervous but I'm confident in my doctors. I'm also hopeful that at 64 years old that I'm in good shape. I have great PTs. And looking forward to starting 5ks this summer.
Wow please keep us posted how you do at Northwestern… I live in Chicago and these videos that Tony has filling the gaps for everything. I feel surgeons and PT just don’t help you with or tell you! I am a 67 year-old retired dancer and fitness instructor, and went into this four months ago in excellent shape but had arthritis in my knee so I had the replacement.. to make my story short… I had to get a manipulation due to a lack of movement in my knee because of scar tissue that had built up almost immediately following my surgery… Some people just have more than others… Unfortunately for me still here at four months cannot go up and downstairs have excessive swelling can only walk a short distance without pain… Very frustrating! And without Tony’s videos to fill in the gaps I would feel hopeless! Keep us posted how you do best of luck!
I shattered my tibial plateau last year. Had exfix and orif, nwb for 14 weeks. Went to pt, therapist cranked my knee back so hard, I honestly felt like I broke it again. Fast forward to hardware removal and total knee replacement last week. Have 0 degrees ext. And cannot get past 70 degrees. I definable am guarding, my new therapist knows I am guarding and we are working towards getting greater rom. In addition to my guarding, I find myself with anxiety that I may never get there, or am behind. I know it's been a week only, I am doing all the exercises, but somehow see this as a failure. I guess I am a mess 😆. I have to really work at relaxing and trusting my new therapist. Heck, identifying the problem is 75 percent towards fixing the problem. Thanks for your video.
I have had both knees replaced. You have to do the PT and push yourself. Off of all pain meds at 6 weeks so I could go back to work. I have complete range and can kneel on both knees with no pain. First knee 10 years ago, second knee 6 years ago. Could not be happier. I will say if you do not move they will stiffen up.
As always your videos are very helpful and encouraging. I had TKR in 9/2021 and it went well. However, my inhome therapy for the first month was not so good. Once I began outpatient PT--experience was much better. While I did well, after PT I kind of fell off my schedule...my fault entirely. I began water walking a few weeks ago and that is going well. Only drawback--I think I am overdoing it because afterwards--my knee is stiff. I am thinking about having TKR on my left knee but my right knee still needs a lot of work. When my daughter ask if I have pain, I explain that it's the stiffness that really gets me. Real Pain was before the TKR!! Thank you so much for the info. on outpatient PT via Medicare Part B....had no idea and will definitely check it out. Look forward to your next video.
One thing that I've noticed from comments about TKR, is that it seems to be that in the USA they are done under g.a. and here in the UK under a spinal anaesthesia. I wonder why that is? I must say I found the spinal amazing, especially afterwards when they reversed the sedation and I felt as if nothing had happened and was able to eat and drink straight away.
Hi there. I am in Australia, and techniques vary. My doctor did the spinal method as well.
It depends on the surgeon. I'm in Illinois,US, and haven't heard of people under GA for years. Spinal and nerve blocks.
I am struggling with this issue after my 2nd TKA. I’m 37 years old, I had my first TKA February 7th. I did amazing with therapy, was pushing knowing I needed to get my strength and stability before having my 2nd TKA April 4th. My 2nd knee was the stronger of both knees, I had more muscle, also 8 weeks of PT prior to surgery. I really expected to recover better after the 2nd surgery. My therapist agreed. I’m now 6 weeks post op, I have 0 extension, but cannot get more than 95 degree flexion. It is a hard stop, wether I’m doing exercises or my PT is doing manual bending. I get to that max and I’m lifting my hip guarding. I did have a complication immediately after surgery with a hematoma over the proximal tibia. I continue to have significant pain and swelling in that area. The surgeon said X-rays were good one week post op, now at 6 weeks suspicious of Pes anu*** Bursitis. We have discussed steroid injection to the area as well as MUA to get better ROM. I am a RN and plan to go back to work full time in 4 weeks. This has really been a discouraging setback. The first knee is doing amazing, no pain, minor swelling.
Amazing video tony..im still struggling..8 months p.o full knee replacement..due for mua very soon i only have 64° rom it has gone down from 87°..i m doing everything im asked by my physio
Hi Irene, sorry to hear that. I know how frustrating it can be.
Hi there. I am 62. I had TKR November last year.
I did heaps of exercises and could only get just past 100 on rom.
I went in for an MUA, on the 7 th Aug 2023, and then your basically back to a swollen painful leg.
Don't expect too much of yourself.
I am still working my way through exercises.
I really like this PT. I didn't think I was doing enough exercises.
It turns out I was doing too much and keeping my leg swollen and painful.
All the best to you. ❤
I’m 7 months post knee replacement surgery and I’m only 100 degrees in my left knee and 97 degrees in my right knee. I really want more bend!!!!!! I don’t know what to do!!!!!! Your UA-cam channel has been very helpful and very informative!!!!!!
Tony is so kind and encouraging
I want that pupper❤😊
Thanks for watching.
Your video just helped me REMEMBER how my brain can hijack my body in relation to pain signals. I had a trauma during hip surgery, and again during knee replacement surgery. I just had knee revision done 12 weeks ago, my initial recovery was going very well, got to 120 degrees, then something happened and I completely lost all of my progress. I am going to use hypnosis to bypass the signals telling my body it is danger. I’ll let you know how it works.
Thank you❤I am 5 days post op and i know that i have unrealistic expectations of my abilities which has led to being really frustrated. I have a great PT group and they have been working with me prior to the surgery. Thank you for calmly stating facts and proper expectations. I really needed that attitude adjustment and will continue to watch your videos has wise reminders of what to expect.
4 week out right TKR. Not using my available rom. Muscle guarding. Reflex of protecting. Hard to push thru by myself. Muscle response. Central nervous system fighting me. Quad muscle very tight. Great info!
You have great videos. Just had my knee replacement 4 weeks ago. And not sure what I am in for. Just doing the bike and your video on it have taught me to try your way with the toe and heel. Will try tomorrow. Thanks
Lucky you i am 7 weeks post op and i am only 80 degrees range of motion however i can walk extremely well with no crutches and i am not too bothered as my knee was extremely tight and too sore to bend at physio so i think its looser now inside so hopefully i will be nearer the 100 in a few more weeks
You should be grateful you are at that level
Hi Tony
I find your videos vey informative
I had TK R in 19 of January 2023
My foot is so stiff and swollen
Like bands of stifness in ankle, at theheel and face of the foot
Now that stifness is going uptowards the knee
Very uncomfortable
I am with biokintist who is helping me
Progress is very slow
I live in South Africa
I wish this condition will go
Very painful to walk
Hi,I had my knee replaced in January and now nearly 7 months in no pain but my knee is still at 70 degrees I still can't kneel I can't drive a manual car with a clutch.I can't get off of a bed or low chair easily.
That said I saw the Consultant today and they are going to manipulate it.Apparently it is brutal,will hurt like hell and for 24 hours I will be on a CPM machine to keep the motion going.I hope for the best now 😊👍
Thank you Tony, I have recently had a TKR here in the UK 10 days ago, I find your approach quite heartwarming and encouraging. I have been delving into different you tube videos to get tips on what I should be achieving when. My physios aren’t big into numbers so all the range of degrees talked about is quite confusing. Looking at the comments sections I feel sometimes, maybe subconsciously people are often competing with each other as if achieving a certain degree of flection/extension reflects how much work you put in and how committed to the process, which I find unfortunate and not encouraging. I have my first post hospital physio session on Monday and I’m dreading it already! I have been exercising using the videos given to me by my in hospital physio team, however I would sign up for your care in a second if you practiced closer to home. Do you fancy a wee working holiday in Scotland anytime soon😁. Take care of yourself and thank you for all the very helpful content. 🥰🏴🇬🇧
Thank you so much. I had to deal with a very aggressive PT at one of my sessions. I thought I was doing something wrong or haven’t done enough. This video has helped me and moving forward I think things will be going much better. Sans the Therapist
Exactly what I am going through! Thanks so very much! I was t give up!
you always calm me down. thank you.
The woman in question sounds like me. I had TKR 7 weeks ago and 90 degrees sitting is painful. In PT, 123 degrees but with great discomfort. Had MUA 4 days ago. Going to PT for 12 straight days. I dread it and am nearly physically sick much of the time. No light at the end of the tunnel. I’m going to consider getting handicapped plates. I had been VERY active before. That life seems so long ago. I now walk with a limp.
I am wondering why it wouldn’t help get the range of motion faster if a patient could have a shot of lidocaine before therapy. I had vein surgery and the doctor used lidocaine to deaden the area without any pain for me or after effects. Just wondering.
It is so awful rebending - thank you for this! :)
I had a tibia plateau Fracture had knee replacement in May and Physical therapy for three month and im only able bend my knee at 107 ° And i still do my bending Exercises . I fall in 2021 and went through sugery and had two plate and 16 screws and almost year of therapy then had my second surgery in may .
Im at 10 weeks. My PT Has been great but my bend is just over 100. Still working on it but a lot of stiffness. Glad to hear im not alone.
Hi I know you from about 2 years ago I had my first knee replacement on 18/5/21 didn’t work at all . Instead it did cause another problem at my right Foot with spurs growing. And was so painful that I have to operate, after I just had another 2 second revision at some knee , at still I can’t bend the knee, was 21/2/24 my Physio’s have pushing a lot and I still doing some exercises at home but it’s very frustrating. Today was just 85 flexion .Thanks for your videos It does help.
Thanks
I too had pain 4 weeks after surgery and pt, I finally went back in for a s
I am 70yr had bilateral tkr over 2yrs ago..surgery and therapy were in middle of covid so very little effective therapy..can't do steps,rom is poor..I'm in new therapy now..hope I do better
Tks Tony for all your help.
You are 100 % correct with the flexion information.
I, too, was tense and unable to bend my knee fast or even far enough.
8 months later, on April 6th 2023, 31st Jan 2024 - RTKR and I could bend and ride a stationary bike . I have started your fascia massage, as you suggested in your video. Thank you for being there square and fair and for your knowledge and expertise.
Go well
United Kingdom North West :))
Ps, there is a light at the end of the tunnel. As my Orthopod said on Jan 15th 2024, you must trust yourself and push through the pain to gain the true flexion goal.
I'm 18 months in after a tkr...my bend is now 87° told it's my new normal. So very depressed. Stairs, nope one at a time up and down, getting in and out of car is tricky. Can't run, jump....basically live..fed up
Thank you so much for your guidance 🙏 I got operated in May 2023 for my right knee. My range of motion was quite good at 120. But from last two months I have pain in my operated knee and can't band properly like before. What can be the reason? Please suggest some exercises to reduce the stiffness 🙏🙏
Dr I moved from Dallas to Atlanta after one month of my knee surgery after coming here I didn’t get insurance after 4 months I get it since 8 months past my knee is not bending properly I have got balance problems it wasn’t before my surgery I was very independent person but now I can’t walk without my walker my therapy started in the month of July but I am still in pain I never stop my exercises my range of motion was 87 but after therapy now this 97 and when my therapy pushed it 105 1st august was my last day of therapy I doing exercises twice a day but I am still in pain
I had rtkr in January 2024 and am scheduled to get the left one done in October. I still have a tightness feeling like rubber bands across my knee cap and still get nerve pain from time to time and still trying to work on my range I was at 110 the day I was discharged from therapy.
I am an active 61 year old female and I need both my knees replaced I am at zero and 117 degrees 17 days after first TKR. Honestly, it mostly feels painful because of all the bruising. I think most women have more tissue. It gets damaged from the tourniquet in the process of replacing the knee. I’m walking fine balances good but pushing my knee to get that extra flexion makes it feel like it’s just gonna bust like a watermelon.. PT suggested that I just find a chair and slide my foot back-and-forth under its own power as much as I can before I try and put the extra torque on it to kind of warm it up. That seems to be helping.
Kavitha.,65 yrs from India.
Hi Tony.,thanks for clearing all our doubts about TKR.I'm post op tenth week right now.But d problem is I had developed a stress fracture on my 10th day post op.doc adv me a ct scan n told me take rest. I had a previous history of tibial fracture in d same leg. Please guide me.I'm not advised to do any exercise. When will I be able to walk?please reply and guide me.Thankyou so much.
Hi Tony from Sydney Australia
Thank you for this video .. I haven’t had a knee replacement but shattered my patella in a fall ..three months after surgery I can’t bend my knee I am devastated I was practicing yoga daily and now I just can’t continue
I am diligent with my physio and try to walk daily but I am not making much progress
This video makes so much sense to me and really puts things in perspective yes I am tensing my quad and guarding when I walk I have to force myself to relax
Thank you I am going to send this video to physiotherapist 🪃🦘🇦🇺
Very good advice! Thank you so much for sharing.
I had TRKR in 1/18/23 wasn’t able to get more than 70 ROM.. MUA on 4/10/23, at hospital able to achieve 110 ROM . In therapy, I’ve had 99 ROM but it was forced. Just like your patient, I chose therapists affiliated with doctors office w/o any research. After weeks of crying and frustration, i decided to start searching for another therapist when I was told there was nothing else they can try. I have a low tolerance for pain & I know that fear sits in whenever I try to bend . Just praying that I’m able to find a therapist that’s understanding & more patient. I do exercises at home, unable to
Make full Pedal on recumbent bike & I just started 5 minutes on elliptical. Im young with small kids & need help. Any suggestions would be greatly appreciated. Thanks !
Right. It’s anxiety. I have it and its scary. Hope you can help.
Thank you for all the information. It is very helpful
It took me 5 months to reach 121 degrees on my own and 132 with therapist pushing. I also developed a DVT in lower leg.
Why is my knee very painful and stiff after almost 10 months after my total knee replacement surgery? My surgery was on October 26th, 2023. I had been doing my exercises regularly and had physiotherapy for months. Pain relievers such as paracetamol does not help and I have swelling with the pain ❤and use cold packs to help relieve the swelling.
Hi I’m am 44 years old I had a total knee replacement 2 years ago since then I’ve had 2 revisions on same knee and 2 manipulations still my knee is at maybe a 70 degree range in flexion it is very painful I want to know if u have any advice for me I’m very active so I’m not sure what went wrong but my doctors say I have so much scar tissue and it keeps coming back
Great video , my problem is after my TKR I had to stop My PT due to excessive swelling preventing any decent ROM . After several ultrasounds it’s been determined that I have a chronic clot which I believe is slowing down my progress , approximately 14 weeks . I’m now using leg pumps twice daily. Just thought I’d be more active by now .
Complications like that can really slow down progress. Stay the course and I hope you are working with a great therapist.
I'm 3 weeks and my therapist just pushed me to bend to 100 degrees when I was just 90, and now I'm in so much pain where I can barely walk and do my exercises.
I have been giving therapy for my patient who had undergone tkr surgery. It's going to be 3 months now. Left knee ROM is 120 degrees but right knee ROM is improving slowly. It's 85 degrees. Initial days she was guarding a lot in her right knee. She always used to complain that her right leg feels heavy. She feels a lot of pain in both legs calf muscles because of which she has sleepless nights. I found muscle knots in her calf muscles. I have been doing passive ROM giving extra attention in right knee. I have done whatever required treatment for this issue but her pain remains horrible( note: day time she is alright but as it gets midnight pain shoots up). Please guide me.
Love it, thank you. I feel a lot better about where I'm at!
I had a bad experience with my first physical therapist who pushed far beyond where he needed to push. I literally thought he broke my leg. Since then, I can’t relax enough to work on the range of motion. I don’t know how to overcome this. I know it’s my anxiety. But I’m at a loss.
Thank you for your video. You hit the nail on the head as to my situation.
I had Bilateral Knee replacements on both knees on April 7th 2023. And have been going to PT 3x a week (since April till now) regularly and still couldn’t achieve 90 degrees ROM. So I decided to have Closed Knee Manipulation on both knees which happened yesterday (06/19/23). The surgeon said he had no problem bending my knees till 120degrees and I hardly had scar tissue! I was shocked but still stiff as ever after the procedure.
Can you recommend any Physical Therapist like yourself here in Southern California? I am so frustrated at this point. But your video helped me understand what might be happening to me.
Thank you for your kind attention and have a blessed day.
Hello . Can you tell me more about this "closed knee manipulation " . I also had a knee surgery before three months and barely can reach 90 degree . I don't know what to do just my knee lock around 90 and can't go More .
@@diyanageorgieva8934 Hi There! It’s a great simple procedure. You are put to sleep through anesthesia and the surgeon bends your knees to its full capacity. It’s non invasive it takes about 15 to 20 minutes.
But when I am conscious my knees don’t bend. So after watching this video I realized that I suffer from muscle guarding.
I hope that helps. BTW I was terrified that I would wake up in pain but I didn’t because my surgeon injected cortisol in both knees.
Take Care!
I'm one of the people that you are talking about in this video. I am 70 ears old and had a bilateral TKR o 7.26.22, I have been going and continue to go to PT twice a week. I have rom on my left at 120 w/help and 117 w/help on the right. I still struggle with stiffness and probably scar tissue. I have a wonderful therapist, very patient, has tried numerous changes, i.ie. ice, heat, stim, no stim, no ice only heat, different stretches, deep massages for scar tissue. I get frustrated with myself and I know there is guarding but how do I retrain my brain to let go of the control?
Yes. You have to build up quad strength and also learn to relax the quad. It's fascinating.
My surgeon prescribed 15 physio sessions in the first 3 weeks. My first physio took 2 months to complete them as it was impossible to obtain another. I am in rural France. Everything was brute force rather than gentle persuasion. She obviously couldn't care less. Have managed to obtain another scrip and go to a new wonderful physio who has the same approach as Tony. It's a huge relief but I feel I've been held back by the first one. Am just 3/12 post op. Can achieve 110 flexion with difficulty but working very hard on bike and with squats. Also practicing 'normal' walking and stairs.
Not particularly looking forward to seeing surgeon next week but all in all improving slowly.
Huge thanks to Tony for his amazing videos. 👏
Thanks for sharing.
Christina, thanks for sharing. It is such a better experience when you find a therapist that understands you and wants to work "with" you instead of "on" you.
@Total Therapy Solution - Physical Therapy yes definitely. I am a trained nurse . The therapeutic relationship is so very important. I am so impressed that your videos show your commitment to excellent care for your patients. It's about 'going the extra mile' and you do that all the time.
You have a great gift for teaching and encouragement. Thank you.