“You know, every time I do this I swear I’m never getting another one. Sorry for the delay. My doctor was very encouraging and told me that after knee replacement surgery I might improve the range of motion in my knee. Due to the number of surgeries Iâve had I have scar tissue on top of scar tissue which is really hindering my progress to flex or extend. That is certainly about as much of a worst case scenario as you can get in this regard. SMH. I don’t want to do anything which could increase my chances of going through that whole process again. I decided to share all the details of my surgery with you. One, which was the night of the surgery. If you’re someone using me as your reference point for pain after ACL reconstruction, you’re in for a rude awakening when you come out from your anesthesia and realize I was an outlier. Diminish Pain and Inflammation. Third, the longer you go without getting it and keeping it, the more likely you are to never get it back again. We are considering getting a knee lock brace for him to sleep but should he not have his knee completely straight? Or the fact I’d be denied health insurance in the future because of having it. Be patient, your maximum knee bend after surgery will return, and may even improve. The first 2 weeks of ACL surgery recovery concentrates on regaining full range of movement at the knee, particularly extension (i.e. This is your knee, you know one of the two things that hold you up and allow you to walk, very important appendages take care of them. Only your surgeon and treatment team can tell you what ... Read More. Ask yourself, “what is/was my maximum bend before surgery”? Not every knee surgery is the same, as there may be different precautions you must follow after a meniscus repair vs. an isolated ACL reconstruction. Before knee replacement, I was measured between 120-125 degrees of flexion. Thanks for your post. Many years ago it was common practice after surgery to put the person on bed rest. “Months and months” is not one, two, or three months. Every word of that affects the rehab. It’s MONTH*S* and MONTH*S*. DO THE RESEARCH. So, I had to have the surgery. When it comes to this, we all have something we wish we would have known, or feel like we should have known! I recently had to visit another surgeon and guess what?? I cover extension ROM fairly thoroughly in the ACL manual, but this is more extensive than before. If there is anything to be learned from athletes in this realm it is that physical therapy after reconstructive ACL surgery does not start a week or two weeks after the surgery, it starts the day of surgery. I only took that because I was afraid a huge flow of pain was about to set in, and I didn’t want to wake up in the middle of the night when it happened. Again and again I respond, “Stop worrying about bending your knee, start worrying more about straightening it!”. I can’t bend my knee past 30 degrees.. im supposed to be at a 120 for ROM… seriously cannot help but to obsess about the bending. You can see more about it and get it here: http://b-reddy.org/2015/09/03/help-i-cant-straighten-my-knee/, I also wrote something detailing why regaining extension range of motion quickly is so important: http://b-reddy.org/2015/09/03/why-you-dont-want-to-wait-to-regain-knee-extension-range-of-motion/. I would never tell anyone differently. Enter your email address to subscribe to this blog and receive notifications of new posts by email. However, if you can’t fully straighten your knee, that’s a really bad knee to be walking on. For instance, someone who has worked with military personnel. There is no reason to wait. You can see reviews and testimonials by clicking here. 0. In some ways, the learning will never stop either, as you start figuring out what works and doesn’t work for your knee and situation. Dan recently decided to have another leg operation. Consider a pre-surgery exercise program before your surgery. I have had ACL reconstructive surgery, the same as yours except both of my meniscus needed to be repaired and shaved down, my ACL was replaced with one of my hamstrings and I did have the bloody power drill through my knee…I’m cringing at the memories. The fact of the matter is your leg will never be “normal” again. -Get with a different therapist and or orthopedist if you’re not making progress / don’t have confidence in them, -Here is a guide on knee bending: https://b-reddy.org/cant-bend-your-knee-heres-what-to-do/. The CPM can also be adjusted to bend your knee at a 0 to 30 degree angle, which is the first step in knee … In the weeks and months after surgery, pain should decrease gradually. Sorry, your blog cannot share posts by email. New posts and products delivered to your email. You very well could get your leg back to its former strength, have no pain, no setbacks, etc. I don’t mean a few hours, I mean like a couple weeks. I have had 7 surgeries since June 2019. Even if you go online and read 20 different accounts, it’s still a small sample size. 1. Since I brought up Daniel Kahneman, I’ll keep that theme. The stronger your surgical leg is before knee replacement surgery and the more overall fit you are the better your TKR recovery will be. Partial meniscectomy surgery involves trimming out the torn piece of meniscus. Rehabilitation of an ACL reconstructed knee begins the day of surgery. Yes, I knew all these things already, but he didn’t know I knew them. Start By Walking With Crutches After ACL Surgery. You swear you’ll never drink again, but next thing you know it’s Saturday night.”. For some reason I wasn’t notified of your comment. When the anterior cruciate ligament is torn, patients may feel or hear a pop in the knee. When you return home after surgery, it’s important to follow your … It takes time to get swelling down and strength of the leg muscles back. 2) I had read up on more research. Need someone around you for a while after the surgery. They were projecting how long the book would take and their chances of actually completing it. Patellar moves all instructions; avoid palpation The longer you don’t use the muscles the quicker and more they atrophy. Second, extension is much easier to lose in the long run. You can use a bathrobe belt to pull your foot towards you for extra bend (and pain). Click here, even if you’re in another state, or another country. This is a common question I get from knee pain sufferers after a knee injury or surgery. Overall, if you’ve gotten started early with PT, but have a broad mindset of not rushing anything, you’re in a good spot. Lie on your back with your legs straight. It’s ok if you can’t bend your knee to 120 degrees, or hell even 90 degrees, that’s not going to affect walking. Extension on the other hand, you need worry about immediately. Soft tissue treatments and mobilization to all associated musculature (quads, hamstrings, gastrocnemius, popliteal fossa, ITB). He came in about a week afterwards. They maintain a location directory for their alumni. Another post on the importance of regaining knee extension range of motion, and why you don’t want to wait to do it: http://b-reddy.org/2015/11/16/how-weak-calves-can-cause-knee-issues/. Don’t forget to check out my eBook! It’s been 4 years since my surgery and I AM STILL NOT back to where I was pre-op, I most likely never will…yes people listen up, it is NOT a miracle surgery, everyone is different so be prepared for that and you may never be the same again. Thank you for sharing your experience, but sorry to hear about all the ups and downs. If you are considering TKR, speak with your doctor about preparation, exercise, recovery, and equipment. NEVER AGAIN, lesson learned…the hard way. By this I mean the day of surgery. I’m so miserable. This does hurt but 5 - 10 minutes a day will surprise you as to how much better you can bend your leg. “I’d say the average was about 7 years.”. I assumed it’d be rare to to complain about progress at 2-3 months, as it ignores the fact you have, at least, *double* that amount of time to go. Would he recommend it? This is an aberration. Because either people aren’t reading the section on “Obsessing over flexion over extension,” or they want to ignore it. Say your friend Jon had ACL surgery. They pretty much all thought it would be completed, and in about two years. Thank you for being so real and for explaining that acl surgery means different progress for different people depending on what was done and how it was done. You can’t do much right after surgery, but that doesn’t mean you can’t do anything. As I mentioned earlier the critical time for improving flexion is the first few weeks and months after TKR. He told my dad, “Call me if he needs more.” That’s an insane amount of pills. 3-12 weeks 125 degrees is great, 135 degrees is excellent (whether you have had TKR or not). I was in pain and trying to do my exercises (read more about my physical therapy after surgery). You increase the person’s risk of blood clots. A much better way of learning what ACL surgery is like is not only to ask former patients, but ask those who were around them right afterwards. It’s almost as I am reliving my nightmare AGAIN! I waited 9 years to do this so I really donât want to screw it up. If you even only briefly look around you’ll quickly find how many people are never the same again after this injury. So now I’m stuck…DO I? Brian Reddy is a personal trainer with a degree in Exercise Science. Before my total knee replacement surgery, my knee was bone-on-bone with no cartilage left in the joint. The first step to getting over any problem is full acknowledgment of the reality of the problem. Get the knee bending Difficulty with knee bending (or flexion) is much less common following ACL reconstruction surgery. Unfortunately, complications can occur after a knee replacement, even when all goes well at the time of surgery. I already can’t bend or straighten the knee & my other leg & hips are causing great pain. I made the big decision to have knee replacement and I haven’t looked back. So, you may only have one or two people you know who’ve also had this done. He has strength and conditioning experience from being a division 1 athlete, has certifications in anatomy from Stanford University and physical therapy from the Washington University in St. Louis. What I enjoy the most, however, is regaining the bend of my knee minus the pain! This is what a lot of people miss when trying to come back from this. He’s not amazing, but he can’t complain too much. Discuss with surgeon: Knee motion expected and allowed after surgery depends specifically upon the surgery performed. I’m not sure how else to get this across. It sucks an injury from perhaps out of nowhere, can fuck your mind and life up so much, but it is reality. Number 2 is what’s important here. (How to decompress your spine. ASK QUESTIONS. Part of me gets the lack of understanding; part of me doesn’t comprehend how people don’t understand a power drill will be put through their bones. It’s going to take some time for all the fluid to get out of there. H ow long after knee surgery you can walk with proper gait mechanics or restart everyday activities will varies between cases. Nurse see day two post-op to change the dressing and evaluate a home program. Making your neck and shoulders feel better while typing, Reconstructive ACL and meniscus repair surgery: Physical therapy days 2-11, http://b-reddy.org/2015/09/03/help-i-cant-straighten-my-knee/, http://b-reddy.org/2015/09/03/why-you-dont-want-to-wait-to-regain-knee-extension-range-of-motion/, http://b-reddy.org/2015/11/16/how-weak-calves-can-cause-knee-issues/, ← Reversing an arthritic spine, degenerative disc disease, spinal stenosis? If necessary, place your hands behind your knee for assistance bending your knee. So many comments here are about lack of ability to bend the knee. Post was not sent - check your email addresses! I’m not familiar with brain surgery, but I’d imagine that would set you up more than sufficiently. I did this 20 times each day. However, if you do even a modicum of research on this topic, you should learn pretty damn quickly it’s normal to: Part of this is definitely the surgeons fault. Repeat 10 times. Mild swelling is typically part of the healing process, as it is a sign of inflammation. During my first in-home physical therapy session, just 3 days after surgery, I was at 70 degrees. Many of you have probably heard “6-9 months,” which is one reason I didn’t hit on this in the article. I just went with what was suggested. If you’re in the States, they may be able to connect you with someone. Pre-injury/surgery I was an extremely active and reasonably fit individual…since surgery that has definitely taken a back seat, I can’t move the way I used to, it has gotten better, but I think a big part is MENTALLY…I’m so aware of how I step, to pay attention to curbs, to watch for rocks and how I step…IT.IS.INSANE how much I am paranoid and watchful of how I step. The pain is unbearable. In Thinking, Fast and Slow, Daniel Kahneman references a time in his younger days when he and some colleagues were writing a textbook. You don’t want to go go too long without the ability to straighten the knee. During my first offsite physical therapy session I measured 113 degrees. I’m so miserable. This is so bad! Is this normal? Physical therapy is a critical part of proper recovery after knee surgery and can play a critical role in ensuring a positive outcome. ACL reconstruction knee surgery involves replacing the torn anterior cruciate ligament with a new graft. With some recovery tips, you’ll be well on your way to getting back on your feet after knee surgery. PT hasn’t helped and my mobility has declined in the last 6 weeks to the point I’v not been out the house in 2 weeks and looking at buying a mobilty scooter. I spent over 3 months reading everything I could, talking to people and writing about things. It was painful to walk and put weight on the knee. Focus on attaining that level first, then as you recover you can try to improve upon it. “Waa, I can’t bend my leg, waa, this hurts.” No shit, a fucking POWER DRILL was just put through it. The only thing I feel like Iâve done right so far is get started early with PT. According to my literature review (study 1 and 2), the range of flexion required to do daily activities is as follows: 0-2 weeks 65 to 90 degrees – This amount of flexion allows you to walk without assistance, stand, and do some stair climbing. It takes time for the joints to heal and begin to move smoothly again. 0 comment. This allowed me to work on my range of motion before my surgery. I not only tore my ACL, I tor my PCL and MCL too. Measuring the maximum bend is not an easy task. 0-2 weeks 65 to 90 degrees – This amount of flexion allows you to walk without assistance, stand, and do some stair climbing. In fact, you need to be careful not to push it too much too soon as that can stretch the graft out. The lack of mobility is definitely concerning, as you’re hitting on. My leg is full of scars along with a huge skin graft. My knee can still only bend a maximum 90-degree angle. I never appreciated my knees as I do now…it has definitely put many things into perspective. I promise many of you, if you get to this point sooner, a sense of relief will come over you. I am desperate to get close enough to a level of activity I was before but I am terribly afraid to re-injure my knee again but at the same time also terrified to go through surgery again…. From day one after knee surgery, it is important that you exercise your surgical knee. 2. For those who have though, they know exactly what I’m saying. There is always the risk of more surgery or lifelong joint problems so take preparation and recovery seriously. Each person will have knee surgery for different reasons and experience successes and challenges during each personâs recovery. How likely is a second tear on the same knee after ACL Surgery? Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com, read more about my physical therapy after surgery, 70 degrees to pick an object off the ground, 95 degrees to stand from a sitting position. If Jon’s dad was his primary caretaker, ask dad what the experience was like. I don’t know if it’s because the surgeons don’t want people to know how bad things are, or because they become jaded after doing so many surgeries, either way, they do a horrible job preparing people for what this surgery entails. As the process goes on, it normally gets better. Here was my full surgery: Reconstructive ACL surgery with a hamstring autograft, medial meniscal repair, partial lateral menisectomy. Hopefully you’ll be on the right track shortly. Hi I’m Ken. I appreciate knowing that the suckage will continue for quite some time and that my short term goals might need to be a tad more modest. You may have questions if you are planning to undergo ACL and/or meniscus surgery in the near future. They use these to create a new graft which is fixed into place and to do the job o… 12 days 100 degrees. When you’re on the inside -you’re the person getting the surgery- you think the odds don’t matter for you, or that you’ll beat them. To go from having ~120 degrees knee flexion (roughly heel to butt) to only… Note: From week 2-6 is when I noticed the biggest increase in knee bend. They’ll almost assuredly give you a more accurate description. I have a couple ideas as to why, but regardless, pretty much no pain. If the patient has undergone procedures like meniscus repair or ligamentous repair or reconstruction, then it may take longer time to return to play. It’s not only a physical game; it’s a mental one too. Hopefully the worst of it is over and you’re only going to get better from this point on. Since people tend to feel better a year, two, or three years after their surgery rather than at two weeks, they tend to mix how they currently feel with how they felt immediately post-up. To reiterate, multiple holes will be drilled through your body, more than likely one of your tendons will be cut apart, it will then be either sewed back together or you’ll hope it grows back, the part of the tendon which was cut off will be screwed into your bones, one or two screws will likely be left in your body, and that tendon will hopefully turn into a ligament with time. 10 days, 98 degrees. 2) There is either a lack of reading before commenting, or a degree of denial. Copyright 2020 | Dust Mite Solutions is a participant in the Amazon Services LLC Note: From week 2-6 is when I noticed the biggest increase in knee bend. So, working on full extension helps get you back to healthier walking while obsessing over bending your knee does not. I agree with your statement in the post about how the doctors don’t even explain any of the surgery to you or even the specifics of what happened to your knee and why this needs to happen or alternate options…THIS.IS.SO.SCARY. Have you heard of anyone with this problem? I understand this is a traumatic time for many who come across this article. Plus, in reality, this is an 18-24 month process. Personally, I needed to check my extension multiple times per day. Beyond that, my standard recommendation (for those living in the States) is to look at someone from the Washington University in St. Louis. This site uses Akismet to reduce spam. Ruptures of the ACL are seen more frequently in professional sports then amateur sports. Getting The Most Knee Bend – A General Schedule. Hopefully others can learn from them. Try and build strength and movement in your joint before surgery. The pain is unbearable. I know my case is unique as are all, but I want to know more about what type of therapy I should be getting. By the end of this stage you should: That can greatly skew your perception of what this all entails. Straighten your leg and bend your knee. If you give up or are inconsistent during your rehab, and if you are not fully committed to gaining back range of motion, you may end up with a stiff knee. Usually surgeons do not limit your knee range of motion after surgery. The insurance companies take this incredibly seriously, so should you. If you read the comments of this post: Reconstructive ACL and meniscus repair surgery: Physical therapy days 2-11, which is about my experience, you’ll see over and over people fresh out of surgery going nuts about their lack of ability to bend their knee. My straight-leg extension was 7 degrees, which meant I could not fully straighten my leg. I’m in desperate need of surgery and your post has confirmed it is my last resort. You’re right the surgeons do not prepare you mentally … they also just tell you where your flexion should be at, at a certain time.. but didn’t really tell me how to safely start bending my knee again… anyways I’m weeks behind in physical therapy and feel like a failure because I’ve been trying so hard to get back to normal.. With leg stuff you’d often be casted up for at least a month and pretty much couldn’t use the leg. After my last formal physical therapy session, I measured 125 degrees. The only reason I asked so many questions this time around was 1) I had the surgery already, so I was more aware and traumatized. I can’t do anything. CPM (Continuous Passive Motion) Machine You should use this machine 2-3 hours… The first few weeks and months of your recovery are the most important for gaining back flexibility, bending, extension, and overall movement. My only other way is all the people I know who’ve had this done have another big theme to them. Daniel Kahneman references a time in his younger days when he and some colleagues were writing a textbook. Be optimistic and be prepared to work hard during recovery. Gently raise your foot off the ground and then point the toes down (then back up) twenty times (read my article on ankle pumps). Hello all I’m hoping that there someone out there that can help me and hopefully put my mind to rest. Additionally, patients are fitted with a full leg/knee brace & crutches, and are given exercises immediately post op. This goes right with lack of mental preparation. If I (or you) was a million dollar athlete I’m sure my mentality could change, but I’m not. Is this normal? Hi Natacha, They also provide stability to the Knee and stop the joint from bending forward beyond a level. It coincided with reduced swelling as well. Rather than consider the endless list of NFL players who never made it back after tearing their ACL, you instead focus on Adrian Peterson. Which brings us full circle: If you only do even a bit of preparation, you should know not to bend your leg too soon, that you won’t be able to bend your leg, that you should be extending it, that you’re going to have a lot of pain and discomfort, etc. For the first week following surgery, your knee may be placed in a passive motion machine (CPM). Learn how your comment data is processed. Look at your leg, imagine a power drill being put through it. He didn’t even bring up the option of not having surgery. Recovering from ACL reconstruction surgery is a long, difficult process. More likely than most people realize. If not for the law changes coming in 2014, for the rest of my life I would have severe health insurance issues because of this injury. Sorry to hear about the rough time you’re having. The 3 Main Reasons Why Your Knee Can't Bend After Surgery is NOT what you think. This machine keeps your leg elevated above heart level, in order to prevent swelling. Asking those who’ve also had an ACL reconstruction can be productive, but you don’t want to rely on other people’s recounts as you’re only information. Kahneman then asks the one colleague who has worked with others who’ve made a textbook, “How many of them actually finished?” The colleague was a bit embarrassed. Needless to say I heard that and burst in to tears…I remember my experience and I never ever wanted to go through that again. Inability to straighten your knee or difficulty contracting your quadriceps muscles may be signs of stiffness and the development of arthrofibrosis. I don’t care how uncomfortable or how imposing you think you are being…ASK ASK ASK your doctor questions! Note while the guide may be helpful, when the knee is having that much issue -if you can only bend the knee from 0 degrees (straight position) to 30 degrees- you definitely should be speaking with the therapist / doctor about it.
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