Ayuda por favor con extensión de pierna

Huesos, articulaciones y músculos
1

I am nearly nine weeks post TKR.   I have been going to knee gym with physios at local hospital.   Last Tuesday they gave me an assessment before going for check up with surgeon on Friday and bend was 117 but extension -3.   The OT discharged me saying if surgeon was not happy she would reinstate me to group.

At hospital on Friday surgeon delighted with bend but not happy with extension which he says will give me a lot of trouble later if I do not get down to 100.  I think this is because I have spinal stenosis and he is trying to give me the best possible result.   Phoned local hospital who have changed their minds and will not reinstate me because she thinks he is being unreasonable.  She says their surgeons would have accepted.    She says go it alone and then she will review in a fortnight.

I am not very happy about this because I have to  be careful because of my spine.   Have been doing the lying on the bed exercise pressing backs of legs into mattress which I have in fact been doing since well before op.  Surgeon told me to press down on area above knee with both hands till it hurts.  He demonstrated and it did hurt!   But I discover I cannot get that sort of pressure because of arthritis in hands, or perhaps more scarily I am pressing wrong bit.  Last night my leg was very, very painful and I got no sleep at all so am unsure of my exercise.  I have also tried lying on tummy on bed with knee and lower leg hanging over edge.

Has anyone any good suggestions.

Angela

 

2

Hi there, not sure I can help as didn't have this problem, but would massage help before and after doing the exercises.  It did for me when trying to get th e bend which I know is opposite to your problem. I also sat with foot only on a stool to encourage the knee to go flat. Im  sure someone will come along with some help.  Good luck.

 

3

Don't know what country your in,I'm in UK and if it was me I would be contacting my surgeon and telling him that his request has been refused. Your health and outcome is the most important factor here and I'm sure your surgeon will sort it . good luck

4

Angela, my therapist had me do the same exercise where you push into the mattress except that she put a rolled up towel under my ankle so there was air under my knee when I was doing it. That way not only does gravity help with the effort you also don't have any resistance (the mattress) when you push down with your hands.

Best of luck with your continued recovery.

5

angela he is right you will have problem later if its not straight mine is not straight at 17mths post revision  ,im doing pretty hard excersises to straighten it .if you dont get it right now you walk will be effected you will start carrying the leg because of the bend now you are lucky its only -3 most physios would say thats acceptable but as you say your spine is a problem i would put in the effort to get it straight now .!!!. to get it straight you can look up utube for ideas some are really good a doctor jo on utube is good .what i do is sit on a chair and have another chair in front of you place your foot on the chair in front leaving your knee between the chairs without support so that the joint is forced to straighten to make it abit harder place a weight just above the knee to push the leg straighter you can use maybe a bag of suger or two i made sand bags it dose work but you have to persist with it at first you will only be able to do a minuite or two but as you do it more often you will increase the lenght of time you do at first little but often if it gets easier either increase the weight or the time you do it .i find using my mobile to time it is best god im counting the seconds to put the leg down .make sure you bend the leg after and use ice everytime after you do it plus if you like use heat to warm it up before you do the excersie it will help to warm up the joint

6

Hi Angela, how frustrating that your Physios and Surgeons have different views, and you're stuck in the middle!

I'm also struggling to get my 2nd knee straight, the last time it was measured it was about -4 and the physios seemed to happy with that (they discharged me!!) But I can feel it's not right. I do an exercise similar to Irish Kinds - I put my foot up on a chair or stool in front of me and then I drape an oven glove (the kind with 2 gloves joined together by a band of fabric) with a tin of baked beans in each glove! Same principle as the bag of sugar, but no balancing involved. As the exercise gets easier, you can replace the cans of beans with bottles of water - or anything that will fit into the gloves and gives you the weight you need.

I also lie on the bed, and put my foot up on several cushions - but I put a long strip of wood underneath the length of my leg so the mattress isn't doing the hard work! It HURTS but it's effective. Try one or two minutes to start with and build up from there.

Good luck with getting straight, I know how hard it is!!

7

the strip of wood is a good idea terri !! i should have said put the sugar/flour in a bag and hang it juse above knee  . as i do . its a very boring job to get it straight never mind the pain we give ourselves . i went out for a walk today thank god no rain well i was practicing my walking !! you think i learned that before but my huusband keeps telling me that im carrying the leg so i went down to the shopping centre it has a long wall of mirrored glass so i walked up and down and yes he was right (hate when he is right) i do it very subtle so now im having to consentrate on walking properly its what happens when your leg dose not straighten properly

8

¿Estás haciendo este ejercicio? Enrolla una toalla pequeña para colocarla bajo la parte posterior de tu tobillo. Mientras estás acostado boca arriba con la cabeza ligeramente elevada. Tensa los cuádriceps, lo que a su vez forzará la pierna a enderezarse. La toalla enrollada debe elevar tu pie unos 3" del suelo o a un ángulo de 10-12%. Haz esto 10 veces manteniendo la cuenta de 10 en cada repetición. Haz 3 series. Después de unos días, añade un par de cuentas hasta llegar a una cuenta de 15. Asegúrate de tensar los cuádriceps lo más que puedas, ya que esto forzará la pierna a enderezarse.

Cuando camines... ve despacio, muy despacio. Con cada zancada, da un paso tan lejos como puedas, apoya el talón, luego la punta del pie, luego dobla tanto como puedas. Parecerás un poco tonto, pero el punto es que lo estás haciendo bien. Asegúrate de hidratarte. Bebe mucha agua durante todo el día. Los tejidos blandos deshidratados no se estirarán correctamente como los hidratados. Esto irá despacio, así que no te desanimes.

9

Si hay un moderador leyendo esto, por favor tenga en cuenta que le he enviado una respuesta a Angela dos veces - ¡NO PASÓ NADA! Sigo recibiendo un texto de inspección de elementos. No significa nada para mí. ¡Absoluto basura!

10

John. Este sitio no permite que ciertas cosas pasen sin revisión, como enlaces a tratamientos y medicamentos cuestionables hasta que sean verificados. También está muy preocupado por ciertos productos que son promovidos por los contribuyentes. Es solo una protección incorporada. Aunque puedas haber encontrado algo útil para ti, podría ser potencialmente peligroso para otra persona. No lo tomes como algo personal, solo están siguiendo las directrices impresas a las que te comprometes cuando te registras en el sitio.

11

Lo siento, Angela, es todo - la tecnología detrás de este sitio web es una porquería - no puedo hacer llegar mi mensaje. Moderador, sugiero que alguien solucione esto. Ya me he rendido y Angela se está perdiendo algo.

12

Por cierto... puedes usar el sobre en la esquina superior derecha de su comentario y enviarle un correo privado si no ha solicitado que esto no esté permitido

13

Thanks everyone for your helpful advice.  Going to try the towel method today and also buy a different sort of over cloth when I go out - currently I have oven gloves.   OFG I am walking heel to toe and my surgeon very pleased with this when he made me walk the corridor!!!!

Terri what did your surgeon say about the -4?

Angela

14

 Hola Oldfatguy,

​Gracias por tus dos comentarios y consejos. Sí, entiendo lo que dices, pero no incluí nada que pudiera haber llevado al problema. Lo que obtuve al escribir el texto, Hi Oldfatguy,

​Gracias por tus dos comentarios y consejos. Sí, entiendo lo que dices, pero no incluí nada que pudiera haber llevado al problema. Lo que obtuve al escribir el texto, y seguía apareciendo fue - la frase "inspeccionar elemento".

​Para mí, eso es jerga de computación y/o programación, por lo que creo que los moderadores deberían investigar con su departamento de TI. (Allí lo hizo de nuevo con la palabra investigar, me tomó 4 intentos escribirla y luego esa frase apareció).

​Para mí, eso es jerga de computación y/o programación, por lo que creo que los moderadores deberían investigar con su departamento de TI. (Allí lo hizo de nuevo con la palabra investigar, me tomó 4 intentos escribirla y luego esa frase apareció). O eso o tengo un problema con Win 10 que acabo de instalar en mi computadora portátil. Lo usaré esta noche y veré cómo va, no tengo tiempo ahora porque tengo que salir a trabajar.​ Este es ahora el 2do intento de enviar esto. ¡Inútil!

15

Estoy de acuerdo... parece ser una palabra desencadenante de algún tipo. Llevo un tiempo aquí y nunca he visto ese tipo de mensaje. Tecnología y rodillas... dos grandes misterios.... geniales cuando funcionan y un desastre cuando están estropeadas

16

Hola, a seis días de la TNR. De pie y caminando el mismo día de la cirugía, vi al fisioterapeuta (PT) el mismo día. El segundo día comencé los ejercicios, uno (de varios) para la extensión de la rodilla es colocar el talón en una silla, sentado con la pierna a nivel. Un peso de 10 libras (4.53 kilos) colocado encima de la rodilla en el muslo. Mantener durante 5 minutos cuatro veces al día. Duele como el infierno, pero se hace más fácil con el tiempo. SIEMPRE tomo medicamentos para el dolor antes del PT. Esto ayudará a extender la rodilla hacia atrás. Todo el PT duele mucho, pero incluso después de unos días he notado mejora tanto en el movimiento como en el dolor.

17

Parece que estás haciendo grandes avances. Nunca he visto ni oído hablar del peso por encima de la rodilla, pero como muchas cosas, si ayuda, genial. Asumo que estás poniendo hielo en la pierna varias veces al día para mantener la hinchazón baja. Mi gran preocupación sería excederte y tener un retroceso, pero solo el tiempo lo dirá y tu cuerpo te hará saber si esto está sucediendo. Una cosa que he encontrado a lo largo de los múltiples rehash. El cerebro ganará sobre el cuerpo si las cosas se ponen difíciles cuando estás volviendo a la normalidad. Sigue con el buen trabajo.

18

Angela, Im SOOOO sorry I missed this message! 

When I saw my Surgeon I was just under 6 weeks Post Op, and struggling with superficial skin infections on my wound, but all in all he seemed pretty well pleased at that early stage. It was mostly as the weeks passed by that I started to worry that things werent moving.

Since this big discussion about inadequate straightening (and, to be fair, inadequate information/forewarning about it from the health professionals!), Ive started doing a few things diligently. I wont let myself get out of bed until Ive done my morning exercises (this is on both legs) Straight Leg Lifts x 20, Inner Quad Lifts x 20, Leg Slides x 20, and then I lift one knee at a time towards my chest, and when its as far as I can get it I clasp my hands around the knee and gently pull it closer towards me(I dont know what this is called, but it flipping well hurts!). After all that its a relief to get out of bed! And I am VERY strict with myself - a couple of times the Postman has interrupted me, but Ive made myself go back and finish them off!

Throughout the day I have a set of static exercise pedals set up, and if the TV is on and theres a programme Im watching, I use the Advert breaks as a timer, pedalling until the programme restarts. I also have an Ottoman (Thanks Cheryl, it works great!) and I use that for passive extention BUT.....I set a timer on my phone, 2 minutes at a time. By the time the first 2 mins is up, if its too painful then stop. I was surprised how quickly I saw an improvement when doing this, and can now manage 5 x 2 minutes (the air is usually pretty blue during the final 2 minutes though ) Ive found that breaking it down like that really makes it less daunting as Ive always really REALLY hated that one! 

If the TV isnt on, but the radio is, when a song comes on with a good beat then Ill do step-ups for the duration of the song. 

Im sure that my house sounds like a bit of a funny-farm, but Ive been at this lark for so long now, including pre op exercises its been a full year, and Im really jaded by it all, so Ive had to rethink things and come up with little mechanisms to "trick" my mind into thinking that Im doing something new and fun! 

Ive also returned to the Physio/OT group - not the structured Knee Group, but the sessions called Next Step. Have you been going to these at all (Im just wondering if we've been there at the same time and not realised! Im going every Tueday at the moment, and its good as I can use the Sci Fit, Leg Press etc which massively helps with strengthening.

Well if youve made it and managed to read this far, you deserve a medal! 

Let me know how youre getting on, and Ill talk again soon xx

19

Hi Terri, Good to hear from you.  Is the next step from 1-2pm on Tues and Thurs and you pay £3 a session.   If so after my assessment last Tuesday I suggested this to OT.  I had not known about it before but a man I had become friendly with came over and pointed it out to me.   My reassessment was OK but still not in agreement.  OT adamant that my surgeon wrong and I will harm back more if I continue and that -5 and below acceptable.  I am now down to -2 and determined to continue.  I said I would join that group and she said OK but not until you have had an assessment by a PT specialising in backs.  After that you can join if she agrees.  It might be quite useful but means I won't be there this week as appointment 2 pm.  Actually I won't be there the following Tuesday either as we are going away for a couple of days as husband working in Leeds on the Tuesday.

However, if it is that group stick your head in to say hello in the waiting room tomorrow.  I get there about 1.45 pm - traffic and parking - and I think your group comes out about 1.55 presumably to clear way for knee group.  I sit near the door and have dark hair and will be wearing dreadful bright flowered trousers - only thing I have that gives them easy access to knee.    Otherwise I will see you in a fortnight.

Angela

20

Hi again, and once again SORRY for not picking this message up, for some reason I'm not getting notifications!

How did you get on today? Well, I hope!

I braved going into the City centre when I left the hospital, had a good walk round, first time in months I've been anywhere on my own apart from Physio, Doctors or my daily walk in the village! Made me feel more human, just pottering around the shops. Can feel it now through, I'm really tired. But hopefully that will lead to a good night's sleep, so its all good!

See you in a couple of weeks, same time same place!