 Poster: A snowHead
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@johnE, Keep trying to increase the range of flexion. Daily stretches, after you have warmed up. You can still get an improvement for upto a year to 18 months. 110 is a nuisance as you are very close to normal function but about 10 degrees off. I try to get 120 for my knees. Any more increases risk of instability and there is not much you can't do ( at this point all the Yoga fans chip in!). You could talk to your surgeon about a manipulation, usually done if only get 95/100. I'd say if you got 120 chairlifts and low seats would be quite alot easier. The other point , perhaps worth making, is that on-the-couch at 6 months i may get 110 but its is "tight" to achieve the range from 105 to 110.If that is how it feels keep going with the stretches as that part of the range from 105 to 110 gets "softer" and requires less effort as the scar tissue matures.110 should be enough to cycle. Get on the bike and warm up then lower the seat till it just nudges the knee and cycle slowly using the bike to gently push the knee a bit further - dont be too aggressive with this, if you have to hitch your hip to turn the crank you've lowered too much. Get the physio to check your patella mobility. A stiff patella ( side to side and especially cranio - caudad, which means in the line of the leg) can restrict flexion quite a bit. Hope that helps a bit. Jonathan Bell
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Thank you for your feedback @Jonathan Bell,. It is appreciated a lot, especially that flexion will continue to improve upto 12-18 months. My biggest improvement occurred after 2 months. Even at 6 months there is still some pain from the knee, but it is decreasing.
I’m back home now and really enjoyed my ski trip to Les Arcs. Though I did take it easy, only skiing for 3-4 hours per day I did ski for 10 days out of the 12 day holiday. The lifts became easier as the week progressed as my confidence increased and I learnt how to get on the lift. Most of the skiing was on smooth, hard packed red pistes though I did a few blacks and some small mogul runs. It all went well. In fact walking was more a problem, especially steep rough downhills, but this will improve with practice and time. I fell a few times, including one occasion when the patella hit the ground (gently as most of the impact was taken by the arms) with no problems.
It has got easier to get to 110 degrees but getting further is proving very hard. Before the operation I had restricted extension not even getting to within 15 degrees of straight. My surgeon said that the best he hoped for was straight and 110 of flexion. I will, however, keep working on it.
The stationary bike is a good idea. I bought one and have been using it now for, perhaps, 4 months. I try and do 20 minutes a day lowering the seat every 5 minutes. Every few weeks I find I can lower the seat a bit more. Since I’m not doing it for aerobic fitness I keep the load very light but vary the speed doing some slowly and some rapidly. The suggestion about dropping the seat so that the knee rises above it is good. Thank you @Jonathan Bell. Strangely I find pointing the toes down at the top of stroke makes it easier. No idea why.
Next trip is to Gressoney for some ice climbing in a couple weeks. Then another two weeks skiing at Easter and back to Kalymnos for some rock climbing in May. I’m happy with the replacement and really am getting back to normal activities.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@johnE,
Great to hear you could enjoy skiing.
The reason pointing toes can help is that the calf muscle passes across the back to the knee, so if tight would restrict movement. Perhaps do some calf stretches aswell!
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You need to Login to know who's really who.
You need to Login to know who's really who.
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Folks I'm just back from 5 days in Flims / Laax for my first real test of the new knee off and on piste - did full days every day, had crusty off piste to deal with, sugary heavy articifical snow below 1400m, ice, moguls, powder and all conditions in between. New knee did absolutely stunningly well, no pain at all. Also threw in a 6km tour just to be sure I'd completely smoked my legs entirely on the last day. I couldn't be happier with the new knee at all, brilliant for me.
Now my issue is a bakers cyst in my "good" knee, my doc is talking about an arthroscopy, or aspiration, or steroids....its in its original condition, I really don't want to operate on it but possibly no choice......having older joints sucks..
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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Had a TKR almost exactly a year ago. End stage OA after 2 severe knee traumas 20-30 years ago, was still somewhat active but main reason to get it done was chronic pain leading to poor sleep. Skied on my old knee in jan 2023, and wasn't fun....turning and loading the knee and hitting bumps was like have a knife stabbed into me knee. Surgery and rehab went well. I was highly motivated and worked hard in the initial post-op period - lots of cycling on a turbo (start off cycling backwards is a good tip), lots of physio. Ice and compression help a lot. Managed to be out walking in the hills at about 3 months (slowly with poles) and did some munro's at about 4 months post-op. Did some long cycle rides - 100Km + in a day from about 3 months. I now have about 120 degrees flexion, it is pain free and minimal swelling. Manage full days out on hills walking and done some climbing. Skied 2 seperate weeks in january. Absolutely fine for skiing- pain free and managed full days without any problems. Did both icy on piste and some steepish off piste -early january without any problems.
2 things:
1). the low chair lift issue - as mentioned earlier can cause some anxiety when you realise your knee is going to be pushed to flex more than you are happy about. Always coped by rolling partially to my side if needed - but you have to adapt and best if not on a full chair.
2). My main concern is a slight fear of the big wipe out or someone skiing into you. I am a pretty gung-ho individual where nothing much stops me/worries me - but I have been surprisingly worried about the consequences of a big crash - which on a normal joint may sprain some ligaments, but with a TKR could lead to catastrophic failure/fracture and disability. I have skied much more carefully than before and it is in the back of your mind that the consequences of a big wipe out are potentially much more significant. I have been surprised by my anxiety over this as it would not have expected this.
Overall I have had a positive experience from a TKR - certainly skiing is fine - but I did put a lot of work in post-operatively, am pretty thin and fit and am highly motivated
The whole experience has been interesting and my advice is probably finding physio who is motivated and will work with you to what you want to achieve is as important (or if not more important) as finding a good surgeon. I very much went into having the surgery with the aim to getting back to a lot of activity (climbing/walking/skiing/cycling) - and I think I have achieved this, but the physio input has been invaluable.
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