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Opinions on Step Up exercise on TKR and partial.
Joint Replacements | Last Active: Jul 3, 2023 | Replies (18)Comment receiving replies
Note the attached photo of a knee lift machine. My first doc opined that this machine results in many injuries, I should avoid it with both knees (TKR and arthritic), but my sports specialist doc (told me yesterday) that, in moderation, I should be using this machine. He also advocated knee straightening exercises that vary in tension from 10% to 100%, twice per day, to elongate the patellar tendon the surgeon attached too short limiting my ROM.
How does a non doc like me know how much is too much? How do we differentiate between contradictory opinions presented by PAs and docs? I'm desperate to regain ROM past 90 degrees and conclude that both opinions are right. Excess invites damage. Find a happy place that gradually allows the tendon to strengthen and lengthen. Allow the healing process to absorb the scar tissue that the sports doc "abrides" every month in a painful Ultrasound needle procedure which breaks up scar tissue. Heed his words which emphatically claim that "inflammation breeds scar tissue". Exercise, but not to excess in my desperate attempt to return to the highly active life I lead before TKR ended it.
In hindsight, I should have recognized this TKR technology is far from perfect, the docs vary in skill, and a smarter choice would have been to stick with cortisone and Hyaluronic Acid. However, I cannot go back in time and "couch potato" is not an option.
Replies to "Note the attached photo of a knee lift machine. My first doc opined that this machine..."
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Your question, "How does a non doc like me know how much is too much?" is a constant puzzle to those of us trying to maintain or regain health, strength or flexibility. As a veteran of ortho surgeries in the double digits, as well as assorted injuries over many years, I think I have found my personal "sweet spot." I am currently also receiving PT for chronic pain, and it also aligns with what we are trying to accomplish.
I try to work hard enough to know I am pushing myself, but not as hard as I would have in my younger days when I was focused on impressing someone or trying to meet some arbitrary number goal.
In terms of machines, today I set them so the first five reps feel almost easy, then focus on form and breathing, and continue until fatigue hits. Rest a minute or two then repeat. I know I have done enough if I can't do quite as many on the second set. Doing this consistently results in slow but apparent progress without injury.
28 years ago, when I was in my 40's, I had a full ACL/MCL repair & graft after a sports injury. 3 weeks later, I was SURE it was a bad mistake. But 6 months of diligent therapy, and I could go back to everything I used to do - even court sports (where I was injured) - this would not have happened in the "metal monster" I had to wear before surgery to stabilize the joint. I can assure you I don't regret it - and now I know when the time comes, it will be replaced.
Remember, most joint replacements are done on people who have been limited by pain and a failing joint for a long time, and the ortho surgeon's goal is to get them back on their feet. Many have little experience with those of us who are eager to get back to being really active. In your place, once the surgeon said the joint is healed, I would rely on the sports doc and PT to guide my exercise regimen.
Sue