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Quad Muscle not getting stronger......

Posted by cindymattern @cindymattern, May 4 5:38am

So I am 17 months from a total knee replacement....no vein issues, genicular nerve block showed no nerve issues and the bone scan showed no inflammation inside the joint or bone. However I have pain below the knee to the to of the knee, pain behind the knee (no baker's cyst) so the new Dr. recommended me wearing a Med Spec Gripper Hinged Knee brace for 6 weeks followed by leg raises, sit to stands, riding bike. step up/down, etc... and doing exercises to strengthen the quad muscle. He feel that I need to do more to strengthen the quad muscle as well as the muscles around the knee and the pain will stop. The brace is so that I can do them without it hurting so bad that I don't want to exercise them. Has anyone had issues with their muscles taking so long to get strong? I walk lots and am doing everything I did prior to surgery, 122 ROM and flexion is good....I just get so sore and stiff by the end of the day I could take stock in Ben Gay lol. Can't take Nsaids but do take vitamins. Would love to hear anyone else's experience.

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barbarasolinski | @barbarasolinski | May 6 12:44pm

Hi, I had both knees replaced at same time in Feb 2013. Three months later I ruptured my left quadriceps tendon. Two surgeries were done, one at the time it happened & one 6 months later. Unfortunately I still have alot of weakness in that leg over the last 10 years despite those 2 surgeries & many PT sessions!! I've needed to use a walker/rollator to get around. I still keep doing those exercises to try to keep it as best I can. Was told that my situation only happens in 2-3% of cases post knee replacement. And usually up to 3 months post op. Anyway keep up with your exercises and taking whichever NSAID you can to help with inflammation. Best of luck to you!!!

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1 reply
kr1 | @kr1 | May 6 1:22pm

I too have quad muscle problems. My Muscles don’t want to stretch. Told me that after they stretch them, they go back to try to protect the area. I am having some success with water walking. I also get a lot Of muscle spasms during the night and sometimes during the day when my legs are elevated, they feel better when they are down.

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2 replies
cindymattern | @cindymattern | May 6 2:19pm
In reply to @kr1 "I too have quad muscle problems. My Muscles don’t want to stretch. Told me that after..." + (show)
@kr1

I too have quad muscle problems. My Muscles don’t want to stretch. Told me that after they stretch them, they go back to try to protect the area. I am having some success with water walking. I also get a lot Of muscle spasms during the night and sometimes during the day when my legs are elevated, they feel better when they are down.

Jump to this post

I am wondering this as well....My ROM is 122 and they feel the best during the night straight as well as first thing in the morning but throughout the day they get sore and stiff. I will ask this in 6 weeks when I go back. This is interesting.

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cindymattern | @cindymattern | May 6 2:22pm
In reply to @barbarasolinski "Hi, I had both knees replaced at same time in Feb 2013. Three months later I..." + (show)
@barbarasolinski

Hi, I had both knees replaced at same time in Feb 2013. Three months later I ruptured my left quadriceps tendon. Two surgeries were done, one at the time it happened & one 6 months later. Unfortunately I still have alot of weakness in that leg over the last 10 years despite those 2 surgeries & many PT sessions!! I've needed to use a walker/rollator to get around. I still keep doing those exercises to try to keep it as best I can. Was told that my situation only happens in 2-3% of cases post knee replacement. And usually up to 3 months post op. Anyway keep up with your exercises and taking whichever NSAID you can to help with inflammation. Best of luck to you!!!

Jump to this post

I'm so sorry...being 18 months out I think my quad is ok just can't get it to be strong for some reason. I'd have thought by now it would have. As kr1 below said I wonder if mine might be the same issue going on since it was stretched for the surgery and is trying to protect itself. Makes you wonder.

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Mentor
Sue, Volunteer Mentor | @sueinmn | May 6 8:40pm
In reply to @cindymattern "i do not as my left knee is bad" + (show)
@cindymattern

i do not as my left knee is bad

Jump to this post

Cindy, I have a bad knee too, but wall squats take pressure off the knee. Have a PT show you how to do correctly.
Sue

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heyjoe415 | @heyjoe415 | May 7 2:53pm

Hey Cindy, sorry you are still having trouble.

One exercise in the gym that a lot of people do to strengthen the quad muscles is the leg extension machine. From a seated position, the ankles go under a pad and lift a given weight until the leg is straight. The feet are lowered and raised repeatedly.

According to my TKR surgeon - DO NOT USE THIS MACHINE. This puts an incredible amount of stress on the knee as it becomes a fulcrum. The leg extension also increases the risk of lateral patellar deviation, meaning the knee cap can slide right or left unnaturally. And to add insult to injury, this "exercise" adds no functionality to the knee or the leg.

A lot of body builders use this machine because it adds definition to the quads and makes the muscles "pop" - but it is actually harmful and, at best, useless from a functional standpoint. It is much better to do squats, with or without resistance, and to do seated leg extensions, where the leg is held straight out for 30 to 45 seconds with no weight.

I hope this helps you, or someone on here recovering from a TKR.

Joe

I don't know if you're using this machine or not. Sounds like you are very active and so, just in case.

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1 reply
cindymattern | @cindymattern | May 7 3:29pm
In reply to @heyjoe415 "Hey Cindy, sorry you are still having trouble. One exercise in the gym that a lot..." + (show)
@heyjoe415

Hey Cindy, sorry you are still having trouble.

One exercise in the gym that a lot of people do to strengthen the quad muscles is the leg extension machine. From a seated position, the ankles go under a pad and lift a given weight until the leg is straight. The feet are lowered and raised repeatedly.

According to my TKR surgeon - DO NOT USE THIS MACHINE. This puts an incredible amount of stress on the knee as it becomes a fulcrum. The leg extension also increases the risk of lateral patellar deviation, meaning the knee cap can slide right or left unnaturally. And to add insult to injury, this "exercise" adds no functionality to the knee or the leg.

A lot of body builders use this machine because it adds definition to the quads and makes the muscles "pop" - but it is actually harmful and, at best, useless from a functional standpoint. It is much better to do squats, with or without resistance, and to do seated leg extensions, where the leg is held straight out for 30 to 45 seconds with no weight.

I hope this helps you, or someone on here recovering from a TKR.

Joe

I don't know if you're using this machine or not. Sounds like you are very active and so, just in case.

Jump to this post

I actually was using this machine when in PT quite a bit...now just doing short arc lifts with the roller under my leg, full leg extensions on the bed as well as raising and lowering like you said I also am riding the bike and pulling my foot back toward by but and things are actually loosening up quite a bit. The hinged knee brace helps tremendously as it doens't let my leg extend to far while supporting the side of the leg with the hinges on either side. I"m looking forward to seeing how I progress in a few more weeks on my own with the recommendations of the second surgeon's suggestions.

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1 reply
ddsack | @ddsack | May 8 8:53am

My PT guy started me doing ball squats at therapy, and I liked them so much I ordered a ball to use at home. You put a large soft Swiss ball between your back and the wall and have a wonderful cushion that allows you to take some of the pressure off your knees, but still work quads effectively. Ask at PT about these ball squats. Here is a Youtube Video as a sample of how it works.
https://www.youtube.com/watch?v=ZeA9Yd2vBXw

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dmk | @dmk | May 8 8:50pm

Yes my surgeon and therapist have me doing squats with ball behind my back since 2021 post TKR
did water aerobics for 2 years still doing squats now along with different leg exercises using 1 and 2 lb ankle weights and endurance exercises and last but not least stationary bike

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1 reply
cindymattern | @cindymattern | May 9 6:10am
In reply to @dmk "Yes my surgeon and therapist have me doing squats with ball behind my back since 2021..." + (show)
@dmk

Yes my surgeon and therapist have me doing squats with ball behind my back since 2021 post TKR
did water aerobics for 2 years still doing squats now along with different leg exercises using 1 and 2 lb ankle weights and endurance exercises and last but not least stationary bike

Jump to this post

I stopped my water aerobics as the water was so cold and the local Y would not make it any warmer though many of us complained (new director). I am wondering if I will ever be able to stop exercising at some point or will I have to do these things the rest of my life. I do try and exercise each day but sometimes life just happens and it doesn't get done.

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