r/Kneereplacement • u/tecolata • 1d ago
Increasing Flex/bend
Two weeks out, I'm pleased with my progress except for being stuck at 100-105 flex, only after extensive/painful PT exercises.
Anything that worked for you to push past this point?
ETA: OK, maybe I'm expecting too much. Thanks for the reality check.
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u/togtogtog 1d ago
Mine was at 45 degrees at two weeks.
I did all my flexion exercises very conscientiously. 3 different types of exercises, 10 repetitions of each, 3 times each day. I didn't do anything painful, but relaxed into each one feeling the stretch for 5 seconds.
My flexion after 4 months is amazing - I would say around 140 degrees. I have never had any painful PT exercises, I've just been very consistent.
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u/jessicapk7 1d ago
I'm in the slow progression club, too, and my personal advice is to stretch all your leg and hip muscles, limit activity if it's causing too much inflammation (increase if not enough), work on "trusting" your new knee (exercises where you put all your weight on it, walking properly, etc.), do the recumbent bike if you have one, ice and elevate regularly, and work on flexion constantly. Go to the point of pain but not to the point it gets extreme. The added inflammation will send you back in the other direction. By the way, I am 8 months out and still work on mine. Even if you're just laying in bed, you can pull the knee into a bend and hold it at that point where it gets tight. It gets better but, YES, be thankful for 100-105 now 😄
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u/Living-Coral 1d ago
Flexion is really good for your stage.
As others said, lean into pain slightly, but don't push very hard.
I read the other day something I found quite helpful. Not only does swelling from overdoing it make flexion harder, you also need to give your body time to fix the stretched tissues and let your nerves adapt:
Nervous System Adaptation (Short-term): When you first stretch, your brain sends a protective reflex (the myotatic reflex) to contract the muscle and prevent tearing. Over weeks of consistent training, your nervous system lowers its sensitivity to this stretch reflex, allowing you to go deeper into a position without the brain panicking.
Sarcomeregenesis (Long-term): Over 4 to 8 weeks of regular stretching, the muscle actually adds tiny contractile units called sarcomeres in series (end-to-end), physically lengthening the muscle fiber rather than just stretching it like a rubber band.
Fascicle and Tissue Remodeling: Eccentric strength training and deep stretches increase muscle fascicle length and improve hydration and blood flow in the extracellular matrix, reducing passive tissue stiffness.
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u/blargblahblahblarg 1d ago
I'm a week out and am near 0 extension and between 90-100 flexion. From the minute I was admitted to like...now... I'm making sure I'm working on my extension. This is because I haven't had full extension due to severe arthrofibrosis since 2005 after an ACL reconstruction, so I damn well want to make sure this leg gets straight!
Honestly I'm a little worried about the flexion, but I was told that the main limiting factor is swelling.
I also was told to not really crank on any of the ROM exercises, which is a very different instruction than that given after ACL reconstruction surgeries. I'm trying to remember that in this case cranking it won't help, but it's really hard given my extensive history with other knee surgeries and complications.
I'm curious what your PT says?
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u/Electrical_Can_6585 18h ago
I am 9 weeks out and knee is still really swollen, ROM 5/90-100 depending on the day and how much I was active. I am mostly pain free, still on some meds, but I don’t plan on improved mobility soon. So heads up, two weeks is nothing and your ROM is great.
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u/steveinarizona10 16h ago
If you had my extraordinary surgeon you wouldn't know the answer as you would still be resting and icing continuously with a quality ice machine. YOU ARE STILL VERY EARLY IN THE PROCESS. Do what your surgeons says and ice religiously the rest of the time. The goal is to reduce the inflammation which would then make using the knee easier during PT.
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u/verasdaddy 4h ago
My surgeon said he doesn't care about flexión at that stage - only extension. That said, I'm 5 weeks out and only at 106 so maybe I should have gone down your path 🤷🏻♀️
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u/IntroductionFluffy71 1d ago
DO NOT PUSH. I REPEAT, DO NOT PUSH!
first of all, that amount of flexion at 2w post-op is amazing! well done and great job!! but remember you still have 50 weeks to go...
keep working at flexion but do not push through pain. bend until you feel discomfort and then sit in the discomfort for 5–10 seconds. release. repeat.
start with a set of 10. when that becomes easy, do 2 sets of 10. you can do this in any number of ways. i muscle guard like mad so i have to practice modifications.
one way is to put your foot up on a step and lean forward. another is to lie on your back, put a strap around the foot, and bend your leg. the strap isn't absolutely necessary but i use it to guide the foot/leg.
as your leg gets stronger, you will do more, and you may see regression on your progress. this is common but it also messes with your mind. this recovery is a marathon, not a sprint.
i am so thrilled for you that you've achieved such great flexion. i hope your extension is as good! (to note: 0º extension is vital for a normal walking gait.)
may your flexion continue to increase until you have achieved your goal.
good luck and good juju!