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Stay Ahead Of Your Pain

The most important thing for you to do after a knee replacement his work on your range of motion. The bending and straightening of your knee.

It’s difficult for some people to work on range of motion exercises after a knee replacement because of the level of pain that they have. But you don’t want an increase in pain to stop you from doing your exercises.

So along with the exercises that you need to do comma it’s essential that you use your pain medication as instructed by your doctor.

A lot of the time if you’re not moving you’re not really having that much pain. And if you’re not having pain, a lot of people wonder why they should take pain medication.

You take pain medication routinely, even if you don’t have pain, so that you are able to move with as little pain as possible.

If you sit back and think about it, it’s important that you have the pain medication already in your system when you start to do your exercises. This way you can get the most out of your exercises and not have to worry about your leg hurting that much.

Some people have difficulty with pain in the morning. This is because they’ve slept through the night and the pain pills I took before bedtime has worn off.

What I like to recommend that people do is before they go to bed put your pain pills on your bedside table with a few crackers or a piece of fruit. That way you can take the pain medication as soon as you wake up and you’ll have some food with it so you will be able to keep it down.

This also will go a long way into preventing the excuse of not getting your exercises in earlier in the day. Since you will have taken your pain medication right when you wake up you should be relatively pain-free when you’re ready to do your exercises.

So the important thing that I wanted to get across in this article is that if you don’t take your pain medication routinely you will not be able to do your exercises as vigorously as you need to.

Build your day around taking your pain medication and doing your exercises and your Rehabilitation time be short and sweet.

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Limited ROM Even After MUA (manipulation under anesthesia)

The following is a response to an email question received from a reader. It is strictly for the purpose of education and information. However, it may be beneficial to some of the other readers of our website.


Disclaimer: The content of this email should be considered educational information and is NOT to be considered medical advice in any way. Only your personal medical professional can give you qualified medical advice after a thorough evaluation.


I am just writing to let you know that I did get your question regarding your total knee.

While each person is different, the stiffness related to knee replacements in typically due to the condition of what’s called soft tissue, i.e the muscles, tendons, skin, and etc.

For the most part, the components of the knee replacement are in their appropriate place and allow for full range of motion (which the MD checks with you still under anesthesia).

Since that’s the case, getting your ROM back is all a matter of stretching the soft tissue to allow for bending.

There are several things that could be stopping your progress.
1. Scar Tissue. You may be more susceptible to developing scar tissue. This condition is called “arthrofibrosis”. Many people have it. There may be some help for this and I will address it below.

2. “Muscle Guarding”. This is a psychological phenomena where you unconsciously “guard” the knee against bending in anticipation of the pain that will come with activity.

3. Swelling or edema. This stops the knee from bending all the way.

And there could be other issues involved.

Possible things to explore:

I wrote a blog post here – that addressed this question and there are a couple of physical therapist techniques that may help you if a therapist in your area practices them

Joint mobilization is another approach which your therapist may have tried. Some therapists are better than others and use different techniques. It may be worth exploring other therapists in the area that may have a different approach.

In addition, it may be worth exploring stretching the hip and ankle of the same leg you had the surgery on. Because they indirectly influence knee ROM you may have a breakthrough there.

Specifically the tensor fascia lata muscle, the gastrocnemius muscle and the group of hip “flexor muscles”.

One more thing that may help stretch soft tissue is massage therapy. Specifically techniques like “hellerwork” “Rolfing” and “myofascial release”.

In any case, speak with your Doctor about seeking any of these approaches as you may have other conditions that may need to be considered before you have clinicians apply any approach different than what you’re currently doing.

Best of luck to you.

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How To Use A Walker After A Knee Replacement

English: Photo of modern-day walker taken Janu...

How To Walk With A Walker (Photo credit: Wikipedia)

It can be tricky and kind of scary trying to get back up on your feet after having a knee replacement. Not only does your leg hurt. The muscles are weak from the surgery and that makes it feel heavy. Plus, it’s also swollen and that makes it feel even heavier.

But, learning how to use a walker after knee surgery isn’t as hard as you may think. One of the biggest obstacles is finding a place to put your fear of falling while you focus on getting up and getting going.

3 Tips on How To Use a Walker

There are generally 3 things you need to focus on when you start walking after a knee replacement surgery.

1. How much weight to put on your knee. Your doctor and physical therapist may already have told you that you’re “weight bearing as tolerated” or “50% weight bearing” (or something else). But, that may not mean a whole lot to you if you have a lot of pain or if your leg feels pretty weak.

What you really need to figure out first is the right amount of weight to put on your leg without causing a lot of pain. This is done by using your hands to support your body weight on the walker as you ease on to the leg with the new knee joint.

Another thing that this particular technique does is it gives you a good idea of whether you knee is strong enough to support your body weight or not. It’ll probably take a couple of practice sessions before you really get a feel for it.


2. Sequencing. When a physical therapist talks about sequencing, they basically mean the sequence of taking steps and moving the walker that gives you the most security and hurts the least.

In general, the proper sequence you will be using is moving the walker first, then the sore leg and the good leg following. Using this particular sequence allows you to get the maximum amount of leverage with your arms and hands so that you’re not putting a lot of weight on your sore leg.

Some people think that leading with the good leg is better and they use that technique. But, when you lead with the good foot you use your sore leg to “push off” with and this throws off the rhythm of your walking.


3. How much is too much. When you’re first starting getting back on your feet after a knee replacement, your tendency may be to do too much walking. There’s something inside of all of us that makes us determined to “show the world” that “a little knee surgery isn’t enough to keep us down”.

But, more walking will not actually make you heal any faster. However, more walking may cause more inflammation and more swelling. And this may actually slow down your healing.

With that said, while more walking isn’t the best idea, some walking is essential. The trick is to find out how much is too much and stay just short of that distance. You can only figure this out by getting a good grasp of the first two points I made above.

How To Use a Walker Is Easier Than You Think

If you’ve had, or, if you’re planning on having a total knee replacement, don’t let a fear of learning how to use a walker spook you. There are probably hundreds (if not thousands) of people learning to use one everyday. If they can do it, so can you.

Once you get the hang of it, it’ll seem like second nature. In fact, once you get used to it, you will probably be asking “when can I get rid of the walker? I’m ready to start walking without anything”.



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