Work on both aspects of the range of motion, you can’t just neglect extension while you’re working on flexion. It hurts A LOT to work on flexion. The Knee [P]Rehab Program is a 12-week, 3-phase program designed to rebuild your knees from the ground up. All Rights Reserved. A great overview of tissue healing phases from start to finish is well explained in a blog post we have recently written! A lack of full knee flexion is the number one reason patients call us six weeks after surgery looking for an “X10 Intervention”. When pain and swelling is present, it is just more comfortable to hold your knee in a slightly bent position. Notify me of follow-up comments by email. The closer your butt is to the wall, the harder it will be, so as you progress, try to lay right up against the wall. Use your other heel or a band to pull your heel to your butt as far as possible. Much of the lack of knee flexion immediately after surgery is not only due to pain, but also knee swelling or edema in response to the surgery. You have lots of work to do but you can get over this with time and proper rehab. Much of the lack of knee flexion immediately after surgery is not only due to pain, but also knee swelling or edema in response to the surgery. We make it easy and teach you how to self [P]Rehab your knees and keep them healthy for anything life throws at you through detailed exercise programming and our signature education resource videos. Motion is lotion. YOU are your body’s best healer! Choose either a chair with wheels or a large exercise (yoga) ball. Locking after ACL reconstruction can be due to lack of adherence to a strict stretching routine post surgery. Repeat the motion of rocking back and forth on all fours 15 times for 3 rounds. Do not lock your knees out straight. Wall slides are one of the first exercises I was able to do for flexion. Keep your leg elevated if your knee swells or throbs when you are up and about on crutches. But for the majority of patients, the outcome is favorable and patients are happy with the results. Pedal as far as possible. Hold it there for a second, pulling as much as possible, before returning it down to a resting position. Loop a band or ACE wrap around your heel, grabbing one end in each hand. What can I do to get my flexion back after ACL surgery? The pain was immense for me and it felt like a tightness as well as a sharp pain. Your knee is unique! Flexion is the number one challenge for most patients after any knee surgery including ACL, MCL, PCL, LCL, Patellar Fracture and Total Knee Replacement. You will most likely find that one or a few of these exercises “feels best” for you, which is expected! especially loss of extension. being able to fully straighten the knee). They found that even a small decrease in knee motion (flexion … If you find that your knee is more swollen after your knee flexion exercises, it means you are doing too much! ACL reconstruction knee surgery involves replacing the torn anterior cruciate ligament with a new graft. Scale back the intensity of the stretches, how much you are doing, or both until you find the amount of mobility work that your knee can handle at this time. But as any good physical therapist will tell you – each day is a new day. While we’ve discussed the importance of regaining knee extension extensively, restoring knee flexion is a close runner up for your rehab goals after surgery. Not every knee surgery is the same, as there may be different precautions you must follow after a meniscus repair vs. an isolated ACL reconstruction. Ideally you should have your full range of motion 6 weeks to 2 months post operatively. As you do this, pull the ends of the band to help pull your heel back more and push you into deeper flexion. Timing of ACL reconstruction surgery and pre-operative rehabilitation is important to settle down the knee, reduce swelling, and most importantly restore range of motion. Enhanced recovery pathways in orthopedic surgery. After surgery, you should have full passive extension. However, the rehabilitation process following the surgery is as crucial as the surgery itself, as rehab restores the normal function and movement of your knee. Knee flexion range of motion in prone: Lying on your tummy, wrap a long belt or rope around your ankle and hold the other end above your head. Healthcare careers are thriving and nursing is a single of the fastest increasing occupations projected in next 5 years. Do Weightlifting Belts Actually Work With Exercise? ), but with dedication and consistent time spent working on your mobility, we are confident you can get there! An article by Kaye et al discusses the positive outcomes related to early mobility after surgery, some of which include decreased hospital length of stay, improved patient satisfaction, and decreased postoperative complications! Restoring knee flexion is often not comfortable (as can be for any motion after surgery! When there is increased swelling in the joint, the balloon gets bigger. Your email address will not be published. When it comes to starting to move so that you can actually improve knee flexion after surgery, it may not be all that comfortable. THE HIGHEST INCIDENCE OF KNEE STIFFNESS OCCURS IF ACL SURGERY IS Again, keep the resistance down. Huge Happy Birthday to my best friend @laurenemeye, I may be 26 today but I still love dogs and so, One of us had the golden boot for the season the o, "So, what do you like to do for fun?" You go bending the knee too much, you might stretch out the graft. Knee flexion, in particular, takes longer (that is expected) but with dedicated time working on it, we trust that you will get it back in no time! Hold for a second before returning up. Meaning your knee should straighten all the way out whe you relax your leg. Whether you’re a weekend warrior, competitive athlete, superhero parent, or just someone interested in improving their knee health, you can 100% benefit from this program. Inside of your knee is a joint capsule that surrounds the entire joint, imagine this joint capsule is shaped like a balloon. Anterior cruciate ligament (ACL) surgeries are done to repair your knees after a ligament injury or tear. Sit on the seat, and keep the resistance down and first. They use these to create a new graft which is fixed into place and to do the job of the ACL. Pain Science Part 2 of 3, Lunge Directions – Forwards, Backwards, Sideways, Rotational. As you improve, increase resistance and lower the seat until it’s in your normal position. This was a phrase I heard often for my PT. You can find out loads more about what happens during surgery in t… You will work on a rehab programme with your physio which you need to do daily. I’m about four years post-ACL surgery and I still get it in the affected knee if I do a squat or any kind of really deep knee bend. You will need to work on it consistently to see results. My suggestions for you: Get your knee cleaned out, get the new ACL surgery and get with the best knee PT you can find. Save my name, email, and website in this browser for the next time I comment. Focus on going down slowly as far as you can. Keep it this way too long and you run the risk of developing scar tissue, or arthrofibrosis. Hi! WHAT YOU NEED TO KNOW ABOUT TISSUE HEALING, Is Pain Really All In Your Head? Today, I’ll share the top exercises I used to get my flexion back after ACL surgery. Slide your foot down toward your butt and hold for a few seconds before straightening again. Thus, it’s important very early on to follow the P.O.L.I.C.E. Now first things first – please listen to your orthopedic surgeons’ range of motion guidelines! And we’re moving! Early knee extension establishes the foundation for the entire rehabilitation program. But many times, certain parts of the body may feel tighter because you did “too much too soon” the previous day or earlier in the day and the knee is more swollen. It is much more important initially than being able to walk long distances. Flexion (bending) the knee, tends to be easier to regain. For most patients at Shelbourne Knee Center, this takes about four to six months. Flexion comes back most from motion, which is why all of the exercises involved motion, not stationary stretches. Rashida is a former division 1 soccer player who played at the University of Minnesota from 2013-2016. Knee extension should be restored as soon as possible after surgery, and should be … She currently is a professional soccer player, content writer, and coach. It can be a complication of knee replacement or anterior cruciate ligament surgery, with infections and bleeding as known contributing factors. It’s very painful to work on flexion and extension. If using an autograft, the surgeon harvests some tissue from either your patellar tendon (below your kneecap) or you hamstrings tendon (on the back of your thigh). If you are struggling with it, you’ll need to do the exercised 2-3 times a day. The following exercises are some of our favorites to improve knee flexion after surgery! The first two weeks after surgery concentrates on decreasing the swelling in the knee and regaining knee extension, with less concern about knee flexion. As the knee bends, the ACL is tautened as the tibia moves forward relative to the femur / the femur moves backward relative to the tibia. And it's … This is are questions that I frequently asked my PT and doctor as I heavily struggled with my range of motion following my ACL and medial and lateral meniscus surgery in 2018. Repeat 15-20 times for 3 rounds. Eventually, you can use the leg press for strength, but early on it’s more about just the motion of bending your leg, and you won’t want to put on weight that you cannot handle. The prone knee flexion stretch was another one I did A LOT. I can't fully bend it. Right now I’m working with someone who had a stiff knee 7 months out. Do 10-15 reps for 3 sets. The phenomenon is called crepitus, which literally just means “crackling”. Today, it still hurts when I try to push flexion. One of the more common complications following ACL surgery is loss of motion, with loss of extension being more troublesome than flexion. My rehab went well and I don't have any issues with my surgery knee except one. Push through the pain, but be smart. Lay on your back perpendicular to the wall. Repeat the motion of rolling back and forth, trying to push yourself into deeper flexion. It gets a lot harder to bend the knee with a bigger balloon inside of it! After surgery, understanding how to improve knee flexion is absolutely critical. As our bodies are healing from surgery, our tissues are undergoing many changes. A third of people who undergo ACL reconstruction surgery will have osteoarthritis in their injured knee within 10 years. It is one of the main goals during the first week of ACL rehab. As your flexion improves, you can move the seat closer and turn up the resistance. You need to work through the pain to progress, but also listen to your body and do not overdo it. Prop your leg on cushions or pillows so your knee is at least 12 inches above your heart for the first three to five days after surgery. Loss of knee extension has been shown to result in a limp, quadriceps muscle weakness, and anterior knee pain. Keep your feet on the footrest areas, and alternate your feet so your legs bend and straighten. For the first 1-2 weeks after surgery, the most important goal is to regain the ability to fully straighten the knee. You need to work through the pain to progress, but also listen to your body and do not overdo it. The key to improve knee flexion after surgery is gently pushing into that uncomfortable range and trying to progressively increase the amount of time you spend there with each successive day. The flexion is within a couple of degrees, and it is enough for every physical activity that I do. The Prehab Guys LLC 2020. Hey friends, just wanted to reach out and ask about your journeys to bending your knee after ACL reconstruction surgery (also meniscal tears and slight MCL tear). For more questions about my ACL and meniscus surgery, head to this FAQ. Your surgery, injury, the current range of motion, pain levels, and so much more will dictate which of these exercises feels the most comfortable and effective for your knee. This is one reason there are often, though not always, flexion range of motion restrictions immediately after ACL reconstruction. After ACL reconstruction surgery, you’ll do physical therapy until you get back to your normal level of activity. My gym had a “NuStep” machine which typically elderly people used for exercise. This will assist in tissue remodeling and the long-term success of tissue healing. Kaye AD, Urman RD, Cornett EM, et al. In this study, the authors take a look at knee joint range-of-motion 10 to 14 years after ACL reconstruction. Gaining mobility – flexion or extension – after surgery is one of the most important goals. Too much walking will cause the knee to swell and hurt, which will prevent the knee from getting straight. Even if you had a perfect knee, I would suggest the same b/c that excessive knee flexion is bad for your kneecaps. Repeat 10-15 times for 3 rounds. Later on, in the middle and late tissue healing phases specifically, we want to gently apply forces to the tissues inside of the knee to increase range of motion. I believe it is. Repeat 15 times for 3 rounds. The most common complication and cause for poorer outcomes following ACL reconstruction is motion loss, particularly loss of full knee extension. Teresa Stockton | December 30, 2016. The benefit of bracing the knee is a subject of debate, but ACL braces have not been shown to improve results or prevent arthritis after having had ACL surgery. What may feel tight and uncomfortable today should hopefully feel less restrictive tomorrow! Your ATG days are gone. Early mobility has not only been deemed appropriate after surgery, but also necessary in order to facilitate a healthy healing response. Required fields are marked *. Raise your leg up so your heel is on the wall. Sit on the ball or chair, and slowly roll forward so that your knees flex more. Gayleen Dell Schiro, I think this web site has some really superb information for everyone : D. Paule Kinny Gianni, Your email address will not be published. You should expect that some days are going to feel tighter than others, sometimes for no apparent reason! Remember – minimizing swelling after surgery is goal number one! Knee Range of Motion Exercise 5 – Quad Sets Quad sets are when you place something, pillow or towel, under your knee and then flex your quad to push your knee into the towel or pillow. Keep your knee moving and focus on working on flexion through normal motions with exercises for knee flexion after ACL surgery. This is taken either from your own tissue (autograft), or from donor tissue (allograft). When did you get full range of motion after ACL surgery? After some surgeries, you may want to push the range of motion to what is tolerable, whereas in others, pushing the range of motion past a certain degree may actually be harmful! Surgery was on Jan. 3rd, had a locked brace on for a week, got it off on the 10th and now have a range of motion brace with the locking fixtures. The incidence of knee flexion contracture with associated quadriceps weakness and extensor mechanism dysfunction following ACL reconstruction has significantly decreased with accelerated knee extension immediately after surgery. This increases the strength in your knee and helps get your knee back to 0 degrees range of motion. Remember – minimizing swelling after surgery is goal number one! Yes. Keep your knee moving and focus on working on flexion through normal motions with exercises for knee flexion after ACL surgery. After that, you may be able to go down to 1-2 times per day. When there is increased swelling in the joint, the balloon gets bigger. Biking is one of the most common flexion exercises. for assisted heel slides, first, sit on the ground. At first, you may only be able to do half-circles, but overtime your flexion will improve and you should be able to do full circles. The first few weeks after ACL reconstruction surgery are by far and away the most important in terms of the long term results. Lay on your stomach on a flat surface. Physical therapy focuses on regaining full range of motion, which helps relieve knee pain, and strengthening your knee. What are the best exercises for knee flexion after ACL surgery? As always, listen to your orthopedic surgeon and physical therapist for guidance, but we are here to help when needed! Never got back to soccer after surgery. The first 2 weeks of ACL surgery recovery concentrates on regaining full range of movement at the knee, particularly extension (i.e. This is accomplished by elevating/icing the leg and riding the stationary bike. principle of protection, optimal loading, icing, compression, and elevation to minimize as much swelling as possible as that will only limit our knee flexion gains after surgery! You need to battle through pain to progress with ROM, but if you are concerned about your pain you’ll need to consult a doctor. As you progress, you can try to push your foot back against the resistance for a few seconds before relaxing the quad again and pulling your foot more. This helps you bend your knee far more than you could if you were squatting. It hurts A LOT to work on flexion. Work on ROM several times a day, especially at first. It takes time for the joints to heal and begin to move smoothly again. Slide your heel back so you are bending your knee. Push through the pain, but be smart. Mild swelling is typically … Equally, getting away to a slow start can add months to the recovery. It’s difficult but not impossible. ⬆️⬆️, My Experience with the COVID-19 Virus As an Athlete, How College Sports Prepared Me for the Real World, https://www.youtube.com/watch?v=cFloe4nPrz0, ACL and medial and lateral meniscus surgery, Knee Surgery Checklist: Items You Need After Knee Surgery, 2 Years Post Op ACL and Meniscus Surgery, 1 Year After Partial Meniscectomy, 5 Months Post Op ACL and Meniscus Surgery. It's been 1.5 years since I had my ACL reconstruction and meniscus repair surgery. Use the machine for 10-20 minutes. Keep your operated leg elevated at a minimum of a 45-degree angle. The amount it can handle, like the tightness you feel each day, will change in time! Popping in your knee can be due to scar tissue after surgery. With all types of shoulder and knee reconstruction surgery, getting away to a good start can take months off the recovery time. Arthrofibrosis, also known as “stiff knee syndrome,” occurs when excessive scar tissue forms around a joint, limiting range of motion and causing pain and disability. The only things you can really work on is your range of motion, level of inflammation and stimulating your vmo muscle – the tear drop quad muscle. I tore my ACL playing soccer. Inside of your knee is a joint capsule that surrounds the entire joint, imagine this joint capsule is shaped like a balloon. There are several types of bikes to choose from, so pick the one you are comfortable with. So again – please listen to your physical therapist and orthopedic surgeon for guidelines on how to improve your knee flexion depending on your exercise parameters! Push yourself back toward the position of sitting on your feet as far as you can and then rock back forward. 2 years after ACL and meniscus surgery, I do not have full flexion. Aim to do this for around 5 mins, with 30sec intervals of pulling the belt. For 4-point kneeling and rocking, kneel on all fours. You need to maintain this knee extension after surgery. You’ll need to work on flexion and extension 2-3 times per day for the first few months after surgery, depending on your progress. Studies have demonstrated that the timing of ACL surgery has a significant influence on the development of postoperative knee stiffness. Use the leg press machine without weight or with very little weight. In this article, we’re going to cover some of our favorite exercises to improve knee flexion after surgery! Make sure to kneel on a pad or something soft. Future Developments As with many medical problems, there is a lot of investigation about how to improve the results for young athletes who injured knee … For flexion, it’s best to work on it via motion, not long-duration stretches. The first thing I seem to notice with people doing after ACL surgery is getting over-ambitious towards their knee recovery. Pull the belt up to bend your knee. 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