Many individuals who undergo Total Knee Replacements (TKR’s) struggle to gain maximum flexion of 130-135 degrees. Many just are unable to go through the window of pain that is in front of them when they undergo Physical Therapy (PT). I talked to many people who are unable to ride a bicycle at all after 6 months post-op.
The video above is of me at Method Strength & Fitness, Seminole, FL, working on the Octane r6000 Recumbent Elliptical at 10 weeks post-op after my TKA on the right knee. This is my primary technique to improve and increase the bend angle.
I have been steadily increasing the maximum flexion at the top of the pedal stroke over the month. There is no doubt that one must endure a level of pain to keep increasing the flexion angle without revision surgery which only increases the rehab time. Riding a bicycle comfortably and safely requires a minimum of 120-125 degrees of knee flexion.
It is also important to have a well-designed stretching program that is performed a minimum of two times per day once the edema (swelling) has receded to a level that allows for both SMR (Self Myofascial Release) and proper stretching of the muscle groups of the leg.
In this video, I have achieved a flexion angle of 130. One must dance with lady pain utilizing your will and determination. If you really want it. The only way is “Through”.
You can call, text, or email me anytime. I will get back to you.
As the Romans used to say, “Carpe Diem!” Each day is the best gift.
As older adults, we have experienced the ups and downs that life brings. With that experience, we have acquired “attachments” to certain ideas. These become reinforcing beliefs as we stay in our “comfort zone.” For instance, many of us have tried all sorts of ways to manage our body weight, and all through these different “diet plans, we may have lost the desired weight only to put it back on again, and in many cases, even more than we lost! The story or beliefs we now have, based on these failed experiences, is that we can’t lose weight.
So, how do we overcome these mental attachments?
Here is my story.
About eight years ago, my daughter, her husband, and my spouse and I went out to get a bite to eat. It was Christmas time here in Florida, and my weight issue was simple. While I was standing, my daughter took a side shot picture of me. My belly was hanging over my belt line. Everyone had a good laugh when I gave a shout out to my new “beer belly” which really wasn’t that new. The very next day that picture shot through me to my core. For quite a while, I held a story; my story, that the extra 30 lb I had gained over a period of 10 years couldn’t helped. I didn’t have the time to work it off. As a full-time caregiver to my spouse, it was just the way it was and is. As a matter of fact, I had all sorts of attachments to being a full-time caregiver. ” Ican’tt do what I want when I want. I couldn’t do this, and I couldn’t do that.” On top of that, I also held a story about myself that I was always in trouble. Particularly in making ends meet. and this was what was really bothering me.
We all have these thoughts and beliefs about ourselves. And you know what? They may be our reality, but they are not reality. They are the product of my “False and Failed intentions.”
Intention- “Intentions are mental states in which the agent (me) commits myself to a course of action.” Now, this goes on all the time in my head, and when I don’t follow through, it is absolutely a “false intention.” In other words, I lied to myself, which also means that I was not “impeccable with my word” to myself.
“Breaking the lying to myself habit.”
How did I break this vicious cycle of lying to myself about my weight? I called a close friend and shared with him the fact that I was decieving myself about having this “Intention of losing the weight.”I wasn’t taking the actions I visualized. By sharing this and being vulnerable about my weakness, I could now be accountable to him. I committed to him that I would start by taking two steps toward my goal of losing 25 pounds. I am going to ride my bike three times per week for a minimum of 45 minutes and cut down on the bread intake. And we agreed that I would speak with him next week to confirm that I had taken the action of my intent.
Within two weeks, I had dropped 1.5 pounds. Sure, it was only 1.5 pounds, but after a month, it was three! I now had momentum and a new healthy habit. Getting on the bike was now actually joyful! I admit cutting way down on the bread wasn’t actually delightful, but I still had my peanut butter on toast, but one slice was enough. It became a real treat! So did eating more vegetables. I improved my diet, and also Deb’s (my spouse) because I do all the cooking as a full-time caregiver.
As I gained more confidence and momentum over the next 14 months, I went from 200 pounds to 175! The major factor in my success was threefold.
1.) I reached out and shared my problem authentically and vulnerably with someone I could trust to be straight with me.
2.) I visualized myself as a fit personal trainer. (This was a longer-term goal)
3.) My commitments ( the actions of my intention) were accountable to another human being.
The major takeaway to this post is that I could not lose the weight all by myself. I needed encouragement from a trusted friend and/or professional coach who understood.
Today, I am full of gratitude for so many things.. particularly for my friends, my coaches, and family. And I try everyday to hold this intention… “To be grateful “
Post-op 8 weeks after my TKA (Total Knee Arthroscopy), and I am on the Spin Bike at Method Strength and Fitness, Seminole, FL. The swelling and pain are down, and I can work on increasing my knee flexion to a max of 130 °. At least that is the goal. Currently worked it to 122° Important in this rehab is the following:
1.) Positive Thoughts and Emotions Generate Positive Outcomes ( The most important!)
From day 1, even though the pain was + 8, thinking and visualizing myself back on the bike was and is crucial in maintaining my drive to move the joint when doing so was a big “Ouch.” One has to keep his or her “Eye on the Prize.”
2.) Elevating the Joint and Keeping it in a 0° to no more than 10 ° position for the 1st four weeks while at rest in thesupine (on your back) position. This is the only way to reduce the edema (swelling in the leg); it is challenging to work the new joint with the increased soft tissue water pressure in and around the knee. It is of utmost importance to be mobile each day to prevent collagen formation (scar tissue). Physical therapy can prevent help this and keep one on track with the proper exercises.
3.) Performing lengthening exercises for the Quadriceps, Adductors, Hamstrings, and Calf Muscle Complexes. At week 4, I started performing SMR (Self Myofascial Release) and warm water Massage Therapy 2-3 times per day in conjunction with lengthening exercises (stretching the muscle complexes.) The optimal length-tension relationships of the muscles need to be readjusted to their newly established ratios from the surgery. It takes time and patience. It is a challenge, and (.1) above is the number 1 factor in achieving success. (As it is in life)
SMR (Self Myofascial Release) of the Quads
4.)Increasing Knee Flexion
Goniometer
xR6000 Octane Recumbent Elliptical
At week 6, I started on the Octane xR6000 Recumbent Elliptical at Method Strength & Fitness. It enables me to measure the knee flexion at the top of the pedal stroke using a goniometer. I am increasing this by 2-3 degrees per week. I have also moved to the Stationary Spin Bike, now working on my stamina, keeping the pedal force tension very low. Easy does it for now. The Spin Bike’s maximum knee flexion is 120° which is the same as my road bike. I use it as a conditioning exercise machine. Next week, I will incorporate more strength exercises and continue to increase flexion using the Recumbent Elliptical machine.
As a fitness and life coach, my first approach to addressing body-weight issues is to discuss your thoughts and emotions on the subject. Do you view yourself as overweight? When you look in a mirror, what are your thoughts about your body? Are they negative? How often do you think about it during your day? Do you compare your body to others and then wish you looked more like them? Can you visualize how you want to look physically?
How you think and what you feel are of the highest importance. This means taking an honest and authentic (real) look at your “State of Being.” Are you being “Impeccable with your word?”
That is to say, for example, are you using the following type of language in your self-talk?
“ I know I should be more disciplined in terms of what I eat.” I know I should be more active.” These are authentic thoughts, and they have integrity because you are being honest with yourself. You are being “impeccable with your word.” When you think these thoughts, however, how do you feel? Do they make you feel good?
Here is another fundamental axiom about you and everyone else on the planet. “You Don’t know what you don’t know.” Let me state that again. “You don’t know what you don’t know.”
Here is what I do know. “Positive thoughts and emotions, on the whole, generate positive actions and outcomes. This is a universal law. Another is that you can become more aware of your thoughts and change them. This is where the “Rubber meets the Road.” This is the time to take action. What we are talking about is your inner self. It’s your will.
It is taking that small step to change the direction of your thoughts.
When a negative thought or emotion arises about your weight issue, do you just let it go to only have that negative feeling come back later? At that moment, what if you changed your inner dialogue to the positive? For example, “I’m calling Gina (a friend I just created, and I know you have someone like her) right now and ask her if she would like to join me in my journey to a healthier weight. If she doesn’t answer, commit to calling her again and making contact. That is a positive thought coupled with a positive action that can lead to a positive result. Just that tiny step…. Be Bold.it is inside you…
