We have done some research recently on the incidence of MUA with a focus on women. This is considered a Literature Review.

Literature Review: This is a comprehensive summary and analysis of the existing scholarly literature on a specific topic. A literature review seeks to identify what has already been written on a subject, identify key themes and debates, and point out any gaps in the current research. It is often a preliminary step in a larger research project but can also be a standalone publication.

To get the full story in the easiest way possible, listen to the podcast for a full rundown on our learnings.

This infographic is an easy way to digest the findings. It provides a quick look at the incidence and risk factors of Manipulation Under Anesthesia (MUA) following Total Knee Arthroplasty (TKA). This review has a specific focus on women and MUA.

This infographic synthesizes findings from peer-reviewed medical literature on MUA following TKA. It is for informational purposes only and does not constitute medical advice.

In this episode of the Bees Knees Podcast, I have the pleasure of speaking with Kevin, who shares his personal journey following knee surgery and a manipulation under anesthesia. Originally from the UK and now residing in the U.S., Kevin opens up about the challenges he faced throughout his recovery process, providing an inspiring insight into not only the physical hurdles he overcame but also the mental resilience required to push forward.

After his initial recovery period included at-home therapy, Kevin transitioned to external physical therapy, where he faced the daunting task of regaining the full functionality of his knee. Each milestone in this journey was marked by pain and effort, especially as he attempted to bend his knee to the desired angle. His perseverance paid off as he shared his progress, reaching a range of motion that spurred his motivations to keep striving for more. He emphasizes the importance of finding the right therapist, which proved pivotal in achieving further improvements in his recovery.

As Kevin shares his experiences, he reflects on the moment when he decided to undergo a manipulation procedure to assist with the tight scar tissue that was hindering his mobility. This decision came with its own set of fears, but upon reflection, he found that the manipulation was instrumental in loosening his knee and providing the much-needed range of motion he sought. This episode stands out as a testimony to the trials and triumphs of rehabilitation, capturing the emotional and physical battles faced in such recovery processes.

We delve into the specifics of the innovative X10 therapy machine that Kevin used during his recovery, which offered personalized assistance in his rehabilitation. He highlights its intuitive technology that adapts to the user’s movements, empowering him to regain control over his physical therapy. Kevin’s excitement about using the machine and the positive changes he experienced in just two weeks is palpable, demonstrating the integration of technology and personal effort in recovery.

Ultimately, Kevin’s journey unveils a powerful message about not accepting limitations. His love for biking, which motivated him through difficult times, serves as a reminder of the importance of maintaining passions and chasing an active lifestyle, no matter the challenges that arise. As he approaches a full recovery and anticipates getting back on his bike, he shares valuable insights for others who might be in similar situations, encouraging them to keep moving forward. MORE ABOUT MUA

In this episode of the Bees Knees Podcast, I engage in a deeply insightful conversation with Debra, a registered nurse from North Carolina, who shares her personal journey through the challenges of post-operative recovery following a total knee replacement. Debra provides an honest look into her experience, detailing not just the surgery but her difficult recovery process plagued by the development of excessive scar tissue. She candidly recounts how initial physical therapy fell short of addressing her complex pain management needs, particularly the nerve injuries that arose during her treatment.

We dive into the technical aspects of how the X10 Therapy operates, highlighting its unique mechanism that safeguards against overexertion. Debra describes her experience enhancing her range of motion by 20 to 30 degrees, while the machine’s thoughtful design provided real-time feedback on pain levels, a feature she found particularly empowering. Through her narrative, listeners will gain insight into the importance of personalized care and the ongoing adjustments that one must navigate in their recovery journey.

As her story unfolds, Debra reflects on how vital emotional support is throughout recovery. She appreciates the care she received, not just from the X10 Therapy team but also from others in the medical community. Her fondness for the machine and her therapists radiates through her words, marking a poignant connection between patient and caregiver that transcends traditional clinical boundaries. As we move towards closing the episode, Debra expresses both gratitude and a bittersweet sense of loss as her time with the X10 machine comes to an end.

In wrapping up our conversation, I invite listeners to take inspiration from Debra’s resilience and determination. Her story is a testament to the power of seeking help, leveraging technology in healthcare, and the value of community support in navigating the complexities of recovery. We hope her insights resonate with anyone facing similar challenges, encouraging them to remain hopeful and proactive in their healing journeys..

PJ and Robert discussed the challenges of adapting to frequent changes in technology and software updates, as well as their personal backgrounds and experiences. They also shared their experiences with knee surgeries, the importance of range of motion in recovery, and the role of AI tools in their work. The conversation also touched on the benefits of subscribing to email series, podcasts, and books, with a focus on those related to health and technology.

Robert Douglas’ Knee Surgery Experience Robert shared his experience with knee surgeries, starting with a torn meniscus and cartilage in 2016. After a steroid injection, his knee became septic, requiring two back-to-back incision and debridements. The infection destroyed all soft tissue, cartilage, and bone, leaving him unable to walk for six months. He received his first knee replacement, which failed due to misalignment and scar tissue. After a revision surgery, he used the X10 therapy device to improve his range of motion from 70 degrees to 125 degrees. He emphasized the importance of an experienced surgeon and proper physical therapy. He has used the X10 three times for his knee surgeries and found it helpful in his recovery.

Robert discussed his experience with knee replacement surgery, emphasizing the importance of range of motion in recovery. He praised the x10 machine for its precision in tracking progress and its role in his rehabilitation. PJ acknowledged the challenges Robert faced and the x10’s effectiveness in such situations. PJ also asked Robert about his experience with the dark period of his recovery, seeking insights for others in similar situations.

Robert shares his personal experience with depression following knee surgery and his journey to recovery. He emphasizes the importance of finding hope and a competent surgeon, as well as the critical role of range of motion in rehabilitation. Robert credits his faith, the X10 machine, and a rigorous therapy routine of using the X10 three times a day for 35 minutes each session as key factors in his successful recovery. He strongly recommends prioritizing range of motion exercises and considers the X10 an invaluable tool for knee replacement recovery.

In the meeting, PJ and Robert discussed the importance of maintaining hope and taking action to overcome challenges. Robert shared his personal experience of overcoming a knee problem through faith, hope, and action, including finding a good surgeon and physical therapist, and using tools like the X 10. They emphasized the need to find the right tools and strategies to manage recovery effectively. Robert also shared a recent setback in his recovery process, but expressed confidence in overcoming it with the guidance of his coach.

Robert discusses his experience with knee surgery recovery and the importance of having a coach. He explains how his coach, Kim, advised him to reduce his range of motion from 95 to 80 degrees, which helped alleviate bruising and improve his overall recovery. PJ emphasizes the value of coaching in the X10 program, stating that it is instrumental to patients’ success. Robert agrees, noting that he wouldn’t have had the confidence to adjust his approach without Kim’s guidance. They both stress the importance of not giving up and seeking proper support during recovery, with Robert adding a final tip about the benefits of pre-surgery strength training.

Robert and PJ discuss podcasts and books they enjoy. Robert recommends “Genius Foods” by Max Lugavere, which explores the impact of food on the body, and its accompanying podcast “The Genius Life.” He also mentions a podcast called “Cold War: Prelude to the Present.” PJ then enthusiastically recommends Dan Carlin’s “Hardcore History” podcast, praising its in-depth historical content, particularly the episodes on Genghis Khan. They both express interest in exploring each other’s recommendations.

In the meeting, PJ and Robert discussed the benefits of subscribing to email series like Knee Surgery Preparation and Knee Recovery Basics. PJ also shared his appreciation for Robert’s talent as a host and his ability to make people feel comfortable sharing their stories. They also discussed their shared interest in podcasts, with PJ recommending several shows including Pivot, Macbreak Weekly, Conan O’Brien Needs a Friend, and science-focused podcasts. The conversation ended with PJ encouraging Robert to revisit podcasts and find new shows to enjoy.

[MARY ELLIOTT} In this episode, I have the privilege of speaking with Rana Palowski, a resilient and inspiring individual from Middle Tennessee who courageously shares her journey through knee surgery and recovery. At 61, life took an unexpected turn for Rana after she sustained a significant knee injury while working. Despite her background as the child of a surgical nurse, she realized that recovery from a total knee replacement on November 14th was more challenging than she anticipated. Rana discusses the initial optimism she felt, believing she would quickly bounce back, only to face difficulties with what she referred to as a “quad shutdown” post-surgery, which left her unable to lift her heel for nearly three weeks.

Rana opens up about her experience with physical therapy, detailing how her leg remained swollen, hindering her progress to achieve the crucial 90-degree bend needed for recovery. She candidly expresses her desperation and dwindling hope after months of little improvement, even considering what she thought might be the end of her healing journey. However, everything changed when she found a community online dedicated to total knee replacement experiences, where she learned about X10 therapy—a therapy machine that piqued her interest. Initially skeptical, Rana researched and presented this option to her physical therapist and doctor, ultimately deciding to invest in the machine herself, driven by the desire to regain her mobility. After Three Knee Procedures | Steady progress came faster than expected.

Rana Palowski’s X10

As Rana shares her transformation from skepticism to empowerment, listeners will feel her journey’s emotional highs and lows. After acquiring the X10 machine, Rana experienced a remarkable shift in her recovery. She vividly recalls the moment when, merely days after her third surgery, she achieved 90 degrees of movement—something deemed impossible for her after months of struggle. Rana emphasizes the importance of having the machine available to her at home, facilitating daily progress and allowing her to make significant strides towards regaining her mobility and independence.

Throughout our conversation, I am struck by Rana’s courage, resilience, and willingness to advocate for herself and her health. She acknowledges the support she received from the physical therapists and doctors but highlights the unmatched value of consistency and accessibility that the X10 machine provided. Rana’s story serves as a testament to the power of persistence, faith, and the willingness to explore new avenues for healing, even when the path seems dim.

Rana’s journey not only illustrates her personal triumphs but also inspires others to remain hopeful and proactive in the face of adversity. By sharing her struggles and ultimately, her success, she embodies the spirit of resilience and reminds us all that healing is possible, and there are always options available. This episode is not just about physical recovery; it’s about embracing possibilities, fostering connections, and inspiring each other to pursue our best selves.

Melissa put together the perfect recovery for herself by doing the right things before and after her bilateral knee replacement surgery. She provides us with an update four weeks after bilateral knee replacement in her own words, and in the videos below.

My name is Melissa. I’m 47 years old and I had bilateral knee replacement surgery four weeks ago. I used the X10 the day that I returned home from the hospital. And now four weeks later I’m able to walk without the aid of a cane or any other device. I’m looking forward to having my new knees.

I started having knee problems at 35. I had been doing a class at the gym on a treadmill and the next day my knees just blew up and I figured I tore something. So I saw an orthopedist and was told that my knees were ‘twice my age’. And that I was ‘way too young’ right now, but someday I’d need a knee replacement. And I was advised to take Ibuprofen and just deal with it. So over the years I saw an orthopedist and a rheumatologist looking for help.

I had injections and shots and all of that to try to manage the pain. At that age I was quite active, but I wasn’t able to run anymore. I had pain just standing up from a chair because my knees would be so stiff. I would have pain during the night. There was a period of years when I felt like I was managing it quite well. I wasn’t seeing any doctors or having any injections at that point. But I would have copious amounts of Ibuprofen. I was able to do most of the things I wanted to do, but certainly not everything that somebody my age could do.

Then about a year ago they started getting fussier and I was experiencing significantly more pain. I sought out another orthopedist. And I was fully expecting to just get some shots and to be told again that I was not a candidate for total knee replacement.

By this time I was 46. On my visit with Dr. Winakur I said, “look, I know I can’t have a knee replacement, but if there’s something else I can do…” He had taken my x-ray and he said, ‘oh no, you are a candidate. If you want a knee replacement you just let me know, but it is completely your decision. You’ll know when the time is right’. That was kind of a revelation to me.

Nonetheless. I did go through a series of cortisone shots, which helped for a time. And after having more conversations with Dr. Winakur about what was involved with knee replacement, I decided to go ahead with the surgery. He said to me it’s a quality of life issue, and that the implants are getting better and better every year.

I said, ‘you know what? I’m done. I’m done being this constrained at this age. I want to be able to be more active and just walk my dog pain-free.’ So I thought, okay, I’m definitely gonna do it. Then the question was, do I do one or both knees? Dr Winakur felt very strongly, given my age and fitness prior to surgery, that I was an absolute candidate for bilateral. And to me that sounded like a more pragmatic approach. Anyway, it’s one and done. So I went for it and I’m glad I did it that way.

One of my big surprises is that, at least in my experience, it wasn’t this horrible, painful, awful thing that so many people warned me about. Prior to surgery I was a little nervous because so many people said I was crazy. But St Joseph’s Medical Center was great. My pain was managed well in the hospital, and by the time I got home I was able to keep track of it. And like I said, I got on the X10 immediately. I think just having something that I could do for myself, to move toward healing, was great psychologically. In fact the machine promotes a reduction in swelling. I think I just put that together, and it ended up being a pretty painless process.

I had the help of the physical therapist at home who helped me to fire those muscles up. We started doing work there and then we moved on to the Dynamic Strength exercises on the X10, primarily the Pump Test. This was where you’re pushing down against weight to get the quadriceps muscles back in the game.

What worked best for me was two X10 sessions of 45 minutes on each leg. That’s a big chunk of time when you’ve got two legs. I did toy around trying three 30 minute sessions once. I just preferred a morning and a late afternoon session.

So I did 45 minutes on one leg, ice the knee, then 45 minutes on the next leg and then ice. And after a 45 minute time I felt like that was enough time to really get the joint loose and push my range of motion a bit.

And I would feel it a little bit, but not to where I was screaming out in pain at all. I mean, it’s just that like ‘breathe through it kind of pain’ is all, nothing. And if that’s too much, you can back off.

In fact, one of the most surprising things to me through this whole surgery was what happens to your muscles. It was crazy. It was almost like they were paralyzed at first. I was somebody who had most of my strength in my legs. And to have them turn to mush was extraordinary and disconcerting, to say the least.

The big turning point for me came at the end of week two when my PT moved me from a walker to a cane. That made me feel like I had a lot more freedom and could get around better. And at that point I was able to start driving too. That was another big game changer. You start to feel a little bit more like yourself when you can have independence. I was excited by that.

I started cooking and doing laundry and being on my feet a lot more, probably even a little too much a couple of times. I would feel the tightness and the stiffness come back. But fortunately I still had the X10 at that point, so I could loosen up my joints by doing a session, with the range of motion on the X10, which, kept me limber.

So now that I’ve finished up with the X10, I’m lucky that I have a Peloton bike to turn to. That was something that I was avid about prior to surgery. I have already started using it a bit. And so I will just fall into that pattern. Now that I don’t have the X10 my daily routine will be to take a class on my stationary bike. And of course, doing the physical therapist’s exercises; they give you plenty to work on, so I’ll do that too.

Editor’s Note: To learn how to use a stationary bike after knee replacement, click here:

To read more about Bilateral Knee Surgery and Recovery click here.

We call it a “Meta-Blog.” We step back and give you a broad perspective on all aspects of knee health as with this article on ‘Four Weeks After Bilateral Knee Replacement’.

In this one-of-a-kind blog we gather together great thinkers, doers, and writers. All our work is related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, patients, and as many smart people as we can gather to create useful articles for you. This is for you if you have a surgery upcoming, or in the rear-view mirror. Or maybe you just want to take care of your knees to avoid surgery. Executive Editor: PJ Ewing

To subscribe to the blog click here.

Two resources for you below. Both are email series that we created to help those who need some additional thinking for pre-surgery and post-surgery.

The Continuous Passive Motion machine (CPM) does not increase a patient’s range of motion or strength. It does not or shorten recovery. It doesn’t help, and can even hurt a patient’s knee.

The CPM machine is a story of failed early research and technology. If you are interested in the enormous body of research about the Continuous Passive Motion machine click here (as compiled by orthopedic surgeon, Dr. David Halley).

Robert Salter (MD) and John Saringer (an engineer) commercialized the CPM in 1978. The original idea was to stimulate cartilage production in knees, at which the machine succeeded extremely well in rabbits, but not for humans. Human knee cartilage has no blood supply and consequently cannot grow back.

Soon patients began using the Continuous Passive Motion machine to increase knee range of motion. Most research studies, before 2005, compared the range of motion of patients who used the CPM to patients who had only bed-rest. When that comparison was made it looked as though the CPM had a tremendous effect. However, after 2005, the experiments on the CPM evolved. These studies compared people who used the CPM to those who did not use the CPM, but who also were not confined to their beds. The non-CPM control group could move about.  None of these studies showed that the CPM could increase range of motion better than those who simply moved about. The results were remarkably clear: the Continuous Passive Motion machine failed to increase knee range of motion.

In the early 1970’s most civilian knee surgery patients had their knees in a cast for six weeks, and were largely confined to bed. The military not only did not cast injured knees, they immediately got patients up and moving. At that point in time the research showed that some movement was superior to no movement. Dr. Salter reasoned that if some movement was better, continuous movement would be better still, and hence the invention of the CPM.

Basically, the CPM flexed a patient’s leg through a prescribed arc. In order to work properly, the patient was to lay absolutely still for up to 20 hours a day. The purpose behind laying still was to preserve the alignment between the patient and machine. However, simply moving a patient’s head disrupted the alignment, and to make matters worse, the machine itself moved over the surface of the bed. Even bolting the machine down did not solve the alignment problem. Because of the alignment problem patient’s legs only experienced 68% of the prescribed arc. And the CPM was painful for most patients. Lastly they were not very compliant.

Surgeons who have kept abreast of the research, as a rule do not prescribe the CPM, though some will admit that they offer it if patients ask for it.

How the CPM failed (the research) – Read More

Click the Play button above to listen to a full analysis of the CPM including recent research by hospital, surgeons, and therapists from the U.S. to The Netherlands to China. We welcome your feedback in the comments below.

We call it a “Meta-Blog.” In these articles we step back and give you a broad perspective on all aspects of knee health. We explore surgery and recovery and such subjects as ‘How the CPM Machine Failed.’

This is a one-of-a-kind blog. We gather together great thinkers, doers, and writers. And it is all related to Knee Surgery, Recovery, Preparation, Care, Success and Failure. Meet physical therapists, coaches, surgeons, and patients. And as many smart people as we can gather to create useful articles for you. You may have a surgery upcoming. Or in the rear-view mirror. Maybe you just want to take care of your knees to avoid surgery. In all cases you should find some value here. Executive Editor: PJ Ewing ([email protected])

Leslie Harrington shares her profound journey of overcoming multiple knee surgeries and the valuable lessons she learned along the way.

Leslie recounts a significant turning point in October 2022 when a freak incident caused her knee joint to fracture, leading to a pivotal surgery to remove debris obstructing her range of motion. We discuss her initial recovery from that surgery and how it quickly devolved into new challenges when her knee began to float in the joint, resulting in excruciating pain.

Leslie Harrington

Throughout her journey, Leslie highlights the mental battles alongside the physical pain—struggles with muscle guarding and psychological hurdles that compounded her recovery experience. After discovering the X10 Knee Recovery System™, Leslie began to see a significant improvement in her mobility and pain management, emphasizing how crucial it was to have the right tools and support throughout her recovery process.

As we explore her sessions with the X10, Leslie shares uplifting insights on achieving newfound ranges in her knee, the correlation between distraction and progress, and the importance of patience in the healing journey. With laughter and vulnerability, she offers advice to others undergoing similar struggles, reminding listeners to stay true to their own recovery pace and not compare themselves to others.

Leslie’s reflections culminate in a sense of hope and excitement for her life moving forward. She articulates her goals not only to regain full physical functionality but also to embrace activities that bring her joy, such as dancing and fitness. Her story stands as an inspiring testament to resilience and the transformative power of self-compassion and support in overcoming life’s challenges.

Bilateral Knee Replacement and Recovery and golf in the spring. Now that’s a bilateral knee replacement story you want to hear.

In this episode of The Bee’s Knees Podcast, we delve into the inspiring recovery journey of Kevin, who has experienced bilateral knee replacement surgery within a brief timeframe. At 64 years old, Kevin shares the challenges he faced due to chronic knee arthritis for nearly eight years, which ultimately led him to decide on surgeries for both knees—first in late August and then just 11 weeks later.

Kevin’s choice to undergo the procedures sequentially, rather than simultaneously, stemmed from a blend of apprehension and the desire for a timely resolution to his debilitating pain.

Kevin Boggs

Kevin discusses the pivotal role the X10 therapy system played in his rehabilitation. After his first surgery, he faced a concerning delay in accessing traditional physical therapy. However, with the X10 available in his home, he was able to facilitate his own recovery processes. His commitment to using the device consistently helped him achieve significant progress, much to the delight of his physical therapist during his first official appointment a week post-surgery. Kevin’s diligent work ethic, aided by the expert guidance of his coach Halima, contributed to his remarkable outcomes. Through a structured regimen of physical therapy, he focused on restoring flexibility, strength, and addressing scar tissue, all while engaging rigorously in exercises that accelerated his recovery.

Reflecting on his experience, Kevin expresses how his actual recovery trajectory far surpassed his expectations. His confidence in the X10 was reaffirmed when he opted for the same therapy approach following his second surgery. Four weeks post-operation, Kevin is driving without assistance and reveling in a newfound freedom from the pain that once confined him. He emphasizes the importance of taking charge of one’s health and views his investment in the X10 as a crucial step toward achieving a vibrant lifestyle again.

Kevin’s story serves as a powerful reminder of the significance of health and the lengths one should go to regain it. His journey illustrates the critical nature of timely medical interventions, informed choices about rehabilitation, and the potential of technological advancements in physical therapy. As he looks forward to resuming his everyday activities, including golf and travel, it’s clear that the hurdles he has overcome have only fortified his resolve to enjoy life to its fullest. This episode encapsulates not just a personal victory, but also serves as a beacon of hope for others grappling with similar challenges, encouraging listeners to prioritize their health and pursue the most effective recovery paths available.

by PJ Ewing

We define ‘good flexion’ as a minimum of 110º bend. A lack of full knee flexion is a problem that can linger forever after a knee surgery if not solved somewhat quickly after surgery. Watch this short video to get a handle on what we’re talking about with range of motion, and why flexion/bending is a crucial part of knee surgery recovery:

We care about flexion because it greatly impacts our overall mobility and activity levels. Mobility is crucial to our overall well being. John McKay (RN) writes in great detail about how important mobility is in his article:  Want to Live Longer, You May Want to Start from the Ground Up.

You need good flexion to do basic things like walk up stairs, enter/exit a vehicle, play sports, garden, kneel down to play with your grandkids. Here are some benchmarks:

If you do not get “good flexion” what are the implications?

There is a decline in muscle strength and other factors as we age. Being mobile helps put off the impact of those conditions.

For those facing surgery, your pre-surgery flexion is predictive of your post-surgery flexion as demonstrated in this research by Natarajan, Narayan, and Vijayaraghavan.

In the study it is shown that “pre-operative flexion significantly influenced the post-operative flexion”. Pre-operative flexion “is a good parameter for predicting the post-operative outcome.” 2

“There was a positive correlation between pre-operative and postoperative flexion; the better the pre-operative flexion, the better the post-operative flexion. However, good flexors tend to lose flexion while the poor flexors tend to gain some. TKR can produce a predictable result, not totally dictated by poor pre-operative flexion. Interestingly, restoration or even improvement in ROM for those with good pre-operative flexion may be limited by implant design and soft tissue tension.”

Just think about that for a second. “Good flexors tend to lose some and poor flexors tend to gain some,” meaning that even if you have good bending before surgery you might lose ground. And if you have poor flexion before surgery there is an opportunity for gains. With a knee replacement surgery, it is not simply the new mechanical joint that can be the determining factor. Rather, it is the ligaments, tendons and muscles that you have had all your life that may impact how well you can flex your knee.

And just for the record this is news for all of us as the study points out: “Other factors such as age, sex, etiology, type and kind of prosthesis did not show much evidence in influencing the outcome on postoperative ROM at the end of one year follow up interval.”

That said, the question becomes which pre-hab program should you go through? For a definitive comparison between a rigorous eight week “boot camp” pre-hab program, and a short prehab program using the X10, listen to this interview with Dr. Carl Freeman. Or just know that you can get more done in 10 days on the X10 than eight weeks of hard core pre-hab using conventional methods.

To read research about pre-hab before knee surgery click here: The Value of Pre-hab Before Knee Sugery

To hear patient accounts about their pre-hab see below:

First look at this quick guide to knee flexion/bending:

Now let’s explore your options depending on where you fit into one of these categories.

If your flexion is ‘very poor’ (<80º) you may need a procedure like MUA/Arthroscopy or even TKA. See a surgeon to discuss your options. If you have already had a surgery there is the option to consider using the X10 to help your ability to bend your knee.

Frank had poor flexion two years post surgery and was still able to fix the problem. You can watch Frank speak about his recovery here: Frank’s Story.

If your flexion is ‘poor’ (80º – 95º)

If your flexion is a concern but ‘manageable’ (96º – 109º)

Nan struggled after her total knee replacement for many months until she finally got to her goal. You can read (and listen to an interview of) her story here: Nan’s Story

For those with flexion over 110º

For more on how to use a stationary bike to help with flexion click here: Using a Stationary Bike After Surgery. An alternative to stationary bike is using a rocking chair which can help you work from 90º to 100º. Another technique is to sit on a dining room table (or better yet a massage table), wrap a TheraBand around your ankle and gently pull back to the point of tension, but not pain. Do this as often as you can for increments of 10 seconds.

Flexion is the number one challenge for most patients after any knee surgery including ACL, MCL, PCL, LCL, Patellar Fracture and Total Knee Replacement. A lack of full knee flexion is the number one reason patients call us six weeks after surgery looking for an “X10 Intervention”

Suffice it to say about knee flexion: “If you don’t got it, you want it. If you got it, keep it!”

This is Part Four of a series of articles on threats to a proper knee surgery recovery. I encourage you to explore the other articles in the series which you can find by clicking on the links below.

This is a free 15-part email series that runs for 30 days. We give you a broad perspective on all aspects of knee health. And we are highly prescriptive on what you can do right now to solve a tough knee recovery. We explore surgery and recovery and such subjects as ‘Lack of Full Knee Flexion’.

Executive Editor: PJ Ewing ([email protected])