Knee help

[Wish]

My left knee has never been great as long as I can remember. But now my right knee has joined the party. 

Looking for some good knee exercises for strengthening. Messed up my right knee in Oct It’s ok now but I’ve lost strength and full range of motion ..maybe stability. Can ski without any pain but do notice strength issues when climbing stairs. And skiing…just don’t want to admit that. 

Also looking for good stretch’s to regain full ROM to go along with strengthening. 
 

 

[Bruce_Butterfield]

@Wishasking for medical advice on the internet 🤦‍♂️

first step is a PT or real doc. All situations are unique. You should know that by now. 

[lpskier]

@Bruce_Butterfield Bruce, I thought you slept at a Holiday Inn Express last night! 

[Wish]

@Bruce_Butterfieldmah... Medical advice is a bit of a stretch. Maybe saying I messed up my knee is vague but I’m way past Docs and PT. Just lookn to strengthen both knees and increase range of motion. 

[Rednucleus]

A good PT's evaluation would help get you on the mend quickly & safely!

[Taynton]

Being overly general because of the general nature of the question, With zero actual medical education, speaking entirely from personal experience... cycling is probably one of the best exercises for the knee. Particularly if you work on the 6 to 12 o'clock pulling part of the rotation, next I would say is deadlifts (done properly). Most issues in the knee start in the feet/ankles so assessing the strength on that always helps.  Maybe swimming next ?

[ghutch]

My knees started aching years ago to the point I didn't want to bend down to pick something up. I started following kneesovertoes on InstaGram. He has some pretty good, simple exercises that have really helped mine out and they definitely feel much better. Just throwing it out there. Give it a shot.

[FlowPointMethod]

Sorry to hear your knees are hurting! @ghutchhas good advice with KneesOverToeGuy on Instagram. Be sure to start with the “less is more” approach though to see what your knees will be okay with. Each situation is different.
 

Starting to just gain range of motion again by spending time each day in the bottom of your pain free squat depth and working toward increasing that range of motion is huge. Other exercises: split squats, glute strengtheners, toe raises. Also working the tissue all around the knee (upstream and downstream) with massage, self my fascial release, Graston, voodoo flossing and just regular good old stretching of the quads, hamstrings, adductors and calves. If you want more info or help, we have more with this on FlowPoint Method program. 

[VONMAN]

I mentioned to my son  my right knee has been bothering me so he sent me the "Knees over toes Guy" book of exercises and after a couple of weeks no more problems. Who knew!

 

    Ernie Schlager

[AdamCord]

With regard to what @FlowPointMethod said: Knees Over Toes guy exercises plus VooDoo Flossing exercises....It's like magic. I have a shredded lateral meniscus in one knee and I went from where I could barely run to now where I'm playing soccer 1-2 times per week, not to mention lots of skiing in between 😀

[Wish]

Been using a stationary bike but as @Taynton suggested, I’m now concentrating on 6-12 o’clock in the rotation and that’s made a positive diff. Also been researching Knees Over Toes Guy and while I’ve only sampled a few exercises , the whole program seems spot on and I’ve only come across positive after positive review. And to see what his 67yr old mom is capable of, he backs up what he’s preaching. 
Gonna try to post progress if I can. Mostly to keep myself accountable to the program. But I feel this is the most promising not only for the recent event but for a life long not so great left knee. 
 

Thank you all for the posting. 

 

[ghutch]

Best of luck @Wish. Keep us posted on progress and how it goes. 

[Vernon Reeve]

In addition to KneesOverToes guy, there's another program that makes lots of common sense for knees, shoulders, etc.  It's CoreXCell.  So I think a combination of the two approaches would be best.  Here's an example of a CoreXCell video that addresses an issue that someone following the KneesOverToes program was lacking.  Maybe if he'd contacted the KneesOverToes guy he might have gotten the same answer, so I'm not knocking KneesOverToes.  I'm just saying CoreXcell is potentially another good resource. 

 

[OldboyII]

I almost restored my knees practicing four simple decompression exercises. At least knees are much better than 20 years ago (no kidding).

Example is here (language in not important):

https://www.youtube.com/watch?v=Z8D77Hd1v74&t=325s

Edited February 23, 2023 by OldboyII

[Drago]

@OldboyII ja ja, don't forget the roids 🇷🇺 

just kidding, can use a band for the adduction, abduction, and hammy curls too💪

[Jaypro]

start with an experienced PT, ortho doc is just going to send you to a PT anyway.  Look for a postural restoration institute PT, otherwise known as PRI.  If you go to their website I believe it allows you to search your area.  Biased, my wife is PRI trained, but she has had great success with patients with knee/hip pain.  

[thager]

@WishYou're getting old! No question exercise will help but at some point it's either quit or get the knee(s) worked on. I fought it for years with moderate success but never totally really got rid of the pain or weakness. Had my knee replaced a few years ago and am stronger and skiing better than ever without pain. Your call obviously, but something to consider. I wish I had done my replacement sooner!

[Jody_Seal]

now the question is when having knee replacement does one rely on a talented surgeon knee specialist or the robot??

Sister in law had both knees done at separate intervals.Rd 1 was talented surgeon with great results and outcome. Round 2  robot router deal... so far longer heal time and not out of pain..

[BraceMaker]

@Jody_Sealthe dirty secret is that the robot is a marketing ploy and the general person isnt' a good candidate for those procedures so they use the robots far less often then one might expect.  Still goes on the billboard, still brings people in, but "introducing the new nano knee procedure from stryker" or whatever the hot product is doesn't mean the surgeons like it or that the patient is a candidate.  Like anything you want a providor who knows his tools and can use them.

 

 

[pugs]

A few years back when I had my second hip replaced, my surgeon had switched to a different manufacturer. When I checked the new hip mfg on the internet I noticed that the new hip mfg was touting the robotic assisted surgery. When I saw my surgeon for the last visit prior to surgery, I asked him if he now used the robotic assist, his response was priceless, " Do you use the navigation system on your car to drive home? I've done this over 5,000 times. I know my way home."

[Cnewbert]

Well, then there is this study published in the National Library of Medicine.  It's pretty technical, so I've cut to the chase by skipping the middle portion detailing all the actual measurements and incomprehensible medical jargon.  The study was based on 20 total knee replacements

Abstract

Introduction: A functional total knee replacement has to be well aligned, which implies that it should lie along the mechanical axis and in the correct axial and rotational planes. Incorrect alignment will lead to abnormal wear, early mechanical loosening, and patellofemoral problems. There has been increased interest of late in total knee arthroplasty with robotic assistance. This study was conducted to determine whether robot-assisted total knee arthroplasty is superior to the conventional surgical method with regard to the precision of implant positioning.

Conclusion: Robot-assisted total knee arthroplasty showed excellent precision in the sagittal and coronal planes of the 3D CT scan. In particular, the robot-assisted technique showed better accuracy in femoral rotational alignment compared to the conventional surgery, despite the fact that the surgeons who performed the operations were more experienced and familiar with the conventional method than with robot-assisted surgery. It can thus be concluded that robot-assisted total knee arthroplasty is superior to conventional total knee arthroplasty.

[BraceMaker]

@Cnewbert

There is no question that you can find loads of studies on both sides of the equation. But you have to be careful reading articles for a number of reasons just searching your article I'd point out the following.

A - 20 knees is nothing on a surgery that does around 1 million a year.

B - its an old article (2011) so pretty dated.

C - "Comparison of robot-assisted and conventional total knee arthroplasty: a controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment"

They were installing fake knees into corpses so there are no outcomes on how well those knees worked just on total alignment.

[Cnewbert]

@bracemaker  as I understand it, all else being equal, precise alignment of the prosthesis is critical to the long term successful outcome for knee replacement, and I believe there is no debate on this fact. As described in the abstract, incorrect alignment leads to a host of long term problems with the replacement.  So the more precise the better.  In other words, precise alignment is the common denominator for long term success, whether the knee replacement was conventional or otherwise. This study focused solely on how well robot assisted arthroplasty alignment compared to conventional knee arthroplasty alignment.  So the fact that cadavers were used is not relevant.  Alignment is alignment, whether the "patient" is alive or not, and if the study showed that the robot assisted surgeries demonstrated superior alignment of the prosthesis (which it did) then clearly the long term result would be improved on living patients, for all the robot does is assist with the alignment. The study was not examining different brands of prostheses, different techniques of attachment to the bone or anything else where a living patient would obviously be necessary to study the long term result. The fact that this study was done in 2011 is relevant insofar as the robot technology only continues to improve along with the familiarity and skill with the technology by surgeons employing it.  Whereas conventional knee arthroplasty is, well, conventional.  By definition, nothing of substance has changed or it would no longer be considered coventional.  Yet even over 10 years ago the robot assisted technology demonstrated superior alignment results in this study.  And while the skill of surgeons may vary, the conventional technique is essentially the same as it has been.  This I learned first-hand when discussing the options of knee arthroplasty with the knee surgeon I was consulting with, very much a conventional surgeon.  His recommendation for me was a conventional total knee replacement, stemming from a snow skiing accident 30 years ago where I tore my meniscus and waited 10 years for arthroscopic surgery to fix it.  By then the damage was done and I now have some bone on bone arthritis in this knee.  So my conventional guy was ready to cut through my quadriceps in the conventional fashion and replace my entire knee.  However after consultation with pioneer knee surgeon Dr. Stefan Kruzer in Houston and Dr. David Moore at Andrews Sports Medicine and Orthopedic Center in Alabama (where Regina had her knee surgery), I became convinced that the conventional route my doctor was prepared to go down was not the best choice and that knee replacement surgery has advanced by leaps and bounds.  One of those advancements being the robot assisted prosthesis alignment.  What I will undergo in a week is a unicompartmental quadriceps sparring minimally invasive robot assisted knee arthroplasty.  My quadriceps muscles will not be cut, thus dramatically speeding up my recovery,  I'll have a 4"-6" incision vs. an 8"-10" incision, and only the medial compartment of my knee will be replaced vs. all three in the entire knee.  The wisdom of my decision to reject the conventional total knee replacement surgery my former knee orthopedist was recommending is of course to be determined.  But my now surgeon at the University of Florida Sports Medicine says I should be able to start skiing in 6 weeks post surgery unless he finds more extensive knee replacement is needed once the surgery is in progress.

If you can find one among the "loads" of studies you refer to that compares the precision of alignment between robot assisted knee arthroplasty and conventional knee arthroplasty that shows a superior result obtained by conventional knee surgery, please post it.  I did a lot of research on this and could find none.  

[Wish]

Ok so the more I looked into knees over toes guy (KOT Guy) the more I feel he’s really onto something. So my left knee has always been bad my entire life. Age has only complicated that and I’ve grown to accept it. Right knee was great till the accident. So this KOT stuff was supposed to be for my right knee but now the left one feels great. I’m baffled. I really have not done as much as I should be but the results are stunning.  I did add stationary bike and concentrated on pulling up vs peddling down as suggested above. In looking at the mechanics of that, it falls directly in line with KOT. I also added VooDoo Flossing as suggested by Adam Cord. How that works I have no idea. Lots of trainers have their  individual  perspectives but no one seems to really know. But that worked as well. So bottom line…ZERO knee pain ..both knees. Getting up out of a chair there’s been that ache in the past. All gone. Still more work to do as the right knee needs more ROM ability in a full bend but I gotta say, no knee pain ( no more meds) has been a surprise. I’m adding sled work the KOT guy promotes and continue with his program with stationary bike added. So THANK YOU to those that suggested KOT Guy and VooDoo Flossing. 
 

Edit; and I really do not see any surgery happening considering these results so far. Bonus!! 

[igkya]

Using an elliptical machine in a backwards motion (power over speed) is similar to what @wish said about about pulling up on a a stationary bike.