[Tbear]

Well its been six weeks since the surgery and I must admit that a bit of confusion is setting in...

The knee is still slightly swollen and as a result my flexion is staying about the same - around 115 degrees with no discomfort at that position. My PT person does not want me doing further flexion stretches, only extension stretches.

I've been reading various sources on the internet about swelling and its treatment ( always dangerous to read stuff on the internet ) and there seems to be several schools of thought.

One suggests that swelling ( within reason ) is good in the sense that it is the body's way of handling the healing process of the trauma to the knee. As such, trying to reduce the swelling too much or too soon with frequent ice sessions can actually slow down the healing process.

The classical school of thought - RICE - Rest, ice, compression, and elevation, suggests that is the best course of action and anything you do to increase swelling should be avoided. Do not exceed your threshold of discomfort by either exercise or daily activities because that leads to more tissue irritation and swelling which you want to avoid.

There is a web site called bonesmart.org that essentially says leave your knee alone and it will heal just fine. Your range of motion is there and will come back as the remainder of the swelling subsides. It strongly believes that the expression 'no pain, no gain' is a total myth.

So what the heck do you believe?

At the moment my knee feels great when walking and doing daily activities. I still can't put full weight on it in the sense of climbing stairs but it seems clear that for at least several more weeks not putting excessive stress on the joint is the right thing to do to allow the bone to grow into the implant (remodel).

My current physical therapist seems to be of the school that only extension stretching is needed at this point. He also has me taking 20 minute walks in a pool as well as 10 minute sessions on a horizontal stepper machine with increasing resistance each week.

So perhaps I'm no longer obsessed with the rest of the swelling rapidly subsiding if in fact physiologically it is needed to complete the healing process. Let me be clear, the swelling that occurred right after surgery is long gone and I'm referring to some residual swelling that is impeding my flexion from continuing to improve towards my goal of the 120-130 range.

I'm in that frustrating phase where I feel good and want to do more athletic related things but I know that I can't for another six weeks or so.

I need to stop whining though; I met an individual the other day that had his knee replaced in November and he can't move it past 60 degrees of flexion and is still in PT 5 months later. He said his knee also 'slides' side to side slightly. He showed me pictures of his leg after surgery and it looked like a truck ran over it - severely bruised from his hip to his ankle - couldn't believe what I was looking at... His surgeon plans to go back in to figure out what's wrong.

I'll continue to count my blessings.

Tbear