Naples Orthopedic Surgeon - Dr. Robert J. Zehr » balance

During my knee exam, I noticed there was more motion with the knee bent. Is this normal?

admin — Thu, 08 Dec 2011 11:00:36 +0000

I saw my orthopedic surgeons assistant for a pre-operative exam today. I notice when he put pressure on each side of my knee I had more motion with the knee bent compared to when it was straight. Is this normal or will they fix it during the operation?

The kind of test you’re describing sounds like the normal joint gap that’s present when pressure is applied. Usually there is slightly more movement on the outside edge of the knee joint compared to the inside. There’s also more motion when the knee is bent compared to when it’s straight.

When the knee is fully straightened, it’s called the closed-pack joint position. That’s the most stable position of the joint so it makes sense the joint gap or laxity is the least in this position. The opposite is true for the open-pack joint position (flexion).

You didn’t say what kind of operation you’re having. If you’ve torn the ligaments and you’re having a ligament repair, then the surgeon will try to restore your normal joint laxity. With a joint replacement sometimes the ligaments inside the knee are kept and sometimes they are removed. The kind of implant you get depends on whether or not you still have your ligaments. Again, the surgeon tries to balance joint movement to mimic normal as much as possible.

This would be a good question to ask next time you have the chance.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com. The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of a visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

When the physical therapist pushes on my knee replacement, it feels like something is going to break. Is that possible?

admin — Fri, 02 Dec 2011 11:00:32 +0000

I’m having physical therapy for my knee after a total knee replacement seven months ago. I just didn’t get the motion back that I needed so the doctor sent me to PT. I’m a little worried about the treatment. When the therapist pushes on my knee it feels like something’s going to break. Is that possible?

Problems with motion, strength, and balance occur in up to 20 percent of the patients who have a total knee replacement. The reasons vary and sometimes are never fully understood. In cases where the cause of the problem is clear, the therapist can apply a specific treatment to regain motion.

Aggressive physical therapy (PT) is often needed when problems persist as much as seven months from the surgery. There’s not much danger that anything will happen to the implant with hands on PT. Besides stretching the muscles the therapist may also us a technique called joint mobilization to improve motion.

In mobilization one half of the joint is moved or glided along the other side. During stretching or mobilization you may be put in positions with strong pressure applied. This is necessary to avoid a second operation to surgically manipulate the joint.

Don’t be afraid to ask the therapist to explain what he or she is doing. Express your concerns so that you can understand your own treatment.

To prevent an ACL injury, I’ve been doing a box heel touch exercise. What’s next?

admin — Tue, 15 Nov 2011 11:00:23 +0000

I’m a 16-year old basketball player with lots of knee problems. I’ve been doing a program of exercises to help prevent an ACL injury. I’ve been doing a box heel touch exercise without problems. What’s the next step in the sequence of exercise?

The box heel touch is an exercise used to improve active control of the knee. The goal is to avoid letting the standing knee collapse inward while stepping down off a 12-inch box. As the athlete stands on the box with one leg, he or she lowers the other leg to touch the heel to the floor and come back up. The supporting leg must hold steady without angling in or out.

Once the athlete can do this exercise using neutral knee alignment there is a next step. Place a foam pad on top of the box. The balance pad decreases the stability of the supporting surface. The athlete must maintain balance while completing this exercise. Be sure and use a mirror to help monitor the position of the knee. Any time the knee collapses inward, correct the position before going on. Different size and density of foam pads can be used to offer more or less of a challenge.

Will I gain my balance back after knee surgery for torn ACL?

admin — Fri, 17 Jul 2009 19:38:52 +0000

I tore my ACL playing basketball, and I’m having surgery to reconstruct the ligament. Can I expect to get my balance back?

The outlook is good. Researchers recently observed patients who had ACL surgery followed by five weeks of wearing either a cast or a brace. Patients also had six to eight months of therapy to get their agility and strength back. Three years after surgery, these patients did as well on tests of balance as people who didn’t have ACL problems. Patients who had ACL surgery had slightly slower reaction times, but in general their balance was just as good.Ask your doctor or physical therapist about ways to manage your knee after surgery to ensure a full recovery.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com

Can a stretching program lower the chances that my elderly mother will fall?

admin — Tue, 07 Jul 2009 10:25:08 +0000

There is evidence that limitations in hip flexibility could impair walking ability in the elderly. This increases the risk of falling. As you walk, the hip extends in the back leg. A new study showed that the hip joint doesn’t extend as far back in the elderly as in younger people. Elderly people at a high risk for falls showed even less hip extension.

So a stretching program that helps improve hip extension could potentially help elderly people avoid falling–and the pain and hospital stays that falling can cause. Before starting any form of treatment, your mother should talk to her doctor. She also needs to address any other problems that may put her at risk for falling. These can include balance, strength, or vision problems.

The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. For more information on this subject, visit www.zehrcenter.com