Posterior Glides

by Chuck Wolf

During the 3-8 weeks post-op from my knee replacement surgery, I had limited knee flexion due to tissue inflammation and swelling. I had many adhesions from my previous 2 knee surgeries that occurred 35 and 36 years prior. Before my knee replacement surgery, I had broken off an osteophyte from the femoral condular groove and had a very large amount of hemorrhaging into the knee capsule, resulting in the shut down of my quadriceps and ambulated with the use of crutches.

Contributing to the limited motion I was experiencing after surgery was the sensation of 2 leather straps either side of my patella that hampered my ability to flex beyond 90 degrees. I kept feeling the knee flex, but not able to glide posteriorly, which is a normal action of the biomechanics of the knee. After strategizing with my son Adam, an outstanding physical therapist from Chicago (and this is not a proud dad's viewpoint, but a realistic assessment) we thought "out of the box" and tractioned my knee as I flexed it. I placed my right foot on a 12" box, drove my hips forward causing the knee to flex. Adam placed a strap around my proximal tibia below the anterior tibial condyle. As I drove forward, he pulled the strap posterior to allow my tibia to glide posteriorly and instantly felt more motion as I flexed. I repeated this 3-4 times, and during a few occurrences felt a couple of adhesions break loose. Immediately after this technique, I gained about 10 degrees of motion into knee flexion. After a week of doing this technique twice a day, I was able to start riding my bike again, play golf, and gain much better motion and improved gait.

As of this writing, I am 15 weeks post-op today. I feel my progress is 70% of where I want to be, but I am definitely far ahead of where I was and where many people are at this time of their convalescence. I still do this gliding technique daily, especially if my knee is stiff. This modality clears up the issue and allows me improved action.

A word of caution if you implement this approach, starts with it slowly and see how your client tolerates the technique..not only knee replacement, but meniscal and ACL reconstruction clients as well. Every person I have used this with has benefited. Let me know how it works for you.

To your good health!