Hi Anna...
I didn't have the 90 degree restriction, so my PT at home started me on stretching the muscles in that area from one week on.
Very lightly and only to any resistance. At the beginning (3-6 weeks), no progress at all. After that, it began to loosen, so I actually got it to about 90 degrees after about three months and outpatient PT.
Just overall, when I went into outpatient PT at five weeks, they measured my ROM and felt I was at about 50-60% of normal. I worked on it with a PT that had experience with THRs for eight weeks two to three times per week.
A big part was stretching (LIGHTLY!) and strengthening both the core and the hip muscles. Not the big ones, but the small supporting muscles. When I graduated from PT (got a t-shirt and everything), my final measurements were either normal or above normal.
This wasn't normal for me, but it satisfied me nevertheless. I still felt tight, by six months, I started my old stretching routine, always careful not to push it past any resistance.
There are several things that play into ROM, in my opinion (and non-medically qualified it is...)
- The flexibility of the big muscles.
- Scar tissue buildup and breakdown.
- Small muscle strength and healing.
I figure if the device has been put in correctly, you should be good structurally (as long as you don't push it too much).
One thing I've found in teaching stretching to new martial arts students is that it is an unusual thing in modern society. Most people don't do work that requires it, so if you are at a desk job or have suffered from a debilitating condition which made your muscles tighter over the years (
), then it will take time to release the tightness and relax your muscles enough to increase your flexibility.
It is also counterintuitive. People tend to stretch at the beginning of a workout, but that is the worst time to do your big stretches.
The muscles are tight and cold from disuse, so if you try to stretch, they will fight you.
The best approach IMO is to do light motion to get your body moving (I would tell students to shadow box, easy movements to get the heart rate going and the joints moving), then when you've broken a light sweat from this, do light stretches (move your neck slowly, arms across your chest, windmill, bend body forward, light kicks).
Then start your workout once you feel a bit limber.
Once the workout is through and your body is fully warmed up, launch into your heavy stretches (usually on the floor, forward bends, pulling knees up to chest or high stretching kicks in my case).
In all cases, I never pushed past resistance. If you feel resistance, that's as far as your body wants you to go. Any stretch in my mind is a complex process, involving several to many muscles.
To go beyond, something has to give. In the case of pulling your knee up, there are several candidates. One is the hamstring and buttocks - those are very large muscles and are not going to give easily. So physics tells you that the best candidate for the stress to go to is the weaker muscles in the link. That would be your newly healing smaller muscles which are weaker than those big muscles even when healthy.
So if you are patiend and only stretch the joint (any joint) to resistance, then hold it patiently and without pushing for a time, you may feel frustrated, but you are making headway that will tell in time. I usually hold the stretch for (any stretch) 20 seconds, then release. If you bring the knee up again to resistance, you may notice that it is slightly more flexible.
It took me a bit of time, probably in the order of a few months, but by gradually stretching this way, I brought the knee to a respectable stretch - probably about 120 degrees. I can now (long time after) rest my thigh on my chest, so am getting to my kind of stretching.
I think it's normal, I think the pinching sensation is either scar tissue working itself out, or you smaller muscles feeling the stress that the bigger muscles are resisting. Just bring it to slight resistance, hold it there and repeat once the leg has relaxed.
Hope this helps...
Topic: ROM (Read 7478 times)
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