After knee surgery , a key aspect to regain is full knee extension. Often, patients and sometimes their therapists are so consumed with concern of regaining the ability to bend their knee that regaining knee extension is not top priority.
The large deficit in to flexion (or knee bending) is focused on because of just that...the large deficit. I would suggest that gaining extension(fully straightening the knee), even just the last few degrees of extension is as important and even more important from a functional standpoint than gaining end range flexion.
Having full extension is imperative for normal gait(no gimp in your giddy up). Without having full extension - walking on a “flexed knee” can cause a myriad of problems from poor healing of the surgical knee to low back pain. Gaining that full extension can be achieved numerous ways. Here I picture just one of the ways to work on functional extension.
Have the patient stand in stride stance with surgical leg being the back leg. Back foot is on TRI-STRETCH®. In this picture, left knee is the knee working on gaining full extension. The patient performs a reach with his right hand over his left shoulder while tipping the TRI-STRETCH® out on to its outside rocker(inverting). This assists in mobilizing the calcaneous and drive the lower leg from the ground up in to external rotation -- while the right arm reach assists to drive the hips the same direction. All assisting to gain functional extension at the left knee. The therapist can also perform mobilization with movement at the lower leg assisting the external rotation and extension.
For more information on functional training , click here.