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How can I get full flexion through exercising?

Q: I had a type III lower femur fracture fixed with K-wire five months ago. I have been undergoing physiotherapy for the past 3 months for knee flexion with the help of continuous passive machine (CPM). Though I have been getting full flexion on CPM i.e. about 120 degrees with lots of pain but actively the flexion is just 60 to 70 degrees. I have also been doing some knee bending exercises. I have regained much of the strength. I am able to stand and walk with the help of support and also climb stairs, but I am not able to get flexion. Please suggest some exercises to get full flexion. How much time does it really take to heal? Is there a problem with my knee?

A:Fractures of the lower end of the femur do produce knee stiffness, but, you can still achieve the active range as you already have the passive range. I would suggest, 1. You do your exercises in short periods instead of doing them at one go which aggravates your pain. 2. Try strong isometrics for both the quadriceps at the same time to get a better advantage. 3. If it still very painful, you can use a hot water bag before the exercises to relax the muscles. 4. You can try self dragging of the heel towards the hip too as an exercise. 5. Squatting should also help you. 6. You will have to learn to relax your muscles too. 7. It has taken a little longer I feel, but, if you go slow and start again, you will come around and get your active knee flexion too.

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