TKR Struggling to Bend

[Claire56]

Sounds like a therapist that you should run away from (or at least hobble ) as fast as you can. The bike is a great tool but not used that way! If you don't have a bike, beg/borrow/steal one. You might be able to find one at a thrift store. Would probably be cheaper than the therapy sessions.

 

[Jockette]

Yesterday I was on the bike and she kept holding me at a higher and higher rotation and I nearly passed out, despite me telling her to stop. When on earth did no stop meaning NO?!

“No” stops meaning no, when you continue to allow them to do this to you. If you want them to stop, get off the bike and find another PT office, if you feel you must go. They are not helping your knee at all.

 

[Jockette]

The PA I seen after my surgery I haven't seen the surgeon yet said I should have 90 at 2 weeks.

There is no timeframe for reaching any number in this recovery. It will come as you heal and as your swelling goes down, and only then. Working hard or forcing the bend is not the answer. Ever.

 

[jessicarogers36]

They tell me if I don't hurry up and get it bending I will have too much scar tissue and won't be able to get it to. So I get scared, anxiety, and frustrated. It gets to the point I cry myself to sleep.

 

[Jockette]

They are absolutely wrong! My ROM continued to improve well into my second year, as my whole leg continued to heal and relax. And we have other members who saw similar progress.

 

[Jockette]

This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[jessicarogers36]

Ok good I will relax and not worry about the scar tissue. I can straighten leg totally flat.

 

[jessicarogers36]

I don't want to stop PT it does make me feel better after leaving. It helps me feel loosen up and able to walk better. I will have them stop pushing on my knee though. I have to be honest I haven't been doing my part at home like I should be and I need to be doing my at home exercises. No excuses but I have them lol. I'm exhausted from lack of sleep and so sore. This is by far the hardest thing I've ever done and there's been times I wished I didn't do it.

 

[sistersinhim]

The PA I seen after my surgery I haven't seen the surgeon yet said I should have 90 at 2 weeks.

That is completely unreasonable and totally out of the normal. You can not increase your bend by exercising but can sure make it worse by over-exercising! We've had tens of thousands of patients through the years on Bonesmart and we know what works and what doesn't work. We also know that the normal knee joint recovery is and it certainly isn't 90 at 2 weeks!

Being flat at 2 weeks out is way better than most others can do. My extension was slower coming in than my bend. Your whole recovery is much better than average. Enjoy knowing that and don't let anyone bring you down by telling you otherwise.

 

[Jockette]

I have to be honest I haven't been doing my part at home like I should be and I need to be doing my at home exercises.

You don’t need to do exercises at home. You can if you want to, and if they don’t increase your pain and swelling, but many of us didn’t. TortiTabby didn’t, that’s what she meant by saying all she did was activities of daily living, which means all the things you normally do in the course of your day.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.

Normal activity is the key to success- this means, activities of daily living.

 

[jessicarogers36]

thank you!! That made me feel great.

 

[sistersinhim]

I have to be honest I haven't been doing my part at home like I should be and I need to be doing my at home exercises.

I'm one of those who never took formal PT. I've had 12 knee surgeries, 2 of them kneecap removals, and 1 tkr. Even after those I never took formal PT. But, I didn't just sit around and do nothing, I am not a lazy person! I used my knee as it was intended to be used by walking around to take care of my daily needs along with the necessary house and yard work. As I healed I was able to do more. Icing and elevation were a huge part of my recovery.

Listen to your knee. It will tell you if you're doing too much by increased pain and swelling. When that happened to me, I found that resting, icing, and elevating helped. Your knee knows how to rehab itself without being told what to do.

 

[jessicarogers36]

I do normal activities plus some. I live on the 3rd floor of an apartment so I have to walk down and up 3 flights from day one. I had a out patient surgery. I was woke up at 4pm and out the door by 5pm. I wish I would of took the time in the hospital to get the pain control I needed. I did not have it in one hour.

 

[jessicarogers36]

I agree it definitely tells me when I've done too much. When I do too much it buckles like crazy and they tell me that's ok push through it but it scares me. They say if you fall in your apartment you'll be ok to just trust the knee. I do not trust it yet. It does not feel like mine yet.

 

[Rain Dancer]

The PA I seen after my surgery I haven't seen the surgeon yet said I should have 90 at 2 weeks.

My PA said the same thing at my 2 week appointment. Ignore him/her!

 

[Jockette]

3 flights of stairs is plenty of exercise, ( if not too much ) and is natural PT. You don’t need any other exercises.

It can take a while to trust this new knee of ours, especially when we overdo anything, including the PT, which results in buckling.

Try not to let them scare you. If you really like PT, maybe consider a different office, if this one won’t agree to your terms.

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

 

[jessicarogers36]

I want to see the surgeon I'm still scheduled to see the PA but I'm canceling that appointment and waiting to see the surgeon.

 

[jessicarogers36]

I think I'm doing great! I actually feel a little bit back to normal. I can walk without assistance I'm so happy.

 

[jessicarogers36]

I couldn't move or lift my leg at all after surgery and in 2 weeks I was able to lift my leg and do the stairs without someone helping me. Then 2 more weeks I can bend to 90 and walk by myself. So I'm doing great. You all are right they are just trying to push too hard.

 

[beesknee]

I want to see the surgeon I'm still scheduled to see the PA but I'm canceling that appointment and waiting to see the surgeon.

The surgeons make all the rosey promises and on follow ups it seems most end up seeing the PA.

I have had two follow-ups and have seen a PA twice that I never saw pre surgery. My last visit I was to see the surgeon, but saw the PA and then at the end she said the doctor is behind, if you want to wait another hour you can see him. I had to leave.

My OS did have me 4 simple exercises for the first 2 weeks after to wake up the quad, no stretching (I think I may have been missing a page). So I was only at 70 at my 2 week follow-up. I kind of wish I had a few light stretches to get a better start.

At my 8 week follow-up I was only at 111. I had a lot of swelling and was told by the PA to quit formal PT as it seemed to aggressive and just do what I can at home and never push through pain. She said if it is scar tissue holding me back, no amount of PT is going to push past the scar tissue. (he opinion, seems everyone has one related to knee replacement).

I will be scheduled for and MUA if I am still in the 110 -115 range next month. Fine with me because I can't live with a peg leg the rest of my life.

I have worked out all my life and have learned from various injuries it the worst thing I can do is rest and baby injury. The injury will linger forever and the muscles weaken and things can get worse. So I got in the habit of pushing through pain and working muscles around the injury which led to me getting better faster.

Knee replacements seem to be different, you need to use and move the leg, but you don't want to push past the pain. If pushing past pain would get me better faster I would have no problem doing that. But the few times I did, I had a bad rest of the day and maybe a bad next day.

My opinion is the stretching exercises to increase ROM are important, but stop when you feel a good stretch but not sharp pain. But take this with a grain of salt as I am heading toward an MUA.