TKR 10 weeks Post TKR - Physician wants Manip

LyvLB

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Hi everyone,

I have been reading the thread for the majority of recovery.

I am a woman
53 y/o, 1.71 meters, 67.13kg

Total knee replacement 12/1/2021. No walking in hospital. Anemic for 2 weeks post op.

I have endured a rather harsh bout of PT for 8 weeks. It has been three times per week until I could not endure another minute. He was a recommendation from my spouse. The pain was severe. He finally pushed the knee backwards so harshly, I thought I might fall off the table. He pulled, pushed, raised, leg lifts. He did get me to 90 degrees. Myself no such luck.

Relieved P.T. of his duties at 8 weeks. There is consistent swelling of leg, scar looks excellent as I massage with organic body oil & lavender, sharp pains through knee, nerve endings engaging incessantly.

Chiropractor massaging and breaking scar tissue, as well as STEM. It feels amazing. Believed I could take a jaunt in our vehicle twice - not a delightful trip.

Heat is normal.

The problem, my surgeon wants to have a manipulation next Wednesday to stay within the "window."

A sonogram will be conducted today surgeons concern of blood clot in leg.

I began this journey anemic and the blood transfusion needed was not completed.

I am mentally exhausted. I cry daily. This procedure challenged me in more ways than I have ever thought possible. I never would have decided upon this surgery knowing the outcome.

Chiropractor said, try to ride a stationary bike. I did. Full-pedal motion. 5 minutes.

Damage and more swelling. I cannot get more than 40 rom myself and I cry.

I have been so active climbing mountains, swimming, running, cardio, etc. I am spent and see no flicker of light.

Any words of wisdom.

Date of surgery - 12-1-2021

Thank you
 
Hi and Welcome!

I am so sorry that you have been so abused in your recovery. And yes, the word is abused.

You were getting very inappropriate PT (I refuse to call it “therapy”) and I’m glad you relieved your PT of his duties (a very polite way to word it) I also stopped PT right about 8 weeks.

While I am a fan of chiropractors, I am concerned when you say he/she is breaking up scar tissue. That sounds aggressive to me.

Right now you don’t need anything aggressive, including an manipulation, which is just more aggression (which is why you need anesthesia)

I’m sorry your doctor believes in the myth of the window of opportunity, it is not true. My ROM continued to improve well into my second year post op, as my whole leg continued to relax and heal. If there was, indeed, a window, I wouldn’t have continued to improve.

The reason your ROM is on the lower side is because your medical team has never giving it a chance to heal. All the painful pushing and pulling is not good for a healing knee (I fail to see how they think it is) All that does is maintain and increase, pain, swelling, and inflammation. All these things are preventing your ROM from improving.

I suggest you cut way back on your activities and rest, ice, elevate, and take pain medication that works for you. What, if any, are you taking now? There’s information about these things in our Recovery Guidelines.

I suggest you tell your surgeon you want to wait on the manipulation. There’s a very good chance if you change how you are rehabbing, you won’t need it. I honestly think if you go ahead with it now, it will only increase your issues, rather than helping.

I‘m so glad you joined Bonesmart, you need our support, and that’s what we do! :console2:

I will leave you our Recovery Guidelines. Each article is short but very informative. Following these guidelines will help you have a less painful recovery.

Just keep in mind all people are 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.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:
rest
ice
take your pain meds by prescription schedule (not when pain starts!)​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​


4. PT or exercise can be useful BUT take note of these

5. At week 4 and after you should follow this

6. Access to these pages on the website

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?

Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.
 
@LyvLB Welcome to BoneSmart! Be sure and read the article Jockette left on window of opportunity. There is no time line for this recovery. Everyone heals differently. I think if you begin to focus on ice, elevation and gentle stretches you will see much better results.
 
Oh, you poor thing. Your having to endure that aggressive, painful therapy has just set your recovery back. It is quite obvious that the therapist hasn't been trained in the current methods of the rehab of a joint replacement. Your main job now is to get that angry knee to settle down. You can do that by doing gentle stretching and bending to the point of discomfort, not pain. Ice and elevate as much as you can. This will help to flush out all that swelling.

Your improvement won't happen overnight. After all, you went to PT way too many times and your knee has to recover from that bad PT. After a week or so you should start to see some small improvements in your pain and swelling. Don't be concerned about your ROM. That improves as your knee heals and the swelling goes down. Can you bend a water hose full of water with the nozzle shut off? Open up that nozzle and as the water runs out you can start to bend it. Your knee is the same way!
 
He was a recommendation from my spouse
Is your spouse an expert on knee surgery recovery? Will I lose money if I bet 'no'?
The pain was severe
The BoneSmart view, as you now know, is not to do painful exercises
I have been so active climbing mountains, swimming, running, cardio, etc. I am spent and see no flicker of light
All is not lost.
The problem, my surgeon wants to have a manipulation next Wednesday to stay within the "window."
Ask him to explain what the window is, and why it applies to knees and to no other soft tissue, which you can train (look at gymnasts and ballet dancers). You may have adhesions (soft tissue stuck together) but it's very early to say. Ask about those, too.
Chiropractor said, try to ride a stationary bike. I did. Full-pedal motion. 5 minutes.

Damage and more swelling
  • Set the bike to zero resistance
  • Set the saddle low enough so that a single rotation is a challenge; difficult but not painful. When a rotation becomes easy right from the start, lower the saddle a max of 1cm.
  • Gently turn the pedals, through discomfort but without pain.
  • Continue until the knee is 'warmed up' and the rotation is now easy, or for 2 minutes, whichever is the shorter time.
  • Repeat several/many times a day, but don't go mad. Diminishing returns will apply; my guess is that half a dozen reps would be enough
  • Do not pedal fast or for more than 2 minutes, this is a stretching exercise, not training.
  • And if you get any pain or swelling in the 24 hours after doing this, cut it down until you don't
Here is a bit more chat and some pix and how 'healing' and 'training' are different
 
Hi lyv, wow you had it tough, if someone came near my knee and pulled it around for 8 weeks 3 times a week they would be driving home with a black eye!!!!!!.
In the uk we are sent home with a couples of sheets with exercises on to do , a couple of times a day to your own tolerance.
Please Please Please listen to our contributers and admins, stop hurting your knee, give it an elevated ice holiday for a week and promise you both will attend counselling:)
Neve let anyone hurt your joint, its yours, so listen to it.
 
Last edited:
Hi Lyv:
I can so empathize with you. Although Im not crying daily I have a general feeling of malaise that doesnt seem to go away. Hiking, walking and running use to be something I looked forward to but now I need to take a nap everyday. I had a very mild PT and thought I wasnt going to get anywhere so I changed to a more aggressive therapist and now Im in constant pain. I think we should both back off the harmful, agressive therapists who really dont seem to know what they are doing. My surgeon actually said to me he'd be happier if I just road my exercise bike at home for ten minutes a day then go to therapy. He must have had experience with these torturists.
 
Your body needs the energy for healing, so embrace the naps right now.
 

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