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TKR 10 week check up

He's seen 9000 TLR patients and insists how important it is to do your PT. he's seen lots of patients that never worked on exercises and ended up with a bent permanently stuff Knee.
Nine thousand knee patients? That does sound like a bit of an exaggeration. Even assuming that he has 30 years in the business, that would be 300 patients a year with TKRs! Not that it matters really....if you like him that's the important thing. But I do think he's pulling your leg a bit (pun intended :heehee:) about that number.

I will disagree with his assessment that "lots of patients that never worked on exercises...ended up with a bent permanently stiff knee." A person must do at least gentle bends and stretches on a regular basis, but just because someone doesn't have therapy or do structured exercises does not mean they will have problems with recovery. We see more people here on BoneSmart harmed by pushing exercises than we do by taking an easier approach to activity levels - especially in the early weeks of recovery when your body is healing.

Whatever works with your recovery is what you need to do. But, since you are complaining routinely of "stiffness" which is a form of pain, I would say it is possible that you are doing too much too soon....either in therapy or in your daily activity. The way to find out is to cut way back for a week or so and see if your pain decreases.

My energy level is still low but I think some of that is the Dilaudid I'm on. Very strong meds.
I'm at 7 wks and knee is still swollen . I ice and elevate all day long. Should I be elevating at nite?
Your pain medications are not causing the decreased energy. You are experiencing "energy drain" that happens to everyone after surgery. Please go back and reread that article posted for you at the beginning of your thread and you'll better understand why you are tired.

My question was should I be elevating since at over 7 wks my knee is still swollen ?
Elevating and icing are always recommended when you have pain or swelling. Your body doesn't know how many weeks out from surgery you are. There is no timetable here other than what your knee is dictating. Swelling means you are overdoing things. To see improvements, you'll need to reduce your activity/exercise, ice, elevate as much as possible and take something on a regular schedule for the pain and swelling.
 
@Jamie
I have read the articles .
I really like my PT guy. He doesn't do anything I don't want him to do or that I don't want to. Working on loosing up my very tight front thigh muscles is helping my knee! I'm down icing and elevating most of the day. I do two stretches every hour. Than ice and elevate again. Yes the stiffness is frustrating but as all of U have said stiffness cans last for up to a yr. PT saw me last week and says knee is smaller than most patients at this stage. So it has gone down but still swollen.
My ROM had increased from 110 to 118. That's why I asked about icing at nite. Elevating makes it hard to sleep sometimes.
I havnt been out of the house except one time a friend took me to get nails done.
I get up to go to the bathroom and get something to eat. I'll sometimes do one lite chore for a few minutes but I do have a house keeper twice a month.
My hubby is a ff and has a pool business so I do need to feed the dog and do a few daily things. I'm not driving yet. Guess I'll try for the next week staying down even more than I am . I'm only going to pt once a week. I do most of it myself at home.
Scope I had a year ago took me a while to get rom back .
Thanx for the info!
 
@naynay30 yrs. , I think your ROM is great for where you are at and your swelling doesn't seem out of the ordinary either. I think I would just move forward as much as possible without overdoing. That's what I plan to do!

Roxie
 
It's a long road. With lots of ups and downs. Don't give up. Your doing great. Xxx


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
Well, I'd warrant I've seen more knees that he has in my lifetime and I can tell you that stiffness is CAUSED by over exercising. Absolutely it is. I did NO exercising for either of my knees and have no stiffness whatsoever in either of them - the second is about 5 months out now. And my ROM is 135 in both. It would be more if my legs weren't so fat! :heehee:
 
Do not ever compare yourself and your recovery to others and to "Where you should be." Your TKR and its recovery is just like you---unique.

You will get to the destination of being fully recovered---but it will be on your knee's schedule, not yours or anybody elses.
 
My concern is the stiffness is caused from scar tissue and doc will have to do a manipulation. even tho I'm at 118 ROM. I havnt done anything today except ice rest and elevate. Had a bad nite and its hurt all day. This is the 1st day in along time I've had this much pain.
 
@naynay30 yrs. , what makes you think your doc would want to do a manipulation? Has he mentioned it as a possibility? Because, honestly, I think you're doing great with a 118 ROM. I just was released from PT with a ROM of 0/120 -- almost what yours is. I still have some stiffness, swelling and pain which I have been assured over and over -- including this site -- is normal for some time yet. My PT said that as my swelling goes down naturally, my ROM will improve even more. I suspect yours will too unless there's an issue I'm unaware of. Now, I do not claim to be an expert in any way, shape or form but do think it's normal to have a bad night and/or day now and then.

Stay positive!
Roxie
 
@Kansas Teacher
Doc hadn't said anything . I'm just concerned because my knee is so stiff and won't bend much when I walk . I'm sure the swelling has a lot to do with it.
Thanx for the encouraging words!
 
@naynay30 yrs. , are you trying to walk around the house just for a few minutes every hour or so? That does seem to help my movement and loosens it up when it feels tight. I really think that time and some easy movement will make a difference for all of us as we recover.

Roxie
 
@Kansas Teacher Yes Roxie I am. But today I stayed down a lot more icing and elevating . Only did a few stretches. Some times I'll do a short easy errand. But since doing the pt exercises is helping with the stiffness Im going to see if taking it easy will . I know the stiffness is normal but they can't expect us to bend much or walk right when out knee is so stiff and swollen .
Jana'(Janay)
 
My concern is the stiffness is caused from scar tissue and doc will have to do a manipulation. even tho I'm at 118 ROM.
Please don't worry about this. You're ROM is fabulous for this early in your recovery. The type of scar tissue (adhesions) that might require a manipulation really doesn't occur all that often. And actually, it can be the result of inflammation from overdoing the activity more than not doing enough. Try to relax and enjoy the fact that you have achieved so much so soon. It's really a good thing.

You can read a little of Jo's background in this thread.
 
I had home PT 2 days a week for about 4 weeks. During that time my therapist had me doing stand up/sit down in a chair and some gentle bends sitting in a chair. Toward the end we did step ups on the stairs and bends into the step. There was also some standing on one leg and doing reaches for balance. She worked with me for about 45 minutes each visit. I did no formal exercises on the "off" days other than bending and stretching every couple of hours for a few minutes and walking around the house. After about 2 weeks I rocked on my exercise bike once during the day for about 5 minutes until I could go all the way around and then rode it for 5-10 minutes. I also would ride the bike for 5 minutes in the middle of the night if I woke up with restless legs (which I suffered with for a couple of months at night). I also did the leg hang on my stomach on the bed with my first knee as my extension wasn't as good as with the second TKR. No weights....once a day for about 5 minutes.

I had no problems with ROM or extension on either knee and my ROM now is probably in the 130-135 range. These days I work out at the gym 2 days a week mostly on quad strengthening and balance.
 
@Jamie Im doing about the same as U did.
But because at 7 wks knee is still swollen most people on here r telling me to stop all exercise.
I want my ROM bk to 135 as I was very active .
PT says my ROM is as good as it is because I started pt from day one and did it daily . 118 .
There's conflicting info so it's confusing.
I'm told by doc pt and several on here swelling will go down with time.
Others say stop all exercises if I want swelling to go down .
I rested iced and elevated all day with no stretches or bike.
Knee started hurting last nite and pain continued today .
What is the consensus on swelling? Should I stop and see if swelling goes gown risking losing ROM, or do I keep up the stretches and alittle bike ?
Thanx for any help
Jana'
 
There are lots of differing opinions about how to approach recovery, simply because there is no one right way, to the exclusion of all others.

Some surgeons recommend lots of PT. Others, like mine, say no PT at all for the first 4 weeks.
In the end, the results seem to be very similar.

What is obvious, though, is that too much PT, or too vigorous PT can upset and inflame your wounded knee, making the soft tissues angry. That can slow down your recovery. That's why BoneSmart recommends a gentle approach to PT.

Yes, your knee swelling will go down on its own as time passes, but you seem to be troubled a lot by the tightness and swelling. That's why we're recommending more rest, less exercise, and lots of elevation and icing.

Less exercise doesn't mean no exercise at all. While you're taking it easy, do get up and walk around the house now and then, and do a few heel slides - Heel slides and how to do them
That's really all the exercise your knee needs for now.

Your ROM is excellent for your stage of recovery. Because you have that good ROM, it's obvious that you don't have adhesions, so stop worrying about that. With that ROM, it's most unlikely that your surgeon will even consider doing a MUA. Has your PT been threatening you with the prospect of a MUA? If so, that's mean and unethical.
 
No! Neither has suggested it!
In fact pt said with my ROM and the way I can pedal no way.. He's the 1st to tell me how difficult and complicated this recovery is!
Tomorrow I'll go bk to gentle stretches and a few min on the bike.
Yes I get up every hr and walk around the house alittle.
It's hard to keep me down so I was probably doing too much around the house on top of one or 2 stretches every hr .
Thanx!
Jana'
 

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