Become an Insider

TKR 2nd TKR - 6/26/2025 - repeating same good BS post op protocols!

ferddword said:
He said my bend was “only” 90 and to let my PT know I should be at 110 by week 2? He did say its goody extension is pretty flat.
Click to expand...
karwask said:
I'm in the midst of week 3 and I'm not at 90° either.
Click to expand...

Most surgeons wants TKR patients to reach 90 degrees by the 6-week mark. Anyone who tells you otherwise doesn't understand this recovery.

To be at 90 degrees at 2 or 3 weeks post-op (when there is still a lot of internal swelling) is excellent. Please don't let this nurse or PT undermine your confidence.

You are both doing great.
 
ferddword said:
Any thoughts on red light and infrared therapy?
Click to expand...
The jury is still out on this type of treatment for post-op TKR patients. There is not enough study to show it is beneficial. It’s not covered by Medicare or most insurance, so that can indicate it’s still in the experimental stage. It doesn’t hurt you, but you’ll probably be out some money with no guarantee it will help with pain or healing.

You’re doing just fine with your recovery. You really shouldn’t need to put money into something like this, in my opinion.

ferddword said:
I also still don’t understand why the majority of the post op therapy field doesn’t adopt the BoneSmart method of letting the knee heal from such a traumatic surgery before trying to get ROM numbers and exercising. I mean it just seems logical that is still swollen!
Click to expand...
We’ve wondered that same thing for decades. It’s not for lack of effort on our part! There are even scientific studies now that support a less aggressive recovery therapy program. It’s hard for people to change their ways, I guess.
 
karwask said:
I'm in the midst of week 3 and I'm not at 90° either. My PT is measuring me every time I go but so far not putting tons of pressure on me for more results but only have been to the first two.
Click to expand...
My surgical team - who were fully united in instilling in me the mantra that in the first weeks Less Is Better - had as a goal 90 degrees at 6 weeks. And goals are aspirational; our individual bodies don't pay attention to to them as they go about their cellular level repair at their own pace. Many Bone Smarties take longer than that but have the same great outcomes.
 
Hey there!
Such a bummer to feel rushed at a post op visit after major surgery. I'm sorry.
I understand they are on a schedule, but to feel as though they're only going through the motions with us because they're falling behind doesn't feel fair.

The one size fits all recovery protocol is hard to wrap our heads around since healing times can vary significantly from one person to another. What might be an appropriate pace for one, can be too aggressive for another. They really need to take into account age, overall health, what type of shape each individual was in prior to joint replacement when deciding how intense your therapy should be. Glad you found us so you can stick to your own pace for a guilt free effective recovery.

Have a great weekend, ferddword! :SUNsmile:
@ferddword
 
Hey folks. PT session today. He pushed a bit harder. I’m at 110 and nearly 0. Said I was doing great. And to ditch the walker. lol. I told him it was my security blanket but also lets me walk properly when my knee is stiff. So I’m going to continue using when I need it. I’m using a crutch other times.

Enjoy the weekend everyone!
 
Good for you on all counts…..your progress and knowing when you’re ready (or not ready) to switch to a cane. You know your body better than anyone.
 
@ferddword when you say PT "pushed a bit harder" we can't tell if you mean he had you do more or he literally pushed or manipulated you knee.

The BoneSmart team strongly opposes PT manually bending or stretching our knees in order to get a "better number." Why?
First, it's counterproductive: the force applied externally will result in increased swelling later on, with a resulting loss of flexion.
Second, early on in recovery, we have had BoneSmarties sustain new physical damage (to tendons for example) from PTs fixated on achieving "better numbers."
It's totally not worth it.
 
ferddword said:
Said I was doing great. And to ditch the walker. lol. I told him it was my security blanket but also lets me walk properly when my knee is stiff. So I’m going to continue using when I need it.
Click to expand...
This tells me, you will not be pushed.
Nope, nah, not today, not happening, nuh-uh...whatever works for you!
Stay strong and carry on, you're doing great! :wink:
 
@mendogal - hi there. Yes, he did actually push down on my knee to get it to almost flat. He would massage a bit. Then push down. Then massage. At the time, it felt a little too much. He also had me do 1 legged presses and had me pull my knee to get to 110 flex. Well today my knee doesn’t feel swollen but I do have increased pain/burning feeling along the side of my calf. Not sure if it’s because of the PT session yesterday or maybe my nerves are waking up? Either way, not feeling great this morning.
 
I encourage you to say no to this kind of aggressive PT treatment, @ferddword . It's counterproductive.

The fact that you have increased pain today is a sign that what he did has aggravated tissues that are not yet healed. ( Muscles, tendons and ligaments take 10-12 weeks to recover from the trauma of surgery.)

Never let a therapist force your knee in either bending or straightening. It's not a true measure of what your ROM really is and, more importantly, it can actually delay your healing and recovery.

You are not even a full month post-op, so there is no reason to be worried about your ROM at this early stage of recovery. Heal first!
 
Deb and I were writing to you at the same time. What you’re feeling is why we recommend that you not allow therapists to push on your knee. The swelling and pain usually appear the day after the session, not right away. Your knee compartment is very compact and it doesn’t take much swelling to result in pain. So you may not actually see swelling. But if you have pain, it’s there. This inflammation and pain can then travel to other parts of your leg like the side of your calf.

This is your cue to take things a bit easier, ice and elevate your knee, and allow it to heal again. There is no rush to gain this ROM. It will come as your body completes its healing process. You are early in this recovery. Your ROM is just fine.

The pain that results from nerves waking up is different. It’s usually a zinger of pain all of a sudden that doesn’t last very long.
 
Thanks yall. Yeah, I think he pushed too much. Sheesh I’m only at 2 weeks and he told me “well let’s get you to 110 and close to zero and you won’t have to do so many sets of exercises.” So instead of gently getting me loose he forced it to those numbers. Urgh. So yeah I guess I’m feeling it now at bottom of my knee and down the lower left side of my calf. I’ll ice and elevate all day. And won’t go to the Monday PT session. Annoyed at myself for not stopping the PT from pushing and pulling on it so hard.
 
Please don't blame yourself, @ferddword! We all struggle with the idea of pushing back with someone we view as a medical professional.

Sadly, very few physical therapists out there have actual training in how to help someone recovering from a joint replacement. As a result, they apply what they've learned about rehabbing sports injuries. But that's apples and oranges!

I think you are wise to skip the session on Monday. And, when you go do back, be clear about your expectations. We are in charge of our recovery -- not the therapist.

Sorry this happened to you. Give it time and you'll feel better.
 
I'm really sorry you're feeling annoyed with your self. It's frustrating to feel like someone else pushed you beyond your limit and then YOU are the one dealing with the discomfort, or pain. You trusted, but in reality the PT overstepped. It is unfortunate and a tough lesson to learn. Obviously you're working at making progress, but your PT needs to make sure you stay within a range that feels comfortable for you. If it causes you pain, slow down, or stop and you'll continue to make progress without set-backs. Best wishes for a good week!
@ferddword
 
Hi everyone. Hope yall had a nice weekend. I’m pretty convinced the PT pushing and pulling on my knee on Friday caused the increased discomfort/pain. So I’ve been taking it fairly easy and icing/elevating throughout the weekend and it feels like my knee calmed down a bit. I’ve cancelled my PT sessions for at least the next week maybe longer. Especially reading over my 1st TKR I didn’t even go to PT but twice! During my 3rd week and my 8th week. But if/when I do go back to PT I’ll make sure they don’t force to get numbers by yanking on my knee.
 
That sounds like a plan! Glad you’re in control of your recovery. It will make a difference because you’re the one listening to the signals your body is giving you about what is too much and when it is time to challenge yourself a little more.
 
I like the plan of you being in charge of what the PT person is doing to you. Afterall your the one whom had the surgery and will have the discomfort after your knee is pushed on. I allowed that once, and I think the noise I made scared everyone in a two mile radius!!! I said never again, and held to that.

Fast forward to my last surgery and insurance ordered home PT. The PT lady and I had a discussion that she wasn't allowed to touch my leg, ever. She agreed. Then the next session she wanted to look at it and started to push down. We had another much firmer discussion that I was in charge and all we were doing was heel slides and walking. She was furious so I said she could leave!!! She chose to stay and walk with me.

The PT people have guidelines they "think" they have to meet. Our bodies haven't read those guidelines. You're doing great.
 
You must log in or register to reply here.
Active Antimicrobial Hydrogel

Members online

No members online now.
Total: 900 (members: 0, guests: 900)

Latest posts

Back
Top Bottom