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PKR 4 weeks post op for Partial Knee Replacement

Dimire

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Hello forum friends. Let me start by saying my first TKR was 15 years ago and was extremely difficult. I was in the hospital for 6 days, then rehab for 1 week and I was just 50 years old and not overweight.
Fast forward to 2nd knee replacement just one month ago, and I am glad I waited for procedures to improve! Sure, there has been pain, but minimal compared to the previous one. I was only on Oxi the first week, and since then only Tylenol, Advil, and a nighttime muscle relaxer.
My question is whether outpatient PT is really needed or not. When I go, it takes 2 days to recover, then it’s time to go back. They measured me at 95%, and are looking for 110. When they physically manipulate my knee I am in tremendous pain, but they keep pushing. They are going to push me out the door soon.
 

Celle

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Hello @Dimire - and :welome:

Please will you tell us the full dates of your knee replacements and which knee was done each time, so we can make a signature for you? Knowing the exact date will help us to advise you appropriately.
Thank you.:flwrysmile:

So you had a TKR in about 2005, but this time you've had a partial (PKR)? Is that right?

I'm glad to hear that your current experience is better than your previous experience. Yes, there have been changes and improvements during those years.

Now, about PT: PT is good, if it's done right, but the PT you are having is not being done right and it;s bad for your knee.
Post-op PT should not be hurting. Your therapists should not be pushing on your knee or causing your pain. It should not take days to recover from a PT session.
Your flexion,at 95 degrees, is excellent for only 4 weeks post-op and they should not be setting artificial and arbitrary goals for your knee.

So, all in all, what you're getting is bad therapy. No PT therapy at all is better than bad therapy.

This is your life and your knee and you have the absolute right to say what happens to your knee.
You have a choice
  • Either keep going to PT, but set limits on what you will allow. That should include no forcing your knee,no pushing on your knee, no multiple sets of exercises, no exercises that cause pain (at the time or later), and no obsessing about Range of Motion (ROM). Your therapists have to respect your wishes.
  • Stop going to PT and rehab your knee at home. Your knee will get plenty of exercise just as you use it for your normal activities of daily living (ADLs), you can take gentle walks,gradually increasing the time and distance, and you can do a few simple exercises.
Here are a couple of exercises you could use at home:
Heel slides and how to do them properly
Extension: how to estimate it and ways to improve it

Just in case you think you can't stop PT, these articles may help:
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used
 

Celle

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Here are the BoneSmart recovery guidelines:
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. Try to 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.
 

sistersinhim

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Many of us never took formal PT or did exercises. I am one of them. I 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 used my knee as it was intended to be used by walking around to take care of my daily needs. 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.
 
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Dimire

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Thank you Celle and Sistersinhim. I probably went to my last PT this afternoon, because I had to stop the therapist twice as she was manipulating my knee and then the 10 minute bike partial rotations were killing me at the end, so I got up and left with 5 minutes left. With everyone wearing masks, I know they can't see your face, which may hinder their judgement, but I believe I'm done.
I can do almost all of what they have me do, without going there. I definitely want to get the best results possible, and I agree with you that enough is enough. I'll be diligent with my own therapy.
 
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Dimire

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July 2005 - Right total knee replacement
June 10, 2020 - Left Partial knee replacement
 

sistersinhim

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Thank you for your dates. I've added them to your signature for you.
 

Roy Gardiner

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They physically manipulate my knee to the point of extreme pain, and put me on the bicycle for 10 minutes, even though I'm not at a full rotation yet. It takes 2 days to recover, then I'm back for another 3x week session.
They are going to push me out the door soon.
:thumb: Walk quickly...

Imagine exercising to the point of 'extreme pain' in recovery for a broken leg or a sprained muscle; counter-productive, obviously, and would worsen the damage. It's much the same with TKR, you have damage needing healing, not unfitness needing training.

All you need is to help retain mobility (not fitness or strength) until healing is complete. This is done with gentle stretching exercises, without pain.

Read full details here https://bonesmart.org/forum/threads/post-operative-exercise-–-the-bonesmart-view.25463/
 

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