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TKR A little confused...

jdennysgirl

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I am having my right knee replaced on Feb. 11. I had the other one done 11 years ago and I remember having to go to physical therapy 3 times a week and I remember it being quite rough and painful at most of the sessions. I was reading on here that all the physical therapy may not be necessary and my knee will "tell" me how far to bend it and work it. So, is physical therapy really not necessary and I will be fine and get full movement back if I just "listen" to my knee? Am I interpretating what I have read wrong? Thanks so much for your help on this wonderful site!
 

Pumpkln

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@jennysgirl,
Welcome Back to BoneSmart! :welome:
So, is physical therapy really not necessary and I will be fine and get full movement back if I just "listen" to my knee?
For some physical therapy is not necessary, many members would like help with walking, gentle post op exercises, and help with controlling swelling and pain with an up to date physical therapist.

For ROM we recommend these two activities,
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .
There is no need for pushing and shoving to gain ROM, your ROM is there waiting to be revealed as swelling and inflammation decrease.

New and returning BoneSmart members like you are in various stages of their journey to joint replacement. Making the decision whether or not to have surgery and preparing for surgery can be easier once you have done your research and know what lies ahead. Here are some tools that can help you decide what is best for you.

If you are at the stage where you have joint pain but don't know for sure if you are ready to have surgery, these links may help:

Score Chart: How bad is my arthritic knee?
Choosing a surgeon and a prosthesis
BMI Calculator - What to do if your surgeon says you're too heavy for joint replacement surgery
Longevity of implants and revisions: How long will my new joint last?

If you are at the stage where you are planning to have surgery but are looking for information so you can be better prepared for what is to come, take a look at these links:

Recovery Aids: A comprehensive list for hospital and home
Recliner Chairs: Things you need to know if buying one for your recovery
Pre-Op Interviews: What's involved?


Regardless of where you are in the process, the website and app My Knee Guide can help you stay organized and informed. The free service keeps all the information pertaining to your surgery and recovery in one place on your smartphone. It is intended to be a personal support tool for the entire process.

And if you want to picture what your life might be like with a replaced knee, take a look at the posts and threads from other BoneSmarties provided in this link:

Stories of amazing knee recoveries
 
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I've learned a great deal from my PT and she's offered some light manipulation around my knee area. I have also learned what I can do at my gym and at home that are similar.

I don't think I will need all 30 sessions I was approved for. Too expensive!
 
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loneshark64

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There are experts on here and so they know more than me. This is just one mans opinion based on one very recent TKR and multiple other knee surgeries and PT over the years.

I think you need to decide for yourself. You are you and they don’t know you. I think there is wisdom in the bonesmart view that pushing through pain for progress early on is counterproductive. I do not think they are saying “don’t do PT and you will be OK by magic”. They are saying time and daily motion matter and painful pushing is counterproductive.

BUT...the bonesmart view is not the only view. My doctor and others say do the full PT. I am and I will. So far my PT has not pushed me too hard and if they do I will deal with it then. I am not afraid of advocating for myself. She does want ROM progress and ultimately so do I. We will work out how I get there.

I had a knee reconstruction 20 years ago and did not like the PT and so I didn’t go. That was a mistake. I know some people that stopped showing up because they did not want to tell the PT their needs. They are not doing great and don’t have a measuring stick for where they are, and worry all the time.

You do what is best for you and adjust as needed. Use these resources and use other resources. Personally anybody that wants to get in my face and tell me they have all the answers about my knee is not helping.
 

Helizabug

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Painful PT may get you where you want to go, but I think you can get there with less pain and fewer side effects of that pain — extra helpings of swelling, depression, and fatigue on top of those symptoms that naturally occur. The recovery is hard enough without adding more of everything to it. For a lot of us, it’s a pretty manageable recovery, though long and erratic; but I wouldn’t want to add any further challenge to it.

That said, while I’m happy with my recovery from a pain and fatigue standpoint, I’m unhappy with my own ROM progress; and I might do something aggressive soon. I’d stick with the BoneSmart approach, though, and adjust if you find you’re not able to progress.
 

InkedMarie

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I did go to PT. However, I interviewed two therapists over the phone. The first would not be for knee. When he said “we’ll get that knee moving”....nope. The second one was very gentle, did nothing until I said ok, stopped when needing to. Not myself, my PT nor my surgeon worried about ROM Numbers. I went by functionality.
 

Sara61

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In the 1st few weeks after surgery I did not have PT - I was sent home with a list of gentle exercises and basically told to rest, ice medicate & elevate (RIME,) I started PT, 3 weeks after my surgery I went twice weekly and again a very gentle approach, my Rom was then measured but no emphasis was put on getting a high Rom & I was told from the beginning that this is a slow process and healing can take up to 1 year, fast forward 3.5 months and I stopped PT with a Rom of 130 since then my only physical exercise is walking the dogs and my day to day home stuff.
The harder we push the knee the more it swells and hurts so it's a catch 22 - the old saying "no pain no gain" does not work with a knee replacement a gentle non aggressive approach is the wisest option. I now can basically do most things but if I push myself too hard I then pay the price x
 

kneeper

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For my second knee I was able to tell the PT that since I wasn't a newbie and already pretty much knew what to do, I could manage with PT twice a week instead of 3 times. My PT was pretty good and offered useful tips. But I also knew to say "enough" and my PT accepted that.
 

steverup

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I was 7 weeks post-op and my kneecap dislocated (I think because of overdoing pt) not that I’m not able or willing to say no but because I was wanting to get better faster and had the mindset that the harder I worked at it the faster I’d get better. Boy was I wrong. This was just over 2 years ago. I’m scheduled for March 4th for the other knee and I will take it a lot easier this time. I’ll go to PT but only if I feel it’s helping and not hurting me. I’ll lean more towards BoneSmart’s advice this time.
 

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