TKR Advice please

[Kneeyoung3]

Thank you all for all of your advice and please know I'm taking everything said into great consideration. I'm going to give the bone smart way a try before agreeing to anything else. Thank you all so much.

 

[tkrme]

Wow. Stop that PT. No one should touch and push your leg. That is why you are not progressing. Gentle exercise as prescribed on this site is all you need with taking care of kids. It would be great if someone could come in to help u a bit

 

[Jennszoo]

My kids are older and I still feel like when I'm alone w them, I'm getting up a million times. I can't imagine how much Up and down you are doing with those littles. Beg, plead, borrow and steal if you have to to get some help.

 

[Kneeyoung3]

Updating you all:

So I had PT today and we talked about taking a more lax approach and not over pushing my knee.. She wants me to try aquatic therapy and a dynasplint to help with ROA.. Do any of you have any experience with any of this?

 

[Kneeyoung3]

Anyone done aquatic therapy and a dynasplint and improved in ROM?

 

[Majic]

Kneeyoung3 I have done what we call hydrotherapiy which I imagine is the same as aquatic therapy. I found it very good, and it certainly improved my ROM. I don't know what a dynasplint is I'm afraid, maybe we don't have them in England, or maybe we call them something else. I would certainly recommend the aquatic therapy.

 

[KarriB]

Be careful with water therapy. It's easy to over do and push the knee because although water is easier on your joints it also provides resistance. So if you do it, be sure not to over do. The best action you take is to rest, ice and elevate that knee.

 

[Celle]

She wants me to try aquatic therapy and a dynasplint to help with ROA.. Do any of you have any experience with any of this?

Before you go into any water, make sure that your incision has healed completely, with no open areas or scabs. If you go in sooner, you will run the risk of introducing infection.

I would forget about the Dynasplint. It's uncomfortable and unnecessary. Your ROM will increase gradually, as the knee heals and the swelling goes down.

What's her rush? It's only just over a month since you had this major surgery. There is plenty of time to increase ROM (Range of Motion), since it can continue to increase for a year or more after a knee replacement. There's no need to try to speed that up, because there are no deadlines you have to meet.
Myth busting: the "window of opportunity" in TKR

For what it's worth, my surgeon does not allow any formal PT for the first month after a knee replacement. He says your knee needs that time, to start on its journey of healing. His patients all do well and he hasn't had to do a manipulation to help with ROM for the last 4 years.
I followed his advice for both my TKRs and my knees are great. They are strong and reliable, with excellent ROM.

 

[kneeper]

I don't think my OS wanted me in the water until at least a couple of months out, for the reasons Celle says. I did water exercise around 12 weeks and like KarriB says, it is easy to overdo. What seemed to work for me for exercise in general was to "under do" at first and then gradually add minutes or repetitions and see what the knee said about it.

 

[Kneeyoung3]

Idk what the rush is.. both her and my surgeon seem worried my ROM isn't above 30 at 7 weeks out. Good to know about the dynasplint from what was explained it seemed like a pain and like it would be uncomfortable. Does 7 weeks. out seem too early for the pool?

 

[KarriB]

Honestly the best thing you can do is rest, ice and elevate that knee to get the swelling down and allow it to bend. Working your knee in any way is going to impede ROM. If you take a few weeks to do that and still doesn't bend then look at the next option. But no exercise is going to make your knee bend at this point.

 

[Celle]

Your knee can't bend more until the swelling has gone down a lot. That's why you need to do as much resting, icing and elevating as you can, and cut right back on the exercises - they are only irritating your knee and keeping it swollen.

Your poor knee has gone through major surgery that caused a lot of trauma. It needs time and gentle treatment, so it can heal. Exercising vigorously just doesn't allow it to do that.

In any case, you can't speed up your ROM by exercising. It's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

Knee recovery - Lose the Work Ethic!!
TKR: work “smarter” and not “harder”
TKR: Evidence shows that less really is more when it comes to exercising!
TKRs and our fast food society
Life in the slow lane
ROM: it's worth the wait for ROM
ROM: it's never too late to get more ROM!

 

[Jamie]

Please give the resting/icing/elevation a try for a couple of weeks. You are doing way too much too soon with your knee. If you cannot reduce your activity because of caring for your children then you need to stop the therapy. You are getting plenty of movement each day and you don't need it. In fact, you should try to figure out ways to reduce your "up on your feet" time even when you're home! Yes, your ROM is a bit low for 7 weeks out. But it's strictly a result of swelling and that will change once you give yourself a rest and allow the swelling to go down.

Tell the therapist you are going to stop for a few weeks and you'll get back to her if you feel you need to.

 

[Jennszoo]

I got clearance for the pool at 5.5w and ventured into the hot tub at 6w. I was nervous bc I've read some had problems with the heat. But it felt good and I will say, I got more bend in the hot water. I was very slow and gentle, but it definitely loosened some stuff up. So if you're cleared for immersion, maybe try it on your own first before someone goes cranking your knee around.

 

[Celle]

I don't think that a hot tub is the right thing to do right now, because the hot water will increase the knee swelling. Maybe later in recovery?

 

[kneeper]

My PT for my second knee spent a good chunk of many of my sessions using the GameReady (there may be other brands too) ice machine on my knee because she could see that the swelling was impeding my bend.
It was very evident that the swelling was the issue because she measured. She measured the size of my knee (which went down at the end of the ice session) and my bend also, which improved too. (Now we're talking very small amounts, but they were nonetheless measurable.
It's not like a few sessions and I was bending up a storm--the swelling could increase again in the short run--but the trend over a few weeks was positive.

So I'd try a week or two so of doing not much but icing before you go the MUA route. If you're still not making progress after that you can think about it again.

I also hope you can get some help and a day "off" from running after the kids. All that up and down is murder on a new knee and increases swelling. Do your OS and PT realize how much you're on your feet?