TKR Almost 5 months post op….struggling, frustrated and worried

[Christie b]

Hi everyone, this is my first post and I hope I’m doing this correctly. I had a total replacement of my right knee on 3/15/2023. I’m 53 years old. My recovery has been slow & painful but nothing that seems to be out of the ordinary. My last PT visit 5 days ago, he measured me at 100 flex upon arrival and then forcibly pushed me to 112 by the end. I was almost in tears. The next day I could hardly walk let alone do my home exercises and that’s been the case since. I’m back using a cane and taking oxy. So swollen no matter how much icing/elevating I’m doing. I’m upset because I feel like this will set me back and it just feels so counterproductive. I’m generally a happy positive person but this has me feeling really low and like I’m never going to get my life back :(. I don’t know where to go from here and I appreciate any advice your group has for me.

Thank you,
Christie

 

[Pumpkin]

@Christie b
Welcome to BoneSmart, glad you joined us!!

he measured me at 100 flex upon arrival and then forcibly pushed me to 112 by the end.

There is no need for you to work on ROM, 100 degrees at 8 weeks is great. Once a person has reached 90 degrees most surgeons are happy. When the swelling goes down, the rest of your ROM will reveal itself.
There is no window of opportunity, many members including myself see ROM increases a year or more after surgery.

Do not let anyone push or shove on your knee going forward, as you have found out, it is counter productive.

Suggest you cancel your PT appointments to give your knee time to recover from all that excessive force on your knee. Once you are ready to go back to PT find an up to date PT to work with, they will address your swelling and mobility.
Saying no to therapy - am I allowed to?

I’m upset because I feel like this will set me back and it just feels so counterproductive.

You are right to be upset, it will set you back, focus on ice, rest, elevation, and medicate on time as prescribed.

Here is your copy of the Knee Recovery Guidelines, the articles are short and will not take long to read.

Just keep in mind all people are different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.

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​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

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

​

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

​

Activity Progression for TKR's​

6. Access these pages on the website

​

Oral And Intravenous Pain Medications​

Wound Closure​

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.

 

[Christie b]

Thank you so much for your nice reply and for all the information. I read all the articles and they all make so much sense. Common sense tells me that anything that the PT does that puts me out of commission for several days can’t possibly be the right answer. I’m focusing on rest, ice, elevation and gentle walking & stretches for now. Hopefully it didn’t set me back too far. Thanks again!

 

[Pumpkin]

When your knee settles down, here are a couple of activities you can do for your ROM.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

 

[Christie b]

Thank you so much!

 

[benne68]

Common sense tells me that anything that the PT does that puts me out of commission for several days can’t possibly be the right answer.

Wise woman!

Unfortunately, very few PTs are properly trained in joint replacement or how to help patients like us recover. They try to use the same methods as they would for someone rehabbing from a sports injury. As someone else on the forum said recently, that's like telling someone with a broken leg they need to forcefully exercise it to recover.

Glad you found us and now know you can "just say NO" to your physical therapist!

 

[sistersinhim]

I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he was interested in was to see what my knee would do and never measured. He never even asked about PT! Of course, he knew I was a single lady that had to take care of myself and obviously trusted that I would not be just laying around all the time.

Because of birth defects, I had to have 12 knee surgeries, so I've had lots of knee recovery experience. I knew from that experience that I did not need formal PT after my TKR, and neither do many others if they do their own daily activities and do not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!

 

[WillB]

Hi everyone, this is my first post and I hope I’m doing this correctly. I had a total replacement of my right knee on 3/15/2023. I’m 53 years old. My recovery has been slow & painful but nothing that seems to be out of the ordinary. My last PT visit 5 days ago, he measured me at 100 flex upon arrival and then forcibly pushed me to 112 by the end. I was almost in tears. The next day I could hardly walk let alone do my home exercises and that’s been the case since. I’m back using a cane and taking oxy. So swollen no matter how much icing/elevating I’m doing. I’m upset because I feel like this will set me back and it just feels so counterproductive. I’m generally a happy positive person but this has me feeling really low and like I’m never going to get my life back :(. I don’t know where to go from here and I appreciate any advice your group has for me.

Thank you,
Christie

You control how your PT sessions go. Do not let them place you into anything other than a mild discomfort. Your ROM numbers will improve over time with normal activities.

 

[Christie b]

Hi everyone, this is my first post and I hope I’m doing this correctly. I had a total replacement of my right knee on 3/15/2023. I’m 53 years old. My recovery has been slow & painful but nothing that seems to be out of the ordinary. My last PT visit 5 days ago, he measured me at 100 flex upon arrival and then forcibly pushed me to 112 by the end. I was almost in tears. The next day I could hardly walk let alone do my home exercises and that’s been the case since. I’m back using a cane and taking oxy. So swollen no matter how much icing/elevating I’m doing. I’m upset because I feel like this will set me back and it just feels so counterproductive. I’m generally a happy positive person but this has me feeling really low and like I’m never going to get my life back :(. I don’t know where to go from here and I appreciate any advice your group has for me.

Thank you,
Christie

You control how your PT sessions go. Do not let them place you into anything other than a mild discomfort. Your ROM numbers will improve over time with normal activities.

Thank you. It sounds silly but I honestly thought I had no choice in what the PT did to me. Thanks to this group I am going to advocate for myself - discomfort ok pain not ok! And certainly not to the point of tears just to gain a few degrees. And honestly, is it really an accurate reflection of flexion when I can only achieve it w/ a grown man pushing down on my knee and me needing 10mg of oxy just to get through it?? How is your recovery going?

 

[Christie b]

I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he was interested in was to see what my knee would do and never measured. He never even asked about PT! Of course, he knew I was a single lady that had to take care of myself and obviously trusted that I would not be just laying around all the time.

Because of birth defects, I had to have 12 knee surgeries, so I've had lots of knee recovery experience. I knew from that experience that I did not need formal PT after my TKR, and neither do many others if they do their own daily activities and do not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!

Thank you for your reply! Your surgeon sounds great. How interesting to hear about a surgeon that didn’t push formal PT. I went into this assuming that I had no other choice but thanks to your group I’m seeing other better options and I’m so grateful. I’ve been in tears almost daily for 2 months and so worried that it’s never going to get better. I just want my life back and this added pain that the PT has inflicted is so unnecessary. I’m going to focus on my healing above all and slowly gently get back into exercises at home. I’m normally a very active person - before knee problems I was taking Jazzercise classes several times a week, taking my 3 dogs on long daily walks, gardening, cleaning, cooking, running errands, etc. Easily getting 15,000 steps a day. Now at 2 months post op I’m lucky to get 5-7000 steps a day. Do you think just my everyday activity along w/ heel slides I’ll recover ok?

 

[Christie b]

Common sense tells me that anything that the PT does that puts me out of commission for several days can’t possibly be the right answer.

Wise woman!

Unfortunately, very few PTs are properly trained in joint replacement or how to help patients like us recover. They try to use the same methods as they would for someone rehabbing from a sports injury. As someone else on the forum said recently, that's like telling someone with a broken leg they need to forcefully exercise it to recover.

Glad you found us and now know you can "just say NO" to your physical therapist!

Thank you! That broken leg analogy really makes a lot of sense. I feel so much better since discovering you guys and I have a renewed sense of hope for my recovery. Thank you.

 

[Christie b]

When your knee settles down, here are a couple of activities you can do for your ROM.
Heel slides and how to do them and Extension: how to estimate it and ways to improve it .

Thank you again for such clear and easy to follow instructions. I’m going to try to get my swelling under control first then will work on gentle exercises. Thanks to this group I just booked a lymphatic drainage massage and I’m hopeful it will help

 

[Christie b]

@Christie b
Welcome to BoneSmart, glad you joined us!!

he measured me at 100 flex upon arrival and then forcibly pushed me to 112 by the end.

There is no need for you to work on ROM, 100 degrees at 8 weeks is great. Once a person has reached 90 degrees most surgeons are happy. When the swelling goes down, the rest of your ROM will reveal itself.
There is no window of opportunity, many members including myself see ROM increases a year or more after surgery.

Do not let anyone push or shove on your knee going forward, as you have found out, it is counter productive.

Suggest you cancel your PT appointments to give your knee time to recover from all that excessive force on your knee. Once you are ready to go back to PT find an up to date PT to work with, they will address your swelling and mobility.
Saying no to therapy - am I allowed to?

I’m upset because I feel like this will set me back and it just feels so counterproductive.

You are right to be upset, it will set you back, focus on ice, rest, elevation, and medicate on time as prescribed.

Thank you again! I’m still learning how to properly reply or ask questions on this forum so please tell me if I’m doing something wrong. Did I understand correctly that if I want to ask a question I should do it under this thread?

 

[Layla]

Yes, you're doing it exactly as you should!

 

[InkedMarie]

My surgeon never mentioned PT. He told me to make sure I got as flat as possible ASAP. He never touched my knee post op, just eyeballed my bend.

Marie

 

[sistersinhim]

Do you think just my everyday activity along w/ heel slides I’ll recover ok?

Yes, I do. For most of joint replacement patients, everyday activity will be enough.

 

[Christie b]

Do you think just my everyday activity along w/ heel slides I’ll recover ok?

Yes, I do. For most of joint replacement patients, everyday activity will be enough.

That’s so good to hear. This is such a crazy roller coaster of a ride that I’m so glad to have found this group!

 

[Christie b]

My surgeon never mentioned PT. He told me to make sure I got as flat as possible ASAP. He never touched my knee post op, just eyeballed my bend.

Marie

That’s so interesting! How are you doing now?

 

[InkedMarie]

My surgeon never mentioned PT. He told me to make sure I got as flat as possible ASAP. He never touched my knee post op, just eyeballed my bend.

Marie

That’s so interesting! How are you doing now?

I’m doing great! My first knee is five years old and knee #2 is a year old. I had my one year post op from #2 a couple weeks ago. My doc & I chit chatted for a bit about lots of stuff and then he finally said “hows the knee” and I said “what knee?” I honestly forget they’re after market parts. Same goes for both new hips!

Marie

 

[Christie b]

Oh wow, that’s amazing! I can only dream of the day that I’m not thinking about this knee every waking minute. Thanks for giving me hope!