TKR And the Marathon Begins<<

[nuttybrunette]

Again, thanks for the support. Party killer for sure. I don't know why he treated that gentle man so differently than me. I guess there could be other circumstances that I don't know about. Are those stand sit stand sit exercises recommended here on Bonesmart? And can we swim now, at 6 weeks? I didn't want to stay in the room any longer with him and ask that question

 

[lovetocookandsew]

I can't answer the swimming question as I don't know if your incision is healed. I'd suggest you email your OS and ask him. I also wouldn't do those sit and stand exercises at all. Go to the library and read the activity progression article-it's really helpful. READ IT AND MEMORIZE IT! lol

 

[Celle]

Then the bend ROM. I’m at 90!! You don’t know how happy that made me. Being a slower healer and my old TKR was stuck at 75 for a long time. Didn’t reach 90 till about 4 months. So to be at 90 now made my day, my week! He was negative tho. Said it should be way more. Ride the bike for an hour a day! Sit/stand 30 times 20 times a day! Or maybe he should just take me back to OR and cut out the adhesions.

What a kill-joy he was!
90 degrees at 6 weeks is absolutely fine, and it will continue to improve slowly.
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR

And you don't have adhesions. They don't form so early.
He was just (meanly) trying to frighten you into working harder. Don't fall for that - 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.

Are those stand sit stand sit exercises recommended here on Bonesmart? And can we swim now, at 6 weeks?

You get those stand-sit exercises naturally every time you sit down on a dining chair and stand up again. I don't think you need to do any more of them than that. If you overdo the exercises, you'll just irritate your knee and make it more swollen and stiff, which is counter-productive.

As for swimming - if your incision is completely healed, with no open areas or scabs, then going in the pool is OK. IF it's not at that stage yet, wait until it is. Immersing yourself in water before your incision is totally healed just might introduce some infection.

When you do go in the pool, be careful not to overdo things. Because the water bears most of your weight, it's easy to do too much without realising it - until you get out and find you are totally exhausted.

 

[Jockette]

You get those stand-sit exercises naturally every time you sit down on a dining chair and stand up again. I don't think you need to do any more of them than that. If you overdo the exercises, you'll just irritate your knee and make it more swollen and stiff, which is counter-productive.

This is what I was going to say but Celle beat me to it!

It’s part of the Activities of Daily Living that is enough physical therapy for your knee, and at a good pace. Doing x amount in a short time is too much.

 

[kneeper]

Me too. Just keep listening to the knee and increasing your activity very gradually as the knee allows. You're on the right track!

 

[nuttybrunette]

Thanks once again for the kind words and advice!! I always need your reminders. My PT was very excited to hear about my OS appointment. I think it triggered some performance anxiety in him tho because after the usual gentle massage he was working on bending my leg. It was pretty gentle at first. Nothing more than the CPM but then he got into it and tried a little too hard. I can’t believe I laid there and took it. I think I needed a slap on the face or something. Now, in hindsight, I’m starting my next appointment with him letting him know how I feel about that and we aren’t doing that again. I’ll assure him that the drs worries are not my worries. That there is another way to achieve results-that apparently he’s not learning in college.

On a side note...I took my first trip through Costco, big warehouse type store, this morning. I made it!! And in no pain!! Last few years it was always a mental exercise to get thru that store with my failing knee. It’s up getting the ice treatment now and I’m ready for Fathers Day BBQ at my house. It’s also hubby’s birthday. Poor guy has to share the 2 big events.

 

[Celle]

My PT was very excited to hear about my OS appointment. I think it triggered some performance anxiety in him tho because after the usual gentle massage he was working on bending my leg. It was pretty gentle at first. Nothing more than the CPM but then he got into it and tried a little too hard. I can’t believe I laid there and took it.

Please don't let your PT bend your leg at all. That's a big no-no. Not only can it cause damage if he pushes too hard, but it's also rather pointless, because it does nothing to increase ROM.

PTs get pretty hung up about the numbers, because it's one way they can show that their ministrations are effective, but the only numbers that count are those you get by using your own muscles.

As long as you're making steady progress, even if it's slow, there's no need to worry. ROM can continue to increase for a year, or even longer, after a TKR. You don't have to rush.

 

[lovetocookandsew]

@nuttybrunette I think we sometimes go with the flow so as to not upset the status quo, and then ask ourselves afterwards what the heck we were thinking. People generally don't like confrontation, so we don't speak up in situations where we may have a confrontation, even a small one, and so allow ourselves to be treated contrary to our wishes. IMHO, you would be better off dropping PT altogether, and just do your ADLs along with the activity progression listed here at BS. Unless you have a specific area they can help you with, the PT isn't really being helpful, and is likely more harmful.

I'm skipping PT altogether this time, except for having them help me with my gait which is a bit cockeyed. I asked my OS the other day what he was thinking about in regards to PT and he told me I already know what I need to do, and as long as I don't turn into a lazy sloth (my translation of his actual words....lol....) I'm good and don't need any formal PT. I did ask him if he thought a session or so of PT just to help me with a normal gait again would be helpful, and he said sure and I could do that and then "dismiss" PT when I was good with that. Think about if they are really helping you, and if you think they are (when not forcing your leg to bend) then stand up for your knee and don't allow them to touch you again or try to bully you into doing things you don't want to do or don't like, and if they agree, then agree to continue. Otherwise, I would advise you to stay away.

 

[nuttybrunette]

I had that convo with my husband last night. Do I really need to continue? I’ve used this place for a decade for ankles, feet, knee, elbow, and neck. Lol. Ya, lots of parts take their rotation with me. Many of the oldies there are like family. I enjoy there company, which makes me sound like a shut in loser-ha,ha, and most of them cheer me and my accomplishments on. I could quit, but might miss the massages.... I’ll give it some serious thought. Maybe judge it based on my “talk” with my PT and his reaction/response.

 

[Jockette]

. Maybe judge it based on my “talk” with my PT and his reaction/response.

My guess is he will do it your way. You’ve known him a long time and I’m sure he values your friendship as much as you do his. He just tested the waters a bit. Set him straight and enjoy those massages. If he doesn’t cooperate after that, then you have to do what’s best for your knee.

 

[VonnieN]

I find that most PT seem to have a process they follow and they are not prepared to change their point of view unless there is some new data out there.

I have seen two different Physio (due to one being away) and the second one is wonderful and he said well what the doctor might want is not going to be achievable. you are moving forward and doing what needs to be done. So he has written a letter that I will take with my to the Surgeon.

 

[nuttybrunette]

I agree Vonnie about their process. I think it’s ingrained in them. My PT had written a report and included lots of info about me, but my OS hadn’t had time to read it. You taking it by your hand is fantastic!! Then they can read it right then. I love it!

 

[VonnieN]

which he did. I see him aga in in two months. his PA rang to say oh you need xrays before you come and I said well he said it was not necessary she was surprised and double checked and no he does not want them she said that was a first

 

[Jockette]

My PT had written a report and included lots of info about me, but my OS hadn’t had time to read it.

The same thing happened to me at my 6 week check up. I’m paying my surgeon how much?? I’m in a difficult recovery process that I’ve never done before and he can’t be bothered to stay updated on my progress.

 

[nuttybrunette]

@Jockette Exactly how I felt!

 

[nuttybrunette]

I've seen on here at least 2 ROM progression lists that people have posted on their progress. It says something like month 1 and the ROM, month 2 and ROM, etc. Can anyone point me to those-I'd love to show my PT, just as an example of not everyone fitting into the same square box.

 

[Jockette]

I copied this from a post from Celle:

(Thank you, @Campervan ) As you can see, her flexion continued to improve for a long time.
"I had a slow recovery. Here's my flex measurements at various points:
92 - 8 weeks post op
105 - 10 weeks
107 - 5 months
110 - 6 months
112 - 7 months
116 - 9 months
119 - 11 months
118 - 1 yr

 

[nuttybrunette]

That's it!! Thank you!! I think there was one more from a fellow.... But this should work

 

[nuttybrunette]

Hope it's ok that I cut/pasted this here on my thread, so I have it handy for today's PT appointment.....

One of our members, Bertschb, kept a record of his ROM process. He agreed for us to post it for those of you that are afraid you're stuck. The key is to have patience! Bertschb says:

I'm 12 months out from my surgery and have some advice based on my experience:
1- Stop going to PT (all it will do is make your knee swell and reduce ROM)
2- Don't worry about your ROM
3- Be patient - VERY patient!!!

Here is my ROM history (more or less):
1 month - 60 degrees
2 months - 80 degrees
3 months - 85 degrees
4 months - 90 degrees
5 months - 90 degrees
6 months - 110 degrees
7 months - 120 degrees
8 months - 125 degrees
9 months - 130 degrees
10 months - 135 degrees
11 months - 140 degrees
12 months - 140 degrees

I spent waaaaay too much time worrying about ROM. I thought I'd be riding my bike a couple months after surgery but it took SIX months! Looking back on my surgery, if I knew then what I know now, I wouldn't have wasted my time with PT and I wouldn't have worried about ROM.

 

[Jockette]

Yes, that’s the other one. I can’t wait to hear your PT’s response!