TKR Annaf's recovery thread<

[Jockette]

Hi, Anna, you really will be ok if you back off the exercises. You really are doing many more than some other people are. If you doctor told you to go let up on them, you wouldn’t hestitate, right? So if other surgeons think less exercises are better then it’s only a matter of opinion.

Are you in the US? If so I understand why you are afraid to stop them. I’m in the US and almost all we hear about knee replacement recovery is that we have to do our exercises. But it’s not true. Just an opinion.

Celle lives in New Zealand and you read what she said her surgeon said. Are the knees of those living in New Zealand any different from ours in the US? Of course not. So you can feel confident taking her surgeon’s approach. Pretend you’ve been to his office and he told you in person.

It’s your body and your knee and you have the right to take care of it the way you think is best.

If you continue to do this many exercises you will continue to have more pain than you would if you stopped, or at the very least, did a lot less.

 

[AnnaF]

30 bends every hour is way too much!

I’m sorry that is what you were told to do. And you are trying to be a good patient and do what you were told. We trust our medical professionals to know what is best for us.

The problem with that is that there is more than one approach to this recovery. You have been advised to do a very aggressive approach.

Since there are different approaches that different surgeons recommend it is my opinion that we can choose the one we want to do, because apparently there is no one right way. What works for some of us does not work for all of us.

What you are doing is causing you a lot of pain and swelling. The Bonesmart approach is much gentler and more sensible. It recommends treating your knee gently so it can heal and the swelling can go down.

Conflicting approaches are confusing and we are scared to not do what we are told to do. But, it’s our knee and our body, so we decide what we think is best for us. We truly have the right to say, I’m not going to cause myself pain any longer.

Hang out with us here, we care and will help you through your recovery.

So what do I do now. I’m still doing chair exercises on roller chair keeping my foot tight to the floor & moving forward bending as best I can holding for 10 seconds. I do 3 sets of 10. Doc told to do these as often as every hour.

If I stop all exercises after all this aggressive PT will I regress? I’m so afraid of having to go through this all over again. I had a physical therapist for the first 3 weeks 3xs a week that literally bent my knee back while I lay on my stomach that made me scream so loudly that my husband thought I was dying. Should I do some gentle bending? How much? This is awful. The only thing on my mind is this knee bending.

 

[AnnaF]

When did you have your surgery? How is you’re ROM now? I want to be able to get in & out of a car,comfortably bend my knee while sitting etc. so scared of my knee not having enough flexibility to do all the essential things.

 

[AnnaF]

30 bends every hour is way too much!

I’m sorry that is what you were told to do. And you are trying to be a good patient and do what you were told. We trust our medical professionals to know what is best for us.

The problem with that is that there is more than one approach to this recovery. You have been advised to do a very aggressive approach.

Since there are different approaches that different surgeons recommend it is my opinion that we can choose the one we want to do, because apparently there is no one right way. What works for some of us does not work for all of us.

What you are doing is causing you a lot of pain and swelling. The Bonesmart approach is much gentler and more sensible. It recommends treating your knee gently so it can heal and the swelling can go down.

Conflicting approaches are confusing and we are scared to not do what we are told to do. But, it’s our knee and our body, so we decide what we think is best for us. We truly have the right to say, I’m not going to cause myself pain any longer.

Hang out with us here, we care and will help you through your recovery.

So what do I do now. I’m still doing chair exercises on roller chair keeping my foot tight to the floor & moving forward bending as best I can holding for 10 seconds. I do 3 sets of 10. Doc told to do these as often as every hour.

@AnnaF i was like you the first two weeks, trying to be a good patient and doing the prescribed exercises even though they caused severe pain and a regression in my ROM. I found this forum and the philosophy makes so much more sense to me. I stopped the aggressive exercise and just work on taking care of myself. My ROM and strength are progressing, maybe behind my surgeon's timetable but I am fine with that. Others' experiences speak more to me.

When did you have your surgery? How is you’re ROM now? I want to be able to get in & out of a car,comfortably bend my knee while sitting etc. so scared of my knee not having enough flexibility to do all the essential things.

To add insult to injury my other knee is very tight right now I’m becoming concerned with that too.

 

[AnnaF]

What about adhesions? Will I have a problem with them if I stop exercises now? Should I just do light easy exercises?

 

[Jockette]

There is absolutely no reason for you to let a therapist hurt you like that. How can that possibly help you recover? That is definitely the wrong kind if “therapy”. In fact that is no therapy at all. Don’t allow anyone to do that again.

My surgery was one year ago. My knee is bending better. It continues to bend better.

My therapists did bend my knee to a painful place but not to the point I wanted to scream. I later learned that it is not necessary for them to do that.

Our knee will recover better if treated gently. Forcing it to extreme pain keeps it inflamed and swollen which prevents us from bending it.

I found Bonesmart at about 4 weeks post op and learned the gentler approach. I stopped doing the home exercises and just did normal things around the house. I did go to PT a few more times but did not do everything they wanted me to do.

You knee will healbetter if you let it rest so it can heal.

If you really feel you have to go to therapy, go somewhere else where they will be gentle with your knee. Call another place and talk to them on the phone and tell them you want gentle treatment. Don’t go unless they assure you that they use a gentle approach.

You will not get adhesions if you stop the exercises. Just do gentle movements.

 

[Celle]

What about adhesions? Will I have a problem with them if I stop exercises now? Should I just do light easy exercises?

No. I told before, the danger of developing adhesions is grossly exaggerated. They're quite rare and you don't have to exercise to prevent them. Do re-read what I wrote in Post #16.

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[sistersinhim]

Many of us have never done PT, even though our OSs ordered it, and have gained our ROM just fine and quicker than someone who is doing all the aggressive therapy like you are doing. Why don't you let us who have had all this experience help you? We are volunteering our time to help others just like you to not have to suffer needlessly. All that PT is bad for a healing knee.

 

[AnnaF]

Ok I understand. Should I continue gentle exercises? Also did s it normal that my knee is stiff every morning & I have less bend? I have been brainwashed!

 

[KM1972]

@AnnaF, I had a right TKR last March, and I heard all the same dire warnings that you did—from my PT, though, not my surgeon. My bend was only at 70 at 4 weeks, but my surgeon said my knee was one of the worst he’d worked on and that ROM would come—and now, at 11 months out, I’m at 125. Trust the Bonesmart approach; it works! I had my left knee done less than two weeks ago, and flexion is already 105–but my point there is that I’m not doing anything differently; even the same person can have a completely different experience from one knee to the next, so don’t compare your bend to anyone else’s. Your knee will heal in its own good time and your ROM will come.

 

[robhunt3]

Hi @AnnaF, I'm a bit behind you at just over 4 weeks since my right TKR and have had a similar experience with my more recent PT sessions. Too much pushing followed by swelling, pain and worsened mobility.

So I listened to my BS friends who have offered the same advice and have decided over the weekend to stop PT for a while, relax and not push it. I may still go, but will ask him to focus on healing, massage, swelling reduction etc. rather than ROM. Before physio I had flexion/extension of 100/0 and after two weeks of physio it had regressed to 85 or 90/0. That's not a great advert.

Already I feel the difference, not necessarily in ROM just yet but in the benefits of reduced swelling and improved walking, which I know feel will translate into better ROM over time.

Each of us is different - I was convinced I would bounce back relatively quickly and still hope to do so, but I'm realising that it will take time and a lot of patience. More importantly, I've realised that pushing an already 'injured' joint won't help it at all. Healing and gentle exercise along the way will help more than anything.

A friend of mine had a serious cycling accident (was hit by a motorbike doing 50mph) and required a TKR as a result of the multiple injuries he sustained. He spent 10 weeks in a hospital bed and did no exercise on the new joint whatsoever, not even in hospital PT. There were too many other injuries and complications to worry about after the accident. A little over 18 months later he has full mobility and is back on his bike operating at a similar level to before. Never underestimate the power of your body to recover, provided it is given the time and space to do so.

Join me in taking a more relaxed attitude to it, do what feels right for you not others - once your knee relaxes, your ROM will come all by itself. We can be living proof of this, as others have been for us.

 

[SusieShoes]

You’re getting so much good advice! The story of Robhunt’s friend is educational: PT is not necessary to get a good result from TKR. You can get a good result with PT; you can get a good result without PT. But there’s also this: You can get a bad result from PT, too. Overly aggressive PT, like what that therapist did to your knee, pushing it until you screamed... bad PT. That was not helpful at all! And your knee was telling you this.

Your knee will let you know if what you are doing is helping or hurting. If it settles down with resting and icing and elevating... those things are helping. If it’s not extra swollen or sore after exercise... it’s happy with that exercise. If it does swell after exercise and hurts more... you’ve done too much and your knee is telling you to not do that again.

That doesn’t mean you’ll never do that exercise again, whatever it is. You just do it later. Give it a week, or a month, or whatever your knee needs before it is ready for that.

I had both knees replaced, so have twice the experience... well, maybe not that, but I did have two knees recovering at the same time. Each was different, but both recovered. The BoneSmart way worked beautifully for me. I did do PT, but I refused any exercise I thought would be too much. I pushed my PT toward more balance, gait, and massage work. And I walked. Walking was how I strengthened and rehabbed my knees. I never did strenuous PT at all. I have excellent ROM in both knees and am pain-free.

It’s natural to feel anxious about this. I mean, my own mother kept fretting about “you have to do everything the PT says or your knee will freeze!” I lied to my own mother to keep her off my back. It’s a sad state of affairs, but nine out of ten people you meet will say you have to “work through the pain” or “your knee will never bend.” That’s simply not true, but that’s what we hear. So we know the kind of anxiety you’re feeling. Many of us have felt it too!

Take some deep breaths. Read some of the recovery threads. You are the one in charge of this journey.

 

[AnnaF]

@AnnaF, I had a right TKR last March, and I heard all the same dire warnings that you did—from my PT, though, not my surgeon. My bend was only at 70 at 4 weeks, but my surgeon said my knee was one of the worst he’d worked on and that ROM would come—and now, at 11 months out, I’m at 125. Trust the Bonesmart approach; it works! I had my left knee done less than two weeks ago, and flexion is already 105–but my point there is that I’m not doing anything differently; even the same person can have a completely different experience from one knee to the next, so don’t compare your bend to anyone else’s. Your knee will heal in its own good time and your ROM will come.

Thank you

 

[AnnaF]

@AnnaF, I had a right TKR last March, and I heard all the same dire warnings that you did—from my PT, though, not my surgeon. My bend was only at 70 at 4 weeks, but my surgeon said my knee was one of the worst he’d worked on and that ROM would come—and now, at 11 months out, I’m at 125. Trust the Bonesmart approach; it works! I had my left knee done less than two weeks ago, and flexion is already 105–but my point there is that I’m not doing anything differently; even the same person can have a completely different experience from one knee to the next, so don’t compare your bend to anyone else’s. Your knee will heal in its own good time and your ROM will come.

You’re getting so much good advice! The story of Robhunt’s friend is educational: PT is not necessary to get a good result from TKR. You can get a good result with PT; you can get a good result without PT. But there’s also this: You can get a bad result from PT, too. Overly aggressive PT, like what that therapist did to your knee, pushing it until you screamed... bad PT. That was not helpful at all! And your knee was telling you this.

Your knee will let you know if what you are doing is helping or hurting. If it settles down with resting and icing and elevating... those things are helping. If it’s not extra swollen or sore after exercise... it’s happy with that exercise. If it does swell after exercise and hurts more... you’ve done too much and your knee is telling you to not do that again.

That doesn’t mean you’ll never do that exercise again, whatever it is. You just do it later. Give it a week, or a month, or whatever your knee needs before it is ready for that.

I had both knees replaced, so have twice the experience... well, maybe not that, but I did have two knees recovering at the same time. Each was different, but both recovered. The BoneSmart way worked beautifully for me. I did do PT, but I refused any exercise I thought would be too much. I pushed my PT toward more balance, gait, and massage work. And I walked. Walking was how I strengthened and rehabbed my knees. I never did strenuous PT at all. I have excellent ROM in both knees and am pain-free.

It’s natural to feel anxious about this. I mean, my own mother kept fretting about “you have to do everything the PT says or your knee will freeze!” I lied to my own mother to keep her off my back. It’s a sad state of affairs, but nine out of ten people you meet will say you have to “work through the pain” or “your knee will never bend.” That’s simply not true, but that’s what we hear. So we know the kind of anxiety you’re feelings. Many of us have felt it too!

Take some deep breaths. Read some of the recovery threads. You are the one in charge of this journey.

Thank you

 

[Celle]

@AnnaF - Please stop quoting long messages. Just go down to the bottom of the page and start typing in the box there.
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[AnnaF]

How long after TKR will the ROM continue to progress? Is there a time limit that the knee will no longer gain ROM? This is what I’ve been told.

 

[AnnaF]

@katchmo

 

[Jockette]

That is not true. I am one year post op and my bend continues to improve.

Read this: https://bonesmart.org/forum/threads/myth-busting-window-of-opportunity-in-tkr.6895/

 

[katchmo]

Hi Anna, I too was told, "Six weeks is all you've got," but many here can attest otherwise. I am at 5.5 weeks and am barely to 90 but I am not sweating it. I'm going to quote another experience:

Robin-

I didn't read all the posts in your thread but I read enough to see how frustrated you are with your slow recovery and lack of ROM. I went through something similar last year. My surgery was 10/24/2016. Here is a history of my pathetic ROM:

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 gave up on PT after 3 or 4 weeks because all it was doing was causing more swelling. Your ROM will improve but if your recovery is anything like mine was, it will take a LONG, LONG time! Hang in there!

Spend lots of time reading others' experience. It is very encouraging.

 

[AnnaF]

@katchmo how are you progressing? I don’t seem to be getting anymore range. Will my ROM improve over time or is there a time frame that it will no longer be able to increase?