TKR Back home in PA

[maryo52]

Re: Too much, what do you think?

Part of your question relates to working helpfully with the PT. I encountered the same problem. Really, they should not push like that. But the bottom line is that we have to "patrol" our boundaries.

I learned to flinch and grimace as soon as it became uncomfortable. I learned to act like a wuss just for the sake of diplomacy instead of pointing out (rightly so) that they were pushing too hard.

If the PT is not of the type that looks for and respects your limits, then somehow you end up feeling as if you've fallen short in your performance. I felt like an utter failure at times, especially since my ROM was poor due to scarring. It was like every session was a failure-fest, which was only icing on the cake of discouragement from slow healing.

But I now think of post-tkr muscles as being injured. PT is designed to enhance muscles to support the injured site. The TKR site is entirely injured! Therefore it must be gentle as you've quickly learned.

 

[Roy Gardiner]

Re: Too much, what do you think?

:I-Agree: :amen1: :I-Agree: :amen1:

Your knee has told you 'don't do that' in no uncertain terms. Swelling and pain and stiffness is setting back recovery because the exercises compounded the damage, so you surely won't let the PT do it again -- or anything close.

 

[Ditzzeechick]

Re: Too much, what do you think?

Too much for two weeks out. You want to exercise so movement is possible not impossible. Slow and steady, this is a long recovery. As my OS said yesterday, recovery for one knee is tough, doing two at once is brutal. Take your time it'll get better in about 10 weeks ;)

 

[Josephine]

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[Josephine]

I agree with all the above and would add that you could do with some reading
The first set is essential reading, the second is useful and the third just good information but you will need it all
The importance of managing pain after a TKR and the pain chart
How Long Does Healing Take ......
Chart representation of TKR recovery
Energy drain for TKRs
Elevating your leg to control swelling and pain
Using ice
Swollen and stiff knee: what causes it?
Progression of activity for TKRs

Knee Replacement - Where Am I in Recovery?
So What Is It Going to Take? The Five “P’s” of Knee Recovery
Work “Smarter” and not “Harder”
About recovering a knee - from one who knows!
Some suggestions for home physio (PT) and activity progress
Myth busting: The "window of opportunity"

MUA (manipulation under anaesthetic) and adhesions
It's never too late to get more ROM!
It's Worth the Wait for ROM
Myth busting: on getting addicted to pain meds
Post op blues is a reality - be prepared for it




btw, would you be a real dear and put your surgery date in your signature like the rest of us do?
You can find the instructions here How to create a signature. Thank you so much.

 

[jmark87]

Last Friday the PT Tech put me through some rought treatment. I knew that I shouldn't have left this happen. I was winding up the PT session with heel slides. When I would reach the uncomfortable point, he would put extra pressure on my leg for about 10 seconds while he measures the flex. He continued this treatment. I now feel that i have lost at least two weeks in my
progress. I could not sleep in my bed for two nights, had to sleep in the lounger. I cancelled this Tuesday's session and will go back on Friday. I know that on one on this fourm believes in flexing to the point on pain. I called my surgeons nurse and she agreed, do not go to pain.
My other problem is that my ankles and feet feel stiff and sore. I don't like to sit up in a chair with my feet on the floor. I continually massage my legs and feet since surgery. I don't understand why I still have this discomfort.
Thanks, John

 

[bottomshollow]

John, have you read the links Josephine gave you? If not, please read them---all of them. There are a couple that talk about swelling and pain. Are you elevating (toes above nose) and icing a lot? This is the very best thing for the swelling. And this is what's going on with your ankles and feet. And frankly, you may be doing entirely too much PT this early on.

You are not quite a month post op. There's still a lot of healing to do. It will be a full year before you are completely recovered. You are now 1/12th through---not far at all. This recovery is going to take you as long as its going to take you. There is no specific time frame to go by. We are all different. Your knee is in charge---and it will not be pushed----if you push it, it is going to push back and take longer to get where you want it.

Please follow the BoneSmart mantra and do not overdo your PT. Take care, keep us posted, we care.

 

[pmonroe]

jmark87,
I say if they are hurting you, protest and tell them to stop. Maybe you need to find another PT.

 

[jmark87]

OK, I mentioned that last Friday at PT, the Tech pushed me pretty hard on the heel slides. I was making excellent progress until that time. Since then my walking and stairs have suffered. My knees were so stiff and sore that I could not sleep in bed. I spent the night between the recliner and the sofa. I contacted my surgeons nurse, she talked with the surgeon and returned my call. He said to not stress my knee and don't go back to PT until my visit with him this coming Monday.
I contacted my PT manager and told him what had happened, He was quite concerned about what hapened and said that he was going to follow up with my surgeon after my visit on Monday. He recommended that I continue at home with light exercises so that I don't stiffen up and lose all of my ROM. That is what I had decided to do, on my own. I never expected a setback like this and hope that I can easily recover and continue with gaining more ROM. I can't wait until I can get on my recumbent bike and really get cranking.

 

[jerseychick]

John, so sorry that you are still feeling the effects of the strenuous PT session. I'm glad you spoke to the PT manager and that you are taking it easy. Sounds like you have a smart surgeon. Rest, ice, and elevate so your knee can heal. Set-backs like these are common after PT pushes too hard.

 

[RestAssured]

Hi John,

One of the strange things is people believe the more they exercise, the better ROM they get!:wink1: Well, let me share a little secret.... I had ROM of 89 by trying in inpatient PT. Then I had a problem set in so the doctor put me in an immobilizer that keeps the leg straight and he made it clear to stop heel slides until I was in outpatient PT. They are having me do 10 heel slides on my own power. The first day in the evaluation, my PT wasn't going to measure for ROM, but I got to talking and casually pulled up my right leg without thinking about it.:wink1: So he came back over and asked if I would pull my leg up again. Without ANY pulling it had already gained to 94 on its own!:biggrin:

So you see, there is no need to let someone hurt you! My PT is excellent, she watches my face, because sometimes I try to overdo it!:th_heehee:

 

[jmark87]

Here I am at 5 weeks post op. I had posted that everything was going so well until last Friday. At PT, the Tech pushed on my leg so hard wnen I was doing heel slides. I haven't been back to PT since. I got an appointment with my surgeon for this coming Monday. He said to not strain the knees until he sees me. I am very mobile but not much ROM. The most bothersome thing would be my ankles and feet. They are so tight and uncomfortable that I can no longer sleep in bed. I hope that this is not a major setback on my recovery. I do a lot of elevation and icing. There is not any noticible swelling but my ankles and feet are so tight and stiff. I wish I had some answers to this.

 

[bottomshollow]

Between now and Monday when you see your OS, just do a lot of elevating and icing. Even if your feet and ankles don't look swollen, if they are tight and stiff feeling then there is some swelling there. Do only gentle easy stretching and bending. Ankle pumps are good too. And I wouldn't even push to mild discomfort until after you see your OS.

If you really do spend this time taking it easy and doing lots of elevating and icing, it may be much, much better by Monday.

Take care, keep us posted, we care.

 

[Jamie]

I agree with Judy....the feeling you're describing is swelling, whether you can see it or not it can be present. Ice and elevation is the best way to make things better. Do it as much as possible!

 

[jmark87]

Well, the wait was worth it. Since my setback at PT a week ago, I was taking it easy and had my visit with my surgeon today. He was very pleased with my progress at five weeks from BTKR. He said I do not need to take Coumadin and get blood tests anymore. He released me from the PT group and OK'd my going on my own at the local health club. They have many pieces of equiptment and a full size pool. I am excited about going on my own but unsure of how to proceed in that I know that I need to do enough work but not over stress my knees. I plan to start out slowly and continue without going into the PAIN zone. Also I have had problems with stiffness and some numbness with my ankles and feet. The Dr. said it was a circulation situation. When I took off my ankle sox tonight I noticed the ridge where the cuff is located. I think they are just too tight to wear since I still have mild swelling in my legs. I need to find some sox without tight cuffs.
I wish to thank everyone that has supported me, on this forum, over the past month. BoneSmart has truly been a lifeline for me.

 

[BJ Mac]

John, I am so glad that you had a good doctor visit today. It will be good for you to do some work in the pool, if you are allowed. My doc has still not cleared me to get in the pool, and I am really looking forward to that. Keep up the icing and elevating as much as possible. And keep us posted with your progress.

 

[Jamie]

That's great news, John.......keep those excellent progress reports coming!

 

[jerseychick]

 

[referee54]

Hey, John, you are very early yet in your recovery, but your PT must want to set a world record for recovery and being totally healed! I was lucky, in that my PT's understood the difference between an athletic injury recovery and a TKR recovery. You cannot force things---they will not get any better or go any faster---and what the PT did to you was wrong. Work to the point of discomfort---no further.

I am glad to read that you have been released and now can work on your own---just take it easy---you know what to do---take it easy and slowly, and resist the temptation to push yourself (that is tough, I know!)

As for the ridge from where your cuff of your socks are, I had those too. No biggy.

Just work gently on your kne and do not push it---you have the right idea. Ice and elevate as often as you can---especially after a workout session.

 

[Ditzzeechick]

John, I recently joined my local gym and began using the pool. I found just walking up and down and then swimming on my side while slowly kicking my legs helped tremendously. Also, the pool probably has kick boards and noodles available for use. I take a noodle (long styrofoam floatation device) and push it down in front of me in the water to create more resistance, it helps me to work on balance too. Then make a U with the noodle, place ur bum in the u and bicycle. Use the pool steps to do stretches or hang on the side of the pool and kick legs, put stomach against side of pool and lift bend foot up so you are bending knee, turn sideways and do scissor kicks while holding onto wall. Anything you did in PT can be done in the pool using the wall, steps or a noodle/kick board. Also, if you gym has a recumbent elliptical machine, give it a try. I found that it made a huge difference in my ROM not to mention it's a wonderful cardio workout without being jarring to the knees. Best of luck!