TKR Beauthecat's Recovery Thread

[Beauthecat]

Thanks for the reminder Celle about ROM improving for up to a year. That really helps. My expectation to be there by 3 months was clearly overly optimistic. Those were also the goals my PT set so she has really been pushing. The last couple of sessions were hard work outs. I took a pain pill today, haven't needed on on a couple of weeks. She doesn't hurt me just lots of quad strengthening and hamstring stretches. She put keniseology tape on . Don't know if that really does anything.
SusieShoes, and Sistersinhim thanks too I definitely do those exercises some.
Just discouraged today.

 

[sistersinhim]

You'll get there! Extension was slower for me, too. I couldn't even lay my leg flat on the bed for a couple of months because of the pain in the back. I kept a small throw pillow under it so I could sleep. Now, it's completely flat! I just stopped thinking about it and it got there!

 

[KarriB]

What is the PT doing for quad strengthening? No weights, squats or lunges I hope. Those can aggravate your knee and inhibit ROM.

 

[Celle]

My expectation to be there by 3 months was clearly overly optimistic. Those were also the goals my PT set so she has really been pushing. The last couple of sessions were hard work outs. I took a pain pill today, haven't needed on on a couple of weeks. She doesn't hurt me just lots of quad strengthening and hamstring stretches.

ROM will continue to improve without doing any extra exercise. In fact, doing too much could slow it down.
Extension often takes longer to achieve than flexion.

Your PT has goals, but they don't have to be your goals. The reason she wants faster improvement is because showing an increase in the numbers is one way that she can demonstrate to the insurance company that her work has been effective.

Go easy on those strengthening exercises. It's barely 3 months since your surgery and really only just time to be starting on strengthening. Your legs will strengthen naturally, as long as you don't try to rush it. As Karri said, no weights, squats, or lunges, and no resistance machines either.

 

[Beauthecat]

This is my usual PT twice a week: I warm up on a recumbent bike, then heel slide then she measures the ROM then, some gait exercises,like goose step, heel toe, backwards; then wall slides, squats holding a ballet bar. On their little practice stairs dips from one step touch your toe on the ground then back up, lunges and Stool scoots (sitting on a rolling Stool and moving it across the floor by digging in my heels) Today she had me walk a whole flight of real stairs for evaluation. Then she massages my knee, plus keniseology tape. Tuesday all the same but no stairs or stool. We went to the ajoining gym and did the knee machines, leg press, quads and hamstrings.
Writing all that down I can see why I needed a pain pill. It doesn't hurt it just make me sweat like a hard gym work out.

One of the other PTs I have does less exercises more manipulation and massage.

What sort of PT do you suggest at this stage? I really tired of going.

 

[sistersinhim]

wall slides, squats holding a ballet bar. On their little practice stairs dips from one step touch your toe on the ground then back up, lunges

These sound like way too much to be doing so early in your recovery. As the ladies earlier said, no squats, lunges, weight, or resistance bands or machines.

All you need to do is to use your knee in your daily living. It will naturally get stronger and ROM will improve without all that harmful PT you are doing. Your ROM is already really good, so you don't even need to go to PT anymore. Your body knows how to rehab your knee without any guidance. God built us that way! Just use it gently.

 

[KarriB]

All of that activity and exercise is probably keeping your extention and flexion from progressing. Squats and lunges are very hard on new knees. You really don't want anyone manipulating your new knee either. Take a look at the Activity progression for TKRs . I am a believer that walking is the very best thing you can do. I didn't walk early on in recovery, but when I did it helped me to stand longer and my knee actually hurt less.

 

[Beauthecat]

Thats the conclusion I've reached, I'm ready to stop PT. I've started to hate going. The few degrees I have left havent changed for a couple of week and they have upped things which has made me feel like I'm failing some how. I was playing with stopping PT this week you have confirmed what I was feeling is what I need.

 

[KarriB]

Yikes, I just reread, LEG PRESSES! I'm glad you've decided to take a break. Keep us updated on how you are doing using BS guidelines.

 

[Beauthecat]

How much walking did you do? Just every day living, groceries light house work? Did you do walks outside, how far?

 

[Beauthecat]

Never mind I found the article on activity for tkrs.

 

[IowaNana]

@Beauthecat - I walk inside when it's too hot outside, otherwise I like to walk outside. I started slowly by tracking time inside and distance outside. Outside - I set a goal to walk one more driveway each day. Inside - I use the timer on the microwave and try to go a couple minutes longer everyday. If I start getting sore, then I quit early. This week, I've been doing a lot more shorter walks inside than two longer walks.


Sent from my iPhone using BoneSmart Forum

 

[KarriB]

I didn't do enough walking in the first months after. But the activity progression chart says 15--20 minutes. It also says at 10 weeks to begin taking back household responsibilities. I found dusting a room then elevating or vacuuming a room and elevating was perfect for me. I needed to spend as much and a bit more time elevating as I did working or walking. So if I went to the grocery store for a half hour I elevated for over an hour. If I walked for 15 minutes, I elevated for an hour.

Just tap or click on the words Activity progression for TKRs it should take you to the acrticle.

 

[Celle]

This is my usual PT twice a week: I warm up on a recumbent bike, then heel slide then she measures the ROM then, some gait exercises,like goose step, heel toe, backwards; then wall slides, squats holding a ballet bar. On their little practice stairs dips from one step touch your toe on the ground then back up, lunges and Stool scoots (sitting on a rolling Stool and moving it across the floor by digging in my heels) Today she had me walk a whole flight of real stairs for evaluation. Then she massages my knee, plus keniseology tape. Tuesday all the same but no stairs or stool. We went to the ajoining gym and did the knee machines, leg press, quads and hamstrings.

All the exercise I've marked in red are too much for your knee right now. Please don't do them for at least another 3 months. Mini-squats, where you only go down as far as you would when sitting on a chair are OK, but don't go any lower.
The wall slides are unnecessary and the leg press is particularly hard on a new knee.

 

[Beauthecat]

Thanks those are very helpful descriptions. That's pretty much how I'm managing daily activities. Although I havent =quoted elevation with time of activity. I'll do that. The driveway suggestion is great. Outside I worry I'll go too far and still have to go back. I'm still parking as close as I can at the store.

 

[flyaway79]

I had my surgery March 20th so one week before you. I stopped my PT about a month ago to give everything a rest. I was also just getting tired of going. I didn't even give them the chance to start all those strengthing things that you are doing. They wanted me to do a wall squat and I told them no. My left knee is bone and bone and my TKR knee is not ready for it yet. They said - okay. I was doing the side steps, heel to toe and a little balancing. That was enough for me. I just couldn't see aggravating my knee that much. They finally agreed to release me and my ROM was at 113.

I'm glad I went to PT at the beginning to have them help get things moving and get some baseline measurements on where I was. They also gave me some good tips on how to do certain things. I also questioned them a lot about their philosophy of healing and basic anatomy questions about my surgery. That was interesting.

A month later after no formal PT my ROM still went up in spite of the swelling I still have. I was pleasantly surprised. My doctor measured me at 126 this week. She was happy and said another 10 degrees or so will come in the next months.

We discussed it and I may go back to PT in about a month or so to do some of those strengthing exercises. She said just don't overdo it. It it flairs things up again then stop it. Or I may just do them at home. I remember from my PKR what I needed to do to get my legs stronger.

For now I'm walking and riding my stationary bike.

 

[sistersinhim]

I think you have made the correct decision to stop PT. You will do great!

 

[Beauthecat]

I've officially cancelled my remaining PT appointments. Feeling relief. Resting much more with elevation and ice. I'll keep you posted. Thanks for all the support.

 

[flyaway79]

I plan on going back later if I feel like I don't have my strength back in a month or so.

 

[sistersinhim]

You'll see much improvement now, @Beauthecat.