TKR Biggest issue - discouragement/pain

[ridgetop01]

Thx for the input. You are right, I am about -5 of a straight leg, and my bend is at 80-82 degrees. My surgeon has very specific expectations for bend - 75 after one week, 90 after two weeks. Today the pt was forcing, trying to get more bend and extension, and everything hurt a LOT for the rest of the day, even walking with walker. I am going to tell her tomorrow I do not want it forced, that can't be right. This is hard enough without added pain! Thx again

 

[Celle]

Don't let the PT force your knee. That will only inflame your healing tissues and make your progress slower.
Remember this, from the mantra:
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.

Your knee will only start to bend more when you get rid of the swelling, so concentrate on doing this -
- rest, elevate, ice and take your pain meds by the clock

Also, regardless of your surgeon's expectations, I think you need to read these:
Myth busting: no pain, no gain
[URL='https://bonesmart.org/forum/threads/myth-busting-the-window-of-opportunity-in-tkr.6895/']Myth busting: the "window of opportunity" in TKR[/URL]
[URL='https://bonesmart.org/forum/threads/rom-its-never-too-late-to-get-more-rom.6185/']It's never too late to get more ROM!
It's worth the wait for ROM[/URL]

Don't let your surgeon or your PT impose their expectations on your knee. It will heal in its own sweet time. The knee is in charge, not them.

 

[Josephine]

I am about -5 of a straight leg

A minus means your leg is more than straight. Given your flexion, I'd imagine it would be unlikely to be getting straight just yet. Therefore it must be +5
Either way, your ROM is not at all bad for less than 2 weeks out.

My surgeon has very specific expectations for bend - 75 after one week, 90 after two weeks.

Well you know what? Let him have his expectations - if you don't meet them, what's he going to do? Put you in detention? And if he starts talking about an MUA (manipulation) just remember that you have the right to say no! If you don't sign the consent then he cannot touch you, simple as that. He can huff and puff all he likes but you stand firm and just keep - politely - saying no thank you. But I think you're doing splendidly thus far. But if you keep up that intense regimen of exercises, you'll find it will start to regress as the swelling and pain increases. Remember, this is in your hands - be strong and stand up to them.

I also erred in my advice to you. I forgot you were only 10 days out but Roy kindly reminded me.

My corrections in red
ankle pumps - 30 - twice a day - these are just anti-clot exercises so you should really be doing them throughout the day, every 15-30 minutes. After another week, you can do them every hour
quad sets - 20 - twice a day - do 5 once a day
glut sets - 20 - twice a day - do 5 once a day
straight leg raise - 20 - twice a day - do 2 or 3 in the morning only, once they are easy, there is no need to do them any more
short arc quads - 20 - twice a day - don't do these until week 4 at the earliest they're very hard on your knees
heel slide stretch - 20 - twice a day - much better to do these 5 every couple of hours throughout the day - read this Heel slides and how to do them
heel slide stretch in chair - 5 - once or twice a day - either do this exercise or the one above, not both
stretch knee on 1st step - a few daily, for now - these are extensions stretches - don't do these until week 4 at the earliest. Extension: exercises for improvement.

 

[ridgetop01]

How long we're you expected to wear the compression stockings? For some reason they make my legs itch terribly, such that I bruise myself scratching! Thanks for input.

 

[ljrfrm]

Every doctor has different protocols for them. My doctor requested that I wear mine for 3 weeks. A few days shy of the third week I discovered my skin was breaking down until the stockings. I ended up having to go to Urgent Care and was prescribed a topical steroid cream. Due to the skin problems, I stopped wearing them just before the three week mark.

 

[Clipless]

I didn't have to at all. I think the use of compression stockings depends on your surgeon and your medical history. I did wear the sequential calf compression device (SCD's) in the hospital. I have several pair of compression stockings because I work long hours. I tried wearing them to see if they would help alleviate post op swelling, but I found them difficult to drag on and off.

Call your surgeon's office Monday morning. Someone there should be able to answer your question.

 

[Celle]

My surgeon's pre-op handout said that the hospital recommends wearing compression stockings for 6 weeks, but that he thinks they probably don't make much difference.
I hated them, so I wore them in the hospital but stopped wearing them as soon as I could get up and about at home.

It is important to do ankle pumps and to walk around the house (just to the bathroom and back at first) as soon as you can, whether you wear the stockings or not.

 

[Phil75070]

No compression socks in the hospital and given none for home use. The compression devices they used on me in the hospital were on each foot this time. With my right TKR it was right foot and left calf.


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[skigirl]

It they are a problem, take them off right now!!! I wore mine occasionally when I had swelling---but the hosptial apparently put everyone in size large---and the top of them would fold over on my thigh---wonderful look!!! I stopped wearing them on day 5.

If you have no history of blood clots, there is probably no reason at all to wear them---especially if they make you itch. You don't want scratches on your legs.

 

[Josephine]

I so wish I could find the study that conclusively demonstrated that TEDS do nothing to affect the incidence of DVT.
I took mine off on day 3 and my surgeon never said a word!

 

[Josephine]

@ridgetop01

PLEASE NOTE THE ANNOUNCEMENT AT THE TOP OF THE PAGE
I merged your threads as per this request One thread for your recovery please?
Please don't keep starting new threads about your recovery.

The reasons for this are that it
1. makes it easier for guests to read the continuous story of a member's recovery - the most important reason
2. avoids people duplicating and repeating things like links to articles
3. helps us to refresh on what you've had done and when, plus what advice was given previously
5. keeps all advice previously given on hand for the poster
6. makes it unnecessary for the member to keep repeating surgery details
7. just makes it easier for everyone all round!

Thank you very much!

 

[pinot]

Yes, itchy and as has been said the Xlarge size falls and folds. But I am trying to wear them for what they said: a month.

 

[Reebok]

I couldnt stand the compression stockings, but did what I was told for the first six weeks.
Agreed . Not the best look, they are uncomfortable, and the proverbial PITA.

But I did what I was told.
Have no idea if they made any difference at all.

Almost believe it is like a canary in the coalmine for the doctors. If you comply with that then maybe you complied with everything else they told you.

What choice do you have? You have to listen to some ones advice.

Maybe they are one of the placebo tests, or maybe they offer a benefit. I didnt have the knowledge to question them, so just did what I was told.


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[referee54]

I am going to tell her tomorrow I do not want it forced, that can't be right.

Remember---the PT works for you---not the other way around.

You get to set the ground rules. Here is what you do:

Yep---draw the line in the sand and let them know that you will not cross it.

do not let anybody force you to the point of pain---and do not let anybody force your knee until it hurts---"NO!!!" ---yell it and let them know.

If they do not like it---show them the door, fire them, and find a PT who will not only work with you, but for you, too.

 

[skigirl]

It is so hard for most of us to question authority. Unfortunately that allows people to assume authority to talk to us in THAT tone of voice. you MUST do this because I said so!! I know that I often folded in front of authority.

Then, I got a bumper sticker for my car that read "Question Authority" and began to do just that. So, if a PT walks into your house---you can question her. What is her authority---does she have a four year degree?? two year?? one year experience or 10 years? When did she learn this idea of forcing your knee? two years ago? Five or ten years ago? has she been to a recent conference?

Just because she assumes the cape of authority she does not necessarily deserve it. You are paying her salary---so you need to vet her just like you would question a cleaning woman. What are her references. Is she up on the new thinking about recovery after TKR?

You do not have to do everything someone in authority tells you=-====QUESTION AUTHORITY!!

 

[SuperSnapper]

@ridgetop01 hope things are going well with you?