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Revision TKR Bruising 3 years out

I used a CPM machine for several months actually and also did PT twice a week. I found some good things at PT - when I told them I just wanted to massage and help get it more flexible but not force bending, some of the exercises that were milder stretching. I do agree that forced bending, trying for that higher ROM number did cause me pain and swelling for a day or two after which made me not want to do exercises. Although my husband wanted me to, I rarely did the strenuous exercises at home.

When I was done with PT, I actually gained more ROM. I can't say PT hurt me, I don't think it did, and I can't say for sure it helped but I think some of it did. I had terrible ROM before surgery due to my accident (about 45) and I think going there helped me but not when it started to hurt more. Doctor's advice last time was quit PT and just do gentle stretching - I went from 85 to 95 degrees in about 10 days after that.

But I did feel the CPM machine - at least for me (I know the studies that show it doesn't make much difference) helped me be more able to bend my knee by keeping it more flexible. Also learning how to use it better (there are several settings to make it work different ways), I was able to get something that allowed my leg to move through the range of motion I had without pain and actually, I believe helped. I could lie down and sometimes even sleep while it worked. I did gradually get more ROM as I could up the settings. I did have it set to go to about -10 because I found the settings on the machine do not correlate exactly to what ROM you are doing. And it depends on whether your foot slips, etc. But I always kept the setting below zero and kept increasing the higher number when I could. When it actually caused pain, I turned it off after one cycle at that level.

But don't feel stupid for following PT's advice - they are professionals that you have been sent to and you should be able to expect them to know what's best. But I've seen, and you'll see by reading here that not all PT is equal! Some still want to force bending and some have seen that it doesn't always help and can hurt. Doctors are the same. Tell your doctor you are doing exercises at home. Your flexion (bending) is good, look on Bonesmart for things to do to help extension. And I'd try setting the CPM machine, if you are still using it, to a number below zero if you can tolerate that.


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Xanaphia said:
I should have stopped her. But I've been so angry at myself lately. Those few days in the hospital, they had my cpm machine set to 0 , but a few days after I got home I could no longer straighten my leg and I guess I blame myself for that. I don't know what I could have done to cause it other than refusing to use the CPM machine for 8 hours a day on top of PT 5 days a week. But I woke up this morning and I can't even walk normal again, yesterday I was fine, until PT and I've been in alot of pain ever since and when I walk my leg gives out on me, bending backwards real hard and fast and now I'm afraid to walk :( I feel like a dummie for letting her do that
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Don't beat yourself up. :friends: Try to be kind to yourself and kind to your knee.

You did the right thing in refusing to use the CPM if it was hurting you. While some people, like charmed-life, find the CPM is helpful, it isn't necessary and using it has no effect on your eventual ROM.
It seems that your surgeon recommends lots of exercise, but it really isn't needed. Your knee is wounded, not unfit or lazy. It needs time and gentle treatment in order to heal.

You need a break from PT. Why not phone your therapist, tell her how your leg feels after what she did, and say that you'll be taking a break for a while?

Spend as long as you can resting, icing and elevating, and don't forget to take some pain medication.
 
Some great advice has been given here. Are you going to take it?? Every time you endure aggressive PT it sets you back. Can you not see the correlation? If you can't say, "No" to the therapist or greatly scale back the exercises, DON'T GO TO PT!
Honestly, you are overdoing it big-time and suffering needlessly.




 
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Xanaphia said:
. She told me "you better work hard on that extension all weekend because you know your dr isnt going to like you not straightening it". She also told me that most of the reason people have problems with ROM after TKR is a mental thing. "It's all in your head". She says it's the fear that keeps your ROM painful.
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What a load of...nonsense. And I hate it when PTs use the "doctor will be mad" threat. :( Usually they (the doctors) are not nearly so hung up as PTs.
 
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That PT is not the right one for you. Don't listen to her. She was taught an old-fashioned way of treating TKRs and she needs to go to a refresher course.
Using threats is unprofessional and unforgivable.
 
She was here yesterday and I told her flat out she will NOT be forcing my leg to bend or straighten anymore and that I didn't care if the doctor got mad or not. I told her that the ROM will come when the swelling goes away and that I'm willing to do GENTLE exercises but no more of the agonizingly painful stuff that destroys all my progress. I've got an exercise routine that I can handle and doesn't cause swelling etc that works nicely on building up my quad muscles and works on my ROM. That's the only exercises I'm willing to do. I think she knew I was serious because this visit I'M the one that led it, not the other way around. I guess I just needed to dig deep and find my assertiveness lol. Thank you for your kind words and advice. You guys really make me feel like I'm not in this alone and it's nice to have people to talk to that know exactly what I'm going thru :) :roseshwr:
 
Yeah for you. Sometimes they can be quite bullies in theray. I remember those days.

Hope your swelling improves and your ROM with it!
 
Good for you for being assertive! May this feeling of empowerment grow as you continue to take charge of your recovery.

One honestly doesn't need much early PT. I did not use home PT at all for my second TKR and didn't begin outpatient PT until 6 weeks post op. My OS was fine with my decision, and he certainly can't argue the results. No regrets!
 
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Ok I gotta give an update because I woke up so happy with myself. I have really been working (gently) on my exercises this weekend, and then last night I was so relaxed I actually fell asleep in my CPM lol. My bend is at 120° and my extension is (almost) at 0, not sure of the number. For the first time in almost 4 weeks I woke up with hardly any pain, swelling, or stiffness. I know it's still early days and I'll have set backs, but today is a good day :) And by the way HAPPY MOTHERS DAY to all the mommies on this forum, I hope yall have a good and pampered day :) :flwrysmile:
 
Good for you. Sounds like you turned the corner. Most everyone does, but until you get there it is hard to fathom that it will get better. You may have a day in the future that sets you back a bit....but relax . ..it is all the process .
 
I had my follow up with my doctor on Monday and he was very pleased at how far I can bend my leg already. He said a 120° Bend at 4 weeks is great. He wasn't worried at all about the straightening. He said that will come in time when the swelling goes down (so my PT was worrying for nothing lol) He said he worries more about the bend because that's the part most people have the hardest time with. He said that since my bend is so good and I'm obviously really putting in a good effort at home he's not going to send me to outpatient PT. That made me happy lol. My home PT sessions have been dropped down to twice a week. I still cannot soak in the tub because there's a couple parts of my incision that aren't fully closed up yet. I guess it's normal because my doctor didn't seem worried about it.. I can now wash my incision with gentle soap if I desire, and he gave me a handful of light cloth bandages to use on it, but he did say I can go without a bandage at this point if I want to. So I guess I'm doing pretty good.
 
You are doing excellent, ask your PT to show you a heel to toe gait, best thing you can do for extension.
:yay:
 
IMO it is time to stop the PT, you are well on your way to a great recovery.
 
I feel very strongly that home PT are often not properly trained. Frankly, I think you would be much better off to go to a professional PT clinic and quit the home pt---especially since you have one of the poorly trained one. She even lied right to your face, "your doctor will be angry with you" is a silly threat especially since she has had absolutely no contact with your physician. Do not let her into your house again---and if you need PT find a professional to work with you.
 
Such wonderful news!! Please don't worry about your extension. Mine wasn't great when I was finished with PT (though my bend was great.) it really did come in time. Just walking and living my life did the trick. I'm sure it will for you, too. Keep up the good work!


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