TKR Confused and Conflicted

I think that you'll be fine without formal PT. As near as I can tell, some surgeons are afraid that without PT we will just sit in our recliners eating bonbons and watching soap operas. Anybody who's naturally active or even fidgety will be getting up every hour or so to do something, anything!
Heck, my daily life - walking, doing some knee range of motion (and after 8 weeks some light strengthening), house cleaning, kitty care, meal prep, and after a month some errands, after 8 weeks some yardwork - has me "plum tuckered out" by evening!
 
I was blessed to have a surgeon who never pushed PT. He gave me a prescription for it, which I threw away and never went. My OS never even asked about PT when I went back for my 3 checkups! Of course, he knew I was a single lady who had to take care of myself and obviously trusted that I would not be just lying around all the time.

Because of birth defects, I had to have 12 knee surgeries, so I've had lots of knee recovery experience. I knew from that experience that I did not need formal PT after my TKR, and neither do many others if they do their own daily activities and do not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!
 
I'm in the US, where they have a very different attitude towards PT following surgery. In following comments in groups on Facebook, it sometimes seems so competitive... as if folks are bragging about how quickly they've achieved a certain ROM, etc. "Push push push through the pain" seems to be the mantra. In reading posts on BoneSmart, however, I feel as though I should relax and just let my body heal and progress at its own rate.
I'm in those same groups and have pushed back just a bit and steered people toward this site. All the posts about MUAs very early in the process. I think the more gentle approach makes sense due to all the trauma and swelling. Why add more trauma with a MUA? It seems counterproductive.
 
IME, a self motivated person doesn’t always need a knee bending and straightening coach. They just need to be empowered with knowledge of how tissues, heal, tighten, scar and be in tune with their bodies. There can be great benefit, however to a PT who focuses on overall body alignment, posture, balance …with a whole person focus, not just a joint. They can identify things not always obvious that are limiting mobility. Learning from my PT’s about manual muscle release techniques I could do myself, and the link between glute strength/posterior chain and knee health…were examples of game changers that helped me delay surgery and get strong before surgery. I learned from my PT’s good self management skills. There are good ones out there who take this approach and can be very helpful, supportive and encouraging. It makes me sad to hear negative stories when there are so many good ones out there.
 
@dotski
You are so correct with your PT skills. With my first replacement I had a decent PT. This time no so much. I cancel after 6 sessions( Should have cancelled after 3!). Saw a PT session 1&2, but the remaining time was a PTA. It was a negative experience, but I am ok with it. Making up my own HEP, was never given any Information.
 
@dotski
Before undergoing TKR operation I have had many injuries during my athletic career. I have dealt with many PTs and there are very different ones for each situation. Just like any occupation there are good PTs, bad PTs and amazing PTs. Most are driven by interests in their chosen field of work. A certain therapist may be great at athletic injury rehab and be terrible at post surgical recovery due to the techniques they employ. I have met a few that don't seem to happy in their PT carreer. Fortunately most PT's are wonderful people who just want to assist and given the right information can be extremely helpful in patient's recovery journey.

This forum is filled with both knowledgeable and experienced individuals who provide extremely valuable information to anyone who asks for help. One of the biggest roadblocks to getting the assistance needed is clear communication and therapy boundaries. Hopefully that valuable info is slowly getting passed on to health professionals. In most cases if patients communicate clearly, consicely and stand up for themselves, health professionals will respect their opinions. I mean, lets face it, it is your body and in the end you will do what you want with it. It's great to reach your recovery goals with other's support.

:)
 
I'm in the US, where they have a very different attitude towards PT following surgery. In following comments in groups on Facebook, it sometimes seems so competitive... as if folks are bragging about how quickly they've achieved a certain ROM, etc. "Push push push through the pain" seems to be the mantra
I think your mantra should be " Listen to your body" and ignore anyone who tries to make you feel bad about your recovery.
I am now at 11 months post my PKR and overall have a very good result ( 150 degrees flexion/ 0 extension and I can walk up to 18,000 steps/ day and kneel if I need to).
But I never did any formal PT beyond a couple of hospital sessions. I did follow the exercises prescribed at my own pace and also had private pilates sessions. My teacher never ever made me do anything painful. It was always "back off if you feel pain".
My recovery was slower than my daughter-in- law's father's recovery. He was playing golf at about 7 weeks and hiking 6 miles etc etc. I felt bad about this and felt some judgement from my daughter- in-law that I was a being a bit slow, because I still had some pain and was icing/ using a stick at 5 months.
We are all different and had different pathology to start with. Turned out I was comparing myself to his very straightforward medial PKR -when mine was a much more complicated lateral PKR with severe valgus deformity and very overstretched ligaments- which explained my residual pain for several months.
 
In following comments in groups on Facebook, it sometimes seems so competitive... as if folks are bragging about how quickly they've achieved a certain ROM, etc.
So they say, but is it true?
We have a thread on that very topic in the Community area of the forum in the Social Room.

Tall Tales from the THR Fairy Tale Book

Go with your gut and do it your way by relaxing and allowing your body to progress and heal at it's own rate, just as you mentioned. Best Wishes!
 
Hi there,
Stopping by to wish you a Happy Two Month Anniversary!
How are you doing? I hope you're pleased with your progress and slowly getting back to anything you've been missing out on due to the condition of your pre-op knee. We'd love to hear how your recovery is going when you have time. Until then, wishing you all the best!
@Sbow3111
 
Hey there! Thanks for checking in on me! ❤️ I'm doing well, albeit not at the flexion that I feel I should be...? I'm probably only at 90, and I'm sure my surgeon would fuss at me for this. (Here in the US, they are all about the numbers!) I'm constantly reassuring myself what BoneSmart tells me... that IT WILL COME. It's so hard not to compare myself to those at the same timeframe who are doing so much better. Meanwhile, I'm working (desk job) about 4 hours/day, driving and doing all the things around the house that I've always done. I stretch, massage, walk steps and do periodic lunges, etc. to encourage the bend. Trying to enjoy each day, and not worry so much about how this will all turn out!
 
I had my TKR on Sep 1st. I have not done any PT but got back to regular activities as soon as I could. I played Pickleball and did Squats today. I couldn't even tell you what my ROM is. Listen to your knee and dont let anyone hurt you. I have managed to get down to a tylenol, once or twice a day and use ice wraps when needed. Take it easy and only do what your knee allows without serious pain. This is my second TKR recovery, so I am confident in the Bonesmart way of recovery.
 
Thanks for the encouraging note! It really helps... To tell the truth, I save lots of messages and quotes so that I can refer back to them when I really feel discouraged or nervous. ☺️
 
You are 10 days ahead of me! We all are on the same road of recovery, some are slow, some are fast. Reminds me of when my children were babies .I was so worried about their potty training, talking, etc…. When a family member said to me, when you see a class of first grader can you tell who was potty trained early? Or talk early?
When our knees are healed, did doesn’t matter who gain ROM first or last!
 
At nine weeks, I'm still struggling with my bend. I'm wondering if the tightness that I feel when I tried to push for more is scar tissue? Or just normal? The thing is, I'm getting around just fine… walking, driving, stairs, doing everything around the house, I typically do. Is there a reason to worry about things at this point? For some reason, I'm a nervous wreck about my doctor telling me he wants to do an MUA when I see him next month. :unsure:
 
I'm getting around just fine… walking, driving, stairs, doing everything around the house, I typically do.
I'm a nervous wreck about my doctor telling me he wants to do an MUA when I see him next month. :unsure:
With everything you are able to do, there is no reason to do a MUA. You are only 2 months out and are stiff. Stiffness is a sign of swelling, which I am sure you still have. You can not bend a swelling knee very well, but your function is great, so there is no reason to worry about the numbers. Function is much more important.
 
By the way, you'll notice that I have merged your two threads together as it's best if members in recovery only have one thread. We find it much easier for everyone.
This is because:
  • That way, you have all your information in one place. This makes it easier for others to go back and review your history before providing advice.
  • If you start new threads, you miss the posts and advice others have left for you in the old threads, and some information may be unnecessarily repeated
  • Having only one thread will act as a diary of your progress that you can look back on.

Please keep all your questions and updates on this thread. We won't miss your new question as, between us, the staff read all new posts each day.
If you need an urgent response to a question, tag a member of staff.
Tagging other members and answering tags

If you prefer a different thread title, just post what you want and we'll get it changed for you.

Here are the instructions on finding your thread, How can I find my threads and posts?

A helpful hint - Many members have found it useful to bookmark their thread so they don't lose it.
 
In addition to swelling, stiffness/tightness is a normal occurrence after this kind of major surgery. Your surgeon did major carpentry work and disturbed every millimeter of soft tissue in this area. You aren't tight because your muscle is underused and needs to be stretched and rehabbed. You're tight because your tissue has been disturbed and is healing...and full healing takes a full year or more.

I'm a nervous wreck about my doctor telling me he wants to do an MUA when I see him next month.
Even if he suggests it, you don’t have to consent to it.
Saying no to therapy - am I allowed to?

ROM is only one way to “measure” recovery. Your function is very good, for so early in recovery. You're doing great, so you can set that worry aside. And, just so you know, my ROM continued to improve into my second and third years post op, as my whole leg continued to relax and heal.
 

BoneSmart #1 Best Blog

Staff online

Forum statistics

Threads
64,781
Messages
1,590,817
BoneSmarties
39,126
Latest member
Martoon
Recent bookmarks
0
Back
Top Bottom