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TKR Denmother's 2nd TKR

Denmother said:
They have been added back to my rehab by my Physical Therapist who is an avid cyclist and helped me through my previous rehab.
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But has he/she had TKR? And are they medically trained on TKR physio. Just saying' and promise I won't comment further!
 
@Celle I completely trust my PT and I am only doing what is prescribed. My Ortho leaves the prescription up to him. I realize that you err on the side of caution. I totally understand. How is it thank you think strengthening the hamstrings is compromising?
 
@Jaycey I used him last time and had no problems. Is there an actual PT program/protocol for TKR? I'll be happy to quiz him tomorrow. I know he and the other therapists in the office have had other TKR patients but I think most of them are elderly and more sedentary.
 
Denmother said:
@Celle I completely trust my PT and I am only doing what is prescribed. My Ortho leaves the prescription up to him. I realize that you err on the side of caution. I totally understand. How is it thank you think strengthening the hamstrings is compromising?
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Denmother said:
@Jaycey I used him last time and had no problems. Is there an actual PT program/protocol for TKR? I'll be happy to quiz him tomorrow. I know he and the other therapists in the office have had other TKR patients but I think most of them are elderly and more sedentary.
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@Denmother
I'm going to ask @Josephine to answer these questions.
She has many years of experience as a nurse in orthopaedic surgery and she also assesses people who are suffering long term effects from such things as over-use post surgery.
 
Denmother,
This early in TKR recovery you are still injured and have inflammation around your knee, your hamstrings cross over the back of the knee, and with strengthening this early they can become inflamed and develop tendonitis.
Your muscles are inhibited after TKR, they are not weak, as you heal your strength will return, no need to "strengthen" your muscles this early.
There is no one PT protocol that everyone uses, that said, your therapist may have a protocol he uses as a guideline.
 
So I'm curious then as to what PT exercises you all deem as safe and acceptable from 6wks - 3 months.

Are there any Physical Therapists that help Moderate on this forum?
 
I think you hit it on the head when you said elderly, and I would probably add not in the best of shape, versus someone who is an athlete (no matter the age). I plan to listen to my surgeon and my physical therapist, both of whom I have total trust in.


TKR 08/26/15

Sent from my iPhone using BoneSmart Forum
 
Denmother said:
Are there any Physical Therapists that help Moderate on this forum?
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Yes.

We also have a Board of Directors, of whom several are orthopaedic surgeons who support the advice given here.
 
It doesn't matter how young or fit you are when you have a joint replacement. Your knee (or hip) still takes as long as anyone else's to recover from the surgical trauma.

Your knee is wounded, not lazy or unfit, and it doesn't need sending to boot camp until the wounded tissues have had time to heal. You wouldn't try to run on a broken leg until the bones had had time to heal, would you?

Do strength training by all means, if that is what you want, but it's asking for trouble to start that before allowing sufficient healing time.
 
Re running on a broken leg - been there, done that! I'm out - back to Nancy.


TKR 08/26/15

Sent from my iPhone using BoneSmart Forum
 
@Celle there is no boot camp involved, I promise!

PT went well today. Working on extension especially when walking. Got the okay to gently ride flat pavement for short periods. Still working on doing shin kisses as step downs are still in the future.

I did talk to my PT and discussed everyone's concerns. He has 13 years of experience and many TKR patients. I will continue to follow his prescription and remain mindful and take my time.
 
@Clipless you stand on one leg with an exercise bench in front of you and bend forward until your shin "kisses" the bench.
 
Denmother, this is not an exercise that I've ever heard of before. Can you provide more details? Maybe an image or video?

When you're on one foot and leaning forward, what is the placement of your foot in relation to your knee? And is your leg straight or bent? If bent, how much? As you "lean forward" is it from the waist, your whole body, just your leg?

Sorry, but your description has left a lot out and I would hate for someone out there to try doing this without proper information. It's really easy to put too much stress on that new knee.
 
@Jamie I'll ask my PT if it has an official name. You start close to the bench so there is minimal movement to start with. You are basically moving downward and forward and as you become stronger you move farther away from the bench. It's a pre-cursor to a step down. You are basically mimicking a similar movement pattern.

I found this video which gives you and idea of the movement involved as far as the bending.

 
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Denmother said:
Are there any Physical Therapists that help Moderate on this forum?
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Just me!
Denmother said:
How is it thank you think strengthening the hamstrings is compromising?
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One word - experience! The reason I am so busy on the forum all the time is that people like you do crazy things like this and then come back complaining of aches and pains all over the place. It never ceases to amaze me how people think that doing excessive exercising on a newly operated-upon knee doesn't have consequences - it does. And most of the muscles around the knee and hip suffer them in spades!
Denmother said:
I know he and the other therapists in the office have had other TKR patients but I think most of them are elderly and more sedentary.
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Speaking as an 'elderly' TKR patient, I take great exception to that assumption. Not all elderly people are sedentary. I still work and I am as active as I want to be.
Denmother said:
So I'm curious then as to what PT exercises you all deem as safe and acceptable from 6wks - 3 months.
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I am of the opinion that NO formal exercises are necessary - especially dangerous ones like the unsupported one legged squat you have described. I have proven this twice now and I have a ROM of 135/-5 in both knee (would be more but I have fat legs!!).

The truth of it is that one does not have to 'work hard' for ROM and there are more and more knee surgeons who are realising this and not requiring their patients to do anything other than rest, icing and elevating in the first 3-4 weeks and normal activities and walking thereafter. Many are quoted by members on this forum.
I recommend you read my recovery threads to see how little exercising I did!
First knee. Knee recovery - UK style
Second knee. Josephine's 2nd knee story - short version where I did even less!
 
7 weeks post op!

  1. Able to walk without the cane (still keep it close by for when I get stiff/fatigued)
  2. Got the ok to ride flat pavement with flat pedals on my mountain bike for short spins
  3. Working on 1 legged calf raises, can do 5 single legged then have to do the 2nd 5 with both legs.
  4. Straight Legged Deadlifts with 30lbs.
  5. Stepdowns from a 2" heighth!!
  6. The PT is alternating mobility between extension and flexion. The extension still needs more work so that the knee doesn't feel like it's hyperextending when the leg is straight while walking.
Happy for the progress and taking it easy.
 

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If you choose to use weights (and 30 lbs at that) it's your choice, but I hope others won't follow your example.
 
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