Diane's Knee Quest finally the real deal

[dianehelen]

Hehe ya make my own darn rules

 

[newlybionic]

Ya got it!

 

[birdwatchr]

I only had to sleep with my leg straight in a foamy thing. Waking hours, they just warned me not to have pillow right under the knee; make sure it was lower down. Depending on the pillow(s), it was pretty comfortable with a little bit of bending.

 

[sistersinhim]

They said the same thing in my class about keeping my leg straight. PT even said if they catch anyone with a pillow under the knee they were going to put one under their heels. We all know how much that would hurt! But I had so problems at all. I just balled up the sheet a little bit under my knee. No one ever said anything. I wonder why they all say that?! What is so important about keeping the leg completely straight! It doesn't matter one bit. There again is ignorance causes torture!

 

[dianehelen]

What is so important about keeping the leg completely straight!

It makes ya wonder why they are all so obsessed with it? I dont get the idea of a pillow undef your heels? How would that hurt?

 

[newlybionic]

It forces your knee extension to be on the hyperextended side. It's even worse than keeping it straight. Pain wise that is.

 

[dianehelen]

Ahh under heel instead of under knee, gotcha. Huh, torture huh? Ok then not happening in my world , they can kiss my fat you know what ( ! ) . I dont accept torture

 

[dianehelen]

Ughhh new (or maybe old) problem , litterally pain in my butt.

@Josephine I know we discussed this a long time ago on the hip side, but Im posting here, in regard to my upcoming knee surgery.

Starting yesterday, and progressively worse today is a pretty severe sharp & constant pain deep in my left butt cheek. What really troubles me is how painful it is to walk, with the pain radiating as I walk towards the front but not down my leg. I had something like this before, and believed it was piriformis and/or sciatica. But with my LTKR just a month out Im concerned about this. My deepest inner worry is that it is not the piriformis or sciatica but a malfuncion or something of the hip, ya THAT hip. I did in the past get relief from my chiropractor for this, but the pain was confined to just deep in the butt cheek. This feels the same in the butt cheek, but the pain towards the front when I walk is very troubling. When sitting the butt cheek pain is constant, and like throbbing, maybe a 7-8 on the 1 -10 scale but the pain towards the front is only when I walk. Any ideas, thoughts, suggestions?

As always, thanks for your time and your help.

 

[Josephine]

This feels the same in the butt cheek, but the pain towards the front when I walk is very troubling.

Yes it's piriformis. It can radiate all over the place. If your chiropractor helped you before, go back to him. But it's not your hip.

 

[dianehelen]

That's a relief, but I know I'm pushing my luck and taking your time - what is making you so sure it is not the hip and is the annoying piriformis?

Thanks as always for your time & wisdom

 

[LoveGiants]

My hospital had a staggered foam thingee to elevate our knees. They wanted a slight bend.

In my pre-op class, the instructor was a PT and it was funny when she said that our OS (all of us in the class had the same OS) doesn't think patients need PT and added in a humorous tone, "but I'm not offended!"

 

[dianehelen]

How interesting and odd the differing opinions on elevation straight vs slight bend. The class person seemed Gestapo like in her demand for perfectly straight
To the point of threats that we would never heal well or have good outcomes if we disobeyed grrr.

 

[uva55]

I'm so tired of elevating and keeping the leg straight, I find it very uncomfortable myself, I am religious about doing it but I don't like it, specially while sleeping I would love to bend the knee a little. I asked my PT if at this point I could bend while sleeping and she said it would be better if I kept my leg straight, I swear I felt like pulling her hair and sticking my tongue out at her, just kidding, hahaha

 

[newlybionic]

I always did what ever I needed to do with my knee to get comfortable enough for sleep. I didn't just put a pillow under my knee but I've tried sleeping on both sides and my back. I tried my bed and my recliner. I was happy to be able to get some sleep.

 

[dianehelen]

The debate goes on. Elevate straight or slight bend. @Josephine can you weigh in on this? I know the bonesmart recommendation is not straight. Why do so many OS's demand straight. It's so confusing/perplexing

 

[Josephine]

But the part that concerned me, was how much they stressed keeping the leg straight and no pillow under the knee, or when elevated which I know is contrary to what Bonesmart success stories, have shown time & time again. They said my Dr is very adamant about this. So I guess we shall see how this plays out.

She said if you don't keep it straight, while elevated you would not have a good outcome

I wonder why they all say that?! What is so important about keeping the leg completely straight!

To answer these collectively, the opinion that a straight let is good stems from the same mentality that we should "work through the pain regardless" and "the window of opportunity". They arose some years ago when professionals pretty much made up their own protocols about these and other issues and weren't really required to substantiate their opinions with research evidence. Not that there has been much research but you get my drift. Nowadays the emphasis is very much on evidence based practice. So doctors, nurses and other allied professionals still stick to these old opinions, kind of old wives' tales kind of thing.

But to get back to the actual topic: the notion about keeping a leg straight was based upon the assumption that laying for long periods of time with a knee bent would encourage a stiff knee which wouldn't easily be corrected. But as in all these issues, 'not having the knee bent' went between these two kinds of extremes. No happy medium.

This is clearly ridiculous as one should be cognisant of the patient's comfort and of not aggravating or intensifying swelling and pain. I believe that a mind that cannot make that obvious adjustment needs therapy!

My hospital had a staggered foam thingee to elevate our knees. They wanted a slight bend.

Excellent! You see, some do have common sense! Besides which, it's not like the patient is going to lay like that for hours at a time, is it?

Ya but will they give me a hard time about the straight part?

The answer is simple - don't tell them! I never did!

In my pre-op class, the instructor was a PT and it was funny when she said that our OS (all of us in the class had the same OS) doesn't think patients need PT and added in a humorous tone, "but I'm not offended!"

Well a sensible surgeon and a stupid PT!

what is making you so sure it is not the hip and is the annoying piriformis?

For the simple reason that those symptoms are not in keeping with something wrong in your hip and that piriformis is a very common problem.

 

[Josephine]

Folks, can I also point out that it's unnecessary to quote a post just to reply to it, particularly when it's the post immediately before yours.

Unless there is some specific phrase you want to address, of course! Then do it like this How to quote a post.

Thanks for understanding!

 

[dianehelen]

@Josephine thank you for always being here to share your wisdom and fierce measure of logic & common sense. I'm going to (virtually/digitally) take you to the hospital with me, and when they try to "fight" I will wave you in their face hehe.

Btw also thanks for the piriformis reassuring thoughts, it does seem to be easing up a few days out. Should I be concerned that a flair up of this might hinder my recovery post surgery? Oh, also , I remembered 2 days before this last flair up, I tried to step up my pre op exercises. My info sheet from the OS suggests 10 reps 2-3 times a day, and I am no where near that. I can't do the heel slides at all, so I've been trying to focus on things like 10 second hold straight leg lifts. Sunday I did like 6 of them, and Monday my thigh felt sore, then Tuesday the piriformis flair up began. Any way these are related?

 

[Josephine]

Oh, also , I remembered 2 days before this last flair up, I tried to step up my pre op exercises. I can't do the heel slides at all, so I've been trying to focus on things like 10 second hold straight leg lifts. Sunday I did like 6 of them, and Monday my thigh felt sore, then Tuesday the piriformis flair up began. Any way these are related?

I am surprised beyond reason that you even asked that question! Of course they are! Stop doing any exercises - you don't need them. All you're doing is aggravating other tissues - like the piriformis!

 

[dianehelen]

@Josephine YES M'AM! thank you AGAIN for the duhhh moment. My only exercises from now till surgery will be my regular gentle swimming, and lifting my wine glass to my MOUTH!

Cheers!