TKR Dr Mirkin Recants RICE

[Citylady52]

Question for you seasoned pros, how long till I can sleep on my side? This back-sleeping is killing me.

I kept trying but found it was too painful until about 3-4 weeks. Use soft pillow under or in between legs.

 

[DEL2021Feb-17]

We had our surgeries same day unfortunately no champagne at midnight. I was in-patient sent home Jan3. Congrats on outpatient!!. Your surgery proves different people have different outcomes. I was able to bend my knee the very next day well over 100degrees I was measured by inhome therapist Tuesday at 127. ROM has never been an issue. This maybe your first time and there are a lot of unknowns hate to say but this was my 7th total on same knee pretty much no what to expect.
Sleeping is going to be an issue some nights will be better some well it makes for a long night. Getting comfortable is a problem while sleeping on your back is uncomfortable sometimes its the only way to get some sleep. Whats worked in the past and I still use have a pillow between your legs have the sore leg resting on the pillow.
As far as ROM goes having been thru this way too many times the way Bone Smart suggests is the best way!! Some Dr.'s nurses, therapists claim that by a certain date you should be at a certain measurement. Some therapist will claim the harder they push you the faster you will get better sorry but that is BS. Having a knee replacement is a big deal on average your in the OR 2-3 hours sometimes less it all depends on what surgeon finds. It is going to take time and lots of patience but it will get there. If you decide your going to over do it or allow therapist to go beyond what your knee is capable of you will pay for it an increase in pain and swelling.My suggestion daily activities if you do PT just keep in mind your paying them they are not paying you its your knee no one knows how you feel except you.
A reasonable time table if this is your first replacement. The first month is crummy by the 2nd its better but still not exactly fun either. Going into 3rd month you should be starting to feel a bit better your activity level will increase by 6 months some are doing great some are close some still having pain but generally by 6th month much better. This is just my experience now I am looking at 1 year maybe a month or 2 longer before I know where I stand pain wise.
Really hope you do well!!

 

[TKRsharon]

@CT-Mike I am sorry to tell you , but you need to reread the recovery guidelines Jaycey gave you. Believe me, I learned the hard way, before I found this wonderful site. They know what they are talking about. Wishing you a good recovery.

 

[sistersinhim]

Be careful on that Biodex machine. That is an awful lot for an infant knee. With having pain from it you know that your knee isn't ready for that. Your PT should have known that. Spend the time icing and elevating until the swelling and pain goes down.

 

[CT-Mike]

Went for second PT session yesterday, told therapist about the lingering pain after the previous session. Based on this he backed off on the settings for the Biodex. He also had me rocking back and forth on a bike and I was eventually able to make full revolutions forward and reverse.

Home exercises include using a strap to stretch the quad while laying on stomach, several leg/ankle raises with ankle weights, lateral step downs (these are hard), and sit to stand without using arms.

 

[sistersinhim]

Home exercises include using a strap to stretch the quad while laying on stomach, several leg/ankle raises with ankle weights, lateral step downs (these are hard), and sit to stand without using arms.

My goodness, your therapist is having you doing things that you shouldn't be doing at all. Straps are a no-no because it is so easy to harm your infant knee. Weights shouldn't be used until you are about 3 months out from your surgery. Standing without using your arms is putting too much stress on a healing knee.

It sounds like the PT you are doing is for someone in training, which you are not. You are in healing mode. Your internal soft tissues have to knit back together from where they were cut and pulled and moved all around doing this traumatic surgery. Too aggressive movements will inflame them and cause swelling and pain. Your number one job for the next few months is to heal, not train. As you heal your knee will naturally get its strength back. Don't set yourself up for a setback by overworking your knee.

 

[FCBayern]

Less than a month from TKR and your PT is suggesting those exercises? I'm guessing he's completely uninformed about how to treat a joint replacement of he is training to be the head torturer in a third world country @CT-Mike. Your are recovering from major surgery not rehabbing a sports injury. Those kinds of exercises are not only going to cause you more pain than necessary but may actually cause a set back in your recovery. I would seriously reconsider if you really want to try and go down this path.

 

[CT-Mike]

I think I will take both of your advice and push the PT out 4 weeks.

 

[FCBayern]

I think you will find that's a good decision. Lots of rest and ice with gentle movements will serve you well.

 

[CT-Mike]

I also ordered one of the cooler based ice machines for the knee, can’t wait for it to arrive on Monday.

 

[FCBayern]

That was a lifesaver for me, it was on pretty much 24/7. I used frozen water bottles, they lasted longer than regular ice and I just kept three sets in rotation, there were always solid frozen bottles when I needed a change.

 

[CT-Mike]

Coming up on 4 weeks post-op tomorrow. Based on how I was feeling and the advice above, I decided to stop going to that particular PT office as it seems they were pushing too far, too fast.

So Friday I am going to the PT office that is owned/operated by the surgeon’s office - we will see how much they will be pushing.

 

[sistersinhim]

So Friday I am going to the PT office that is owned/operated by the surgeon’s office - we will see how much they will be pushing.

There should be no doubt about it, you are the boss and you should tell them No Pushing. Better yet, hands off of your leg or foot. It's your knee and you are responsible for everything that happens to it now. Your surgeon did his job. Now, it's your job to heal the best way you can and that is without painful PT.

 

[CT-Mike]

Yesterday was 6 weeks post-op, had PT this morning - numbers were as follows:

- Flexion was 80 degrees, extension was 5 degrees.

Therapist feels we aren’t making the progress we should, and is going to talk to the surgeon about doing a MUA.

I would appreciate any and all input.

Thanks

 

[Jockette]

I would appreciate any and all input.

My opinion is that it’s too early to agree to an MUA. You are in early days, we call this the “angry tissue stage” and you recently had PT that is too aggressive for your particular knee.

Regaining our ROM is more about Time than repetitions of a list of exercises.

Time to recover.
Time for pain and swelling to settle.
Time to heal.

Our range of motion is right there all
along just waiting for that to happen so it can show itself.

In the general run of things, it doesn't need to be fought for, worked hard for or worried about. It will happen. Normal activity is the key to success.


This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."
It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[FCBayern]

I agree with Jockette, WAY to early for an MUA. It can always be done later if it's really necessary. If I were you I would at least try stopping all PT and just stick with ALD's and lots of ice. Swelling is likely the culprit to your ROM numbers and reducing it will likely increase your ROM numbers. What do you have to lose by giving that a try?

 

[CT-Mike]

For clarification, the flexion ROM was measured with me laying on my back and doing a heel slide. Is that how it is typically measured?

I do know that when I sit in to flexion (surgical side foot under chair) I can get more than 90 degrees, same with rocking the pedals back and forth on my Peloton.

If the surgeon does recommend MUA I am leaning towards following the advice above and not agreeing to it this early.

 

[Jockette]

I was usually measured laying down, too, and I could bend much better when sitting. Maybe show them that, next time you are measured.

Your numbers are not bad at all, for 6 weeks post op. They will improve with time and healing. Some PTs and surgeons want us to regain our ROM right now! But we are all different and should be allowed to give our knee the privilege of sorting itself out, on it’s own timeframe.

 

[CT-Mike]

So the surgeon‘s scheduler called me today trying to book me for a MUA next Tuesday. I told her that I have my 8 week post-op appt next Thursday and will discuss it then.

 

[CT-Mike]

7 weeks post-op today. Still having a decent amount of pain, “tight band” feeling, and overall stiffness. At PT this morning my supine heel slide was measured at 87 degrees, and 90 degrees with overpressure.

This is an improvement of 7 and 8 degrees respectively - seems like decent progress to me.