TKR Dr Mirkin Recants RICE

I hope this new surgery will be helpful. Take things slow and easy after it, this will be a third procedure in less than a year, so your knee has been through a lot. Give it time to heal before stressing it with a lot of exercises, as we are often told to do. Your knee will need gentle treatment even more then a knee that has only had just the one original replacement surgery.
 
Got home from surgery a short while ago. I didn’t see the doctor after so I didn’t get much information on what he found/did. I guess I’ll get that information at my follow-up. I‘m sincerely going this goes a long way to free up my ROM.
 
Mods, if this isn’t the right forum please move to the correct one.

So Dr Gabe Mirkin is the physician who coined the term RICE back in 1978. It seems he recanted his position back in 2015:


I know Bonesmart and my OS recommend icing as much as possible?

Wondering what everyone’s thoughts are?
 
The OS docs in our area all advocate using ice to help deal with pain. Dr Mirkin may have changed his mind, but I think lots of us patients really benefit from ice for pain.

When I asked my PT about this change a few weeks ago after someone else here brought it up, she shrugged, rolled her eyes and said, "Some people like to have opinions. Mine is that if it helps my patients, I think it's good. Having a knee replacement is hard enough without taking the aid of ice for pain relief away."

I felt sorry for the person who was told not to use ice; those of us who have been using it do just fine! So, that's my opinion!
 
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@BBCG I asked my PT about it too, and he said pretty much the same thing. He did say "all things in moderation" so he said after the first couple of weeks "try not to overdo it, but if it makes your knee feel better, then just go ahead" and for the first couple of weeks, ice ice baby!
 
One day I got scared I was icing too much. Probably about 3 wks out. My thought maybe it can’t heal as fast. So I decided to stop. Wow, I was in so much pain within about 3 hours I quickly got out my ice pack, lol.
 
I was watching a video by a chiropractor yesterday who explained how icing helps healing in a way that made more sense than I’ve ever heard before. He said the ice acts as a vasoconstrictor while it is in use, slowing the blood flow. When the ice is removed and the veins warm up, they pump the blood faster in order to reverse the effect of the icing, thereby stimulating healing. I’ve always heard 15 on/15 off as the icing rule which seems to support this chiropractors explanation.
 
There is a HUGE difference in treatment following an injury (which is what RICE is all about) and post-operative pain management following joint replacement surgery. Chronic or extreme inflammation and pain can slow healing and do damage too. The ice doesn't stop all of the body's inflammatory response after surgery. It just helps get the body's reaction to the trauma to a controlled state that does permit healing to take place. Please don't interpret this article to mean you should stop icing and not take pain meds after surgery!

Ask any joint patient who has tried to stop pain meds too soon or who didn't ice a painful joint about the pain levels they experience. Everyone is different in how much icing works best or how long pain meds are needed. But both are a helpful and necessary component of post-op care for joint replacements.
 
I merged your newest thread with your original recovery thread, as we prefer that members in recovery have only one thread.

This benefits you because all your information is in one place, easy to find, and maintains a nice journal for you.

This also benefits our staff, as your information is all in one place, and we often go back through your thread for previous details, so we know what you‘ve been through which helps us advise you better.

So, please keep all your posts in this thread. If you’d like a new title, let us know what you want, and we’ll change it for you. You can always bookmark this thread so you can find it easily.

Best wishes on your continuing recovery! :flwrysmile:
 
I think one of the reasons the ice machines are popular is that you get cold and compression at the same time.
 
I wasn’t allowed to ice for the first six weeks after surgery. I did elevate as recommended and that seemed to help. I am now almost 9 weeks out. I still have some swelling but my ROM is 130 and my extension is 1. I still have pain most days. I do ice sometimes now, but I find it only to be a temporary relief (just topical numbness)but elevating does seem to help with swelling combined with certain exercises to loosen the knee up. Walking helps, also. It’s a journey. I would say I still have a few more months to go until I start to feel fairly normal again.
 
Well I had the roto-rooter surgery on 14JUL, and after a couple days recovery I noticed less pain, my ROM is much better, and the joint just seems like it is smoother. Started PT this week (same therapist as previously), and she made similar comments.

Post-op is this coming Thursday - interested to hear what they found.
 
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Had my two week follow up on Thursday, the Doc said he was surprised at the large amount of scar tissue. He said they performed electric ablation to remove the tissue and minimize the chance of it coming back.
 

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