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[TKR] Foot swelling at 3½ weeks postop

Discussion in 'Knee Replacement Recovery Area' started by Iloveemma, Feb 19, 2019.

  1. Iloveemma

    Iloveemma new member
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    I’m 3 weeks, almost 4 weeks postoperative. I’ve been seeing this PT person for three visits. For extension, I’m at -5 and for flexion, I’m at 118. But he has been pretty tough. When he takes a measurement, he presses on my knee in flexion and extension. And he’s not gentle. He makes me scream out loud for him to stop.
    I feel he’s pushing me too hard.
    Any thoughts or opinions..??
     
  2. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Welcome to BoneSmart!
    Big Tip - PT should never hurt! Please do not let anyone force your knee. It is totally counter productive. If it were me I would not go to this PT again. Your ROM is very good for so early out.

    Here's some reading for you. I think you will find that the approach we recommend here works a bit better and certainly has lasting results.

    Knee Recovery: The Guidelines

    1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary

    2. Control discomfort:
    rest
    elevate
    ice
    take your pain meds by prescription schedule (not when pain starts!)
    don't overwork

    3. Do what you want to do BUT
    a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
    b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

    4. PT or exercise can be useful BUT take note of these

    5. At week 4 and after you should follow this Activity progression for TKRs

    6. Access these pages on the website

    The Recovery articles:
    The importance of managing pain after a TKR and the pain chart
    Swollen and stiff knee: what causes it?

    Energy drain for TKRs

    Elevation is the key

    Ice to control pain and swelling

    Heel slides and how to do them properly

    Chart representation of TKR recovery

    Healing: how long does it take?

    Post op blues is a reality - be prepared for it
    Sleep deprivation is pretty much inevitable - but what causes it?

    There are also some cautionary articles here
    Myth busting: no pain, no gain
    Myth busting: the "window of opportunity" in TKR
    Myth busting: on getting addicted to pain meds

    We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

    While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.
     
  3. Iloveemma

    Iloveemma new member
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    Number 3 really spoke to me. As well as, assisted' heel slides, often done to the point of extreme pain with stories of patients being given pillows to bite on and to muffle their screams! It will inevitably cause excessive pain and swelling
    [​IMG]

    2. force bending the knee by the therapist - also causes excessive pain and swelling.

    When he takes measurements, he does the assisted heel slides and force bending and it HURTS. I cry out to stop.
    I’m also doing straight leg raises with a one pound weight. They kill me.
    I’m in pain most of the time. I went to this place for my right knee replacement PT.
    My fear is I won’t get the results I have with my left knee.
     
  4. Jaycey

    Jaycey SUPER MODERATOR Moderator

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    Please stop this! All this is doing is causing pain and more swelling. Rest, ice and elevate. I think you will find much better results if you do not try and push through this.

    Can you please give us your actual surgery date and which knee? I'll pop this information in your signature for you.
     
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  5. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    He is.
    Sack the baa-lamb now.
     
  6. Iloveemma

    Iloveemma new member
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    My right knee replacement was done in April 2017 and the left knee replacement was done January 25, 2019.
     
  7. Josephine

    Josephine FORUM ADMIN, NURSE DIRECTOR Administrator

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    My opinion is that you should be more assertive and tell him to stop. Better yet, quit the place!

    Also if you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?


    I'd really like to offer you some structured advice but in order to do that, I also need to ask you some questions. Are you willing for me to do that?
     
  8. Iloveemma

    Iloveemma new member
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    Yes I would certainly welcome your advise. Ask any questions you want.
     
  9. Celle

    Celle FORUM ADVISOR Forum Advisor

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    PT should never hurt. If it hurts, it's doing more harm than good.

    This is your knee and your recovery. You are the only one with the right to say what will happen to it and you have the absolute right to say STOP if your therapist hurts you. If he/she won't listen, remove yourself and your knee from their presence.

    Your knee is wounded, not lazy or unfit. All it needs is gentle movement.

    It's not exercising that gets you your ROM (Range of Motion) - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.

    No matter what you have been told, there's no need to rush to get ROM, because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
    Myth busting: the "window of opportunity" in TKR

    @Iloveemma - Your ROM is already excellent for so early in recovery. Many people will envy you. Stop worrying about ROM. Give your knee a break from this aggressive therapist and just let your activities of daily living be its exercise for a while. It needs time to heal, without being hurt and abused, and so do you.
     
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  10. Iloveemma

    Iloveemma new member
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    I’m really intimidated by my PT. He’s a guy and is strong. I’m not sure I could tell him no, don’t do that.
     
  11. Zommom

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    That’s horrible and cruel and unnecessary, I am also at 3 weeks and my PT wanted to push and pull but I absolutely refuse to let her do that. I told her my it’s my knee and my numbers not hers! My initial ROM was 75/5+. My second visit today was 90/ 3+ I got there by doing very little, some walking , some stretches etc. as my swelling is going down I am improving naturally. That aggressive approach is only going to cause you to swell and puts you back!
     
  12. Zommom

    Zommom member

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    You can fire him! If you don’t want to confront him just cancel your appointments if the ask tell them you have a different therapist. Look at other facilities if you want some structured PT that uses a gentler approach there are a lot of personnel trainers available all around or just follow some of the great options here on bonesmart. Please don’t let him hurt you. You are doing so well with your numbers now.
     
  13. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    He is doing the wrong therapy for you. There are many opinions about this rehab and his way is just that, his opinion.

    If you feel the need to go to PT, (and it is not essential like we are told) then call around to other facilities and ask about their protocol for post TKR. Keep calling until you find one that will assure you that they use a gentle approach.

    What this current therapist is doing to you is unnecessary, and counterproductive and doing you more harm than good.

    And, if you have told him to stop as he’s hurting you, and he doesn’t, then he is breaking the code of ethics beteeen patient and therapist. Please don’t see him again. This recovery is tough enough without a “therapist” like that.
    :console2:
     
  14. Iloveemma

    Iloveemma new member
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    Thanks to all !!! I have been in so much pain everyday. I will fire him. I can’t go through this pain.
    My numbers may be great but my knee hurts most of the day.
     
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  15. Iloveemma

    Iloveemma new member
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    Thank you Jockette..!! Gotta go get blood drawn for PT and INR. I’m on Coumadin. I had a clot in my lung after my RKR. I’ll be canceling my appointments with him.
     
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  16. Roy Gardiner

    Roy Gardiner FORUM ADVISOR Forum Advisor

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    There is a profanity filter on this site making it difficult to give an opinion of the person.
    Good. Shooting him might be better, but firing will have to do.
     
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  17. Celle

    Celle FORUM ADVISOR Forum Advisor

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    So phone and say you're not coming top Pt any more. Don't get into a debate. Just say your piece and then hang up.
    There are other PT places that won't hurt you.

    This guy isn't your boss and when he does things you ask him not to, he is committing assault on you.

    No means no, whatever the situation.
     
  18. Jockette

    Jockette FORUM ADVISOR Forum Advisor

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    I see you had your right knee replaced in 2017. What was the PT like for that one?
     
  19. Lindylee

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    So pleased to hear you're not going to put up with this PT any longer..he sounds a bully and a brute. You've got a great ROM already, but you would probably have got there anyway. Good luck with the rest of your recovery, I hope it all goes smoothly from here on in.
     
  20. Iloveemma

    Iloveemma new member
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    I had the same man. I was able to walk with a cane at 6 weeks. The cane was just a crutch. My doctor was impressed with my recovery.
    I would have to believe the physical therapist did many of the same things then.
     

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