TKR Freedom works on recovery<<

[Celle]

If your PT tries that bullying and threatening tactic again, hang up on her!

 

[sistersinhim]

Shoot, they don't care about you. They just want the money. It sounds like you are headed in the right way without them!

 

[referee54]

did I know there is a window of opportunity?

Tell her , that, while you may believe in the tooth-fairy, Cupid, the Easter Bunny and such, you do not believe in the "Window of opportunity."

warned I would lose what ROM I have (that is my one fear!), I've done so well gained 20 degrees and should keep it up.

I hope you told her that you have gained a great deal of ROM, all ironically, without her help!

 

[Freedom]

I hope you told her that you have gained a great deal of ROM, all ironically, without her help!

You really believe this? That all the PT I did was NO help whatsoever?

Last inhome PT was Feb 10, with discharge Feb 24. At that discharge: 90/0.
Outpatient Pt assessment was Mar 9 regular sessions started Mar 14. On Mar 14 I was 70/12; and last Friday I increased to 90/3.

 

[referee54]

Here is what I did. I did go to PT's as I needed a protocol to get back on the baseball fields calling balls and strikes. My regimen lasted longer than others, because of that.

That being stated, however, my PT's never hurt me, nor did they ever force me to do anything that hurt. In act, there were times that the PT's had to reign me in and told me to back off on exercises. They were also very careful to monitor my activity, as I found out when I overdid things---they gave me the "I told you so..." lecture.

You can have all of the aggressive PT you want, but I did fine doing what my PT's told me to do---with no urgency and with just to the level of discomfort. My ROM now is around the 130's, and my extension is excellent (keep in mind that I had my BTKR eight years ago, which makes my PT's ahead of folks, as they already had subscribed to the "no pain, more gain" philosophy.)

You can keep on keepin' on with a rough protocol, but I can tell you that did fine without all of that. I am wondering what you would have done without the stress placed on your surgical knee.

 

[Freedom]

You can have all of the aggressive PT you want, but I did fine doing what my PT's told me to do---with no urgency and with just to the level of discomfort.

So confused. That is what I have been doing! I have told them "no hurty stuff." They only go till I say stop. I have never cried in this outpatient PT. I stubbed my toe once when leaving the pool after a session (didn't lift foot high enough for the step) and said a soft ouch. Right away she was there asking me what happened? We both laughed, when I told her.

You can keep on keepin' on with a rough protocol . . . .

I thought it was the number of repetitions which was the issue. Nothing rough about it. I think the cardio glide was something Josephine would call rough? Doesn't hurt when I do it.

Well, I've stopped the PT now, so let's just see how I do. I sure hope I continue to improve. I've only managed 2 hours of ice and elevation today, one hour of ice while on the recliner, so the elevation was not there. Gotta go do my hour before bed.

 

[referee54]

I've been told by numerous people that I should ice for 10 minutes. After that, they say I defeat the purpose as the body finds the temperature in that area is too low so it sends red blood cells rushing in to heat up the area, and that increases the swelling again.

I iced for an hour at a time on both knees. It was a great help to ice for long periods of time. It really did help keep the swelling down.

I KNOW my ROM is not good for 12 weeks out.

How do you know this? We all recover at different rates and on different schedules. While I umpired my first baseball game at five months post-BTKR, I still had a very tiny little limp. It was not until six months when I could say that I was at 80%-85% and it was not until eight months when I could say that I was 90%-95%-close to 100%.

I went to PT twice a week, and there were times that my PT's were just fine with me taking a session off here or there---they told me the same thing that people on this board have said---"You are recovering from a serious surgery' you are not training for an athletic event."

The only other activity that I did was that I went to the gym on Saturday mornings, rode the stationary bike, stretched and used the exer-bands, and stretched even more in the sauna. I then iced and iced and iced.

 

[referee54]

I thought it was the number of repetitions which was the issue. Nothing rough about it. I think the cardio glide was something Josephine would call rough? Doesn't hurt when I do it.

All of this does seem innocuous at the moment, but it all adds up to doing a bit too much.

You see, it is not just what you are doing, but also how much you are doing.

In fact, my OS told me to stay off of the elliptical machine for at least six months post-op.

 

[Celle]

They only go till I say stop. I have never cried in this outpatient PT.

It's not just the pain. It's both the type of exercise and the sheer number of repetitions. That poor knee has suffered major trauma. You wouldn't expect to do all you have been doing on a badly fractured femur,would you? Well, what your knee has gone through is as bad, even worse than that. It isn't lazy. It's wounded.

I thought it was the number of repetitions which was the issue. Nothing rough about it. I think the cardio glide was something Josephine would call rough? Doesn't hurt when I do it.

The cardio glide may not hurt you when you do it, but it is a very punishing exercise, even on a healthy knee. It makes me cringe to think of doing it, even on my TKRs, which are 18 months and 4 years old.

Your knee doesn't need it. In fact it doesn't need any of those exercises at all. I did no PT at all and no exercises for my last TKR and I only went to PT twice for the previous one (on my other knee).
Both my knees work perfectly. They are strong, with full extension and a bend of over 125 degrees.

It isn't exercises that give you back your ROM. It's time. Time and gentle treatment. The ROM is already there, just waiting to show itself, once all the swelling and inflammation have subsided.

 

[referee54]

Outpatient Pt assessment was Mar 9 regular sessions started Mar 14. On Mar 14 I was 70/12; and last Friday I increased to 90/3.

Something else to consider is that recovery is anything but linear---it is much like this:

or like this:

You will make progress and gain ROM, then, for no apparent reason, you will regress and ROM will disappear. I gave up trying to figure out what I did to backslide. I had ups, downs and plateaus. The general movement, like the picture of the stock market is up, but there are down times in there, as well as times when no progress is made. In the end, though, you will reach your destination of being fully recovered.

 

[charmed-life]

Why is cardio glide hard on knees?


Sent from my iPhone using BoneSmart Forum

 

[Celle]

Why is cardio glide hard on knees?

1. Because it involves squats, which are bad for a new knee. They exert a lot of pressure on the knees.
2. Because it involves not only squats, but squats with movement and pressure against resistance. That's like doing squats with weights. Weights are bad for a recovering knee.

 

[Josephine]

Or to put it another way, doing cardio workouts means you have to work hard enough to increase your pulse and respiration rate. Exactly the scenario we urge people NOT to engage in as such activity is hard on the knees.

 

[Freedom]

How do you know this? We all recover at different rates and on different schedules

Because Josephine said so! Please don't take things out of context, I am confused enough! LOL

It isn't exercises that give you back your ROM. It's time. Time and gentle treatment. The ROM is already there, just waiting to show itself, once all the swelling and inflammation have subsided.

Now THIS I LIKE! Thanks!

 

[referee54]

Because Josephine said so! Please don't take things out of context, I am confused enough! LOL

I did find what Josephine wrote, and the idea behind is that you are doing too much. Please take a look at her comments:

Not good for 12 weeks out.

I have added these up and you are doing 100 reps in PT and 260 reps in the pool.This is not just overdoing it, this is BOOT CAMP! I beg you to stop doing it. It's unnecessary and is only going to cause you problems in the long run. Even though you said your swelling is moderate, I would venture to suggest that you have a lot of internal swelling and that this is why your ROM is only 93. If you continue with this, you will end up with chronic issues and a poor outcome. Stop it now while you still have a chance for your knee to recoup from all this abuse.

It's 'agonizingly slow' because all that you've been doing is stalling it. Did you not read that article I left you?Did you not understand that this can only get worse?

What we are trying to tell you is very simple---you are doing way too much at this point in time of your recovery.

It is true that everybody gains ROM at different times and on different schedules. It is also true that there is nothing you can do to speed things up in your recovery. What you can do, though is to slow things down, by overdoing it, and that is what I---Josephine---and others have been trying to tell you.

 

[Freedom]

And since I have cancelled all my PT, and I am doing ice and elevate, one moderate paced 20 minute walk per day, I'm not sure why you are still telling me!

 

[referee54]

What I am telling you to do is to take it easy and gently on your knee and "stay the course"--that I agree with you canceling you PT at this time---let the knee relax and rest and recover. Do not give in to the PT and her "window of opportunity." Your knee, as Josephine has pointed out, most likely has internal swelling and it needs to let the inflammation subside so that you can move forward. Do not give in to the aggressive PT approach.

I am betting if you rest, ice, elevate, and take the course that you are on now, you will see progress.

 

[Josephine]

@Freedom you're doing well. Please try not to worry. The others are just expressing their concern for you. You see, we ALL want you to have a good outcome, in all aspects, ROM, swelling, functionality and anything else you can think of. Be patient with us all!

 

[Freedom]

Thursday morning, so frustrated, aggravated, annoyed, depressed.

I am sticking to the ice and elevate, limited walking, left knee feels good. Still VERY swollen and I feel tightness from that if I try to bend it too far. Fairly sure my ROM has increased a little bit since Saturday when I started this new routine.

Of course I am not living my normal life at this point. Last few days have been sunny and bright, cool at 50 degrees F / 10 C. If I were 'normal,' ( I mean physically, mentally my cousins often say the jury is out as to my normalcy ha haa), I'd be doing yard work. Mow the lawn; get from the DIY store the 7 40-pound bags of pelletized lime, 2 36-pound bags of milorganite and 2 35-pound bags of grass seed and put all that down. Typically a 4 hour job total, I work straight through with one 15 minute break. The dogs love it as they are out there with me, not sitting inside moping and wondering when the HuMom is going to get moving. Not this year, at least not so far. And the flower beds need a bit of attention, I wasn't able to work them last Fall. I sit and look out the window at my yard and wonder how / when it is going to be addressed.

Since about 5 PM yesterday, my RIGHT knee has been terribly painful. I am now taking Motrin and Tylenol for THAT knee, not my left. It is also somewhat swollen on the inside just below the kneecap. I didn't fall, didn't do anything different yesterday compared to the prior 3 days. Haven't been down cellar for laundry since Saturday when I started the new routine, it isn't that. I was awakened by the pain in the right knee several times during the night, took another round of either Motrin or Tylenol (depending which was next due). Just had to pause in my typing to let the 2 male dogs inside and realized I took the 2 steps up with the LEFT knee! "Good knee up" well, that is now the good one apparently.

I am sitting around like an invalid and the weeks just keep flying past.

 

[Celle]

I am sitting around like an invalid and the weeks just keep flying past.

I know how frustrating this can be! This recovery is a tremendous trial of patience. However, investing time an patience in allowing your knee take things slowly and gently will reward you many times over when recovery is complete.

It's only about 12 weeks since you had your TKR; that is almost a quarter of the way towards full recovery. It dies get easier as time passes.
Hang in there!