TKR Good morning! I’m new here.

[marieltha]

Happy new knee!

 

[Jockette]

I have to admit that if like to b done with it (and him) as soon as possible.)

Then be done with it. It is your knee and your recovery. You don’t need formal PT, especially if it is physically painful and emotionally stressful. Neither of those things will help you heal.

You can easily do your own rehab at home. Gentle bends and walks (though not to excess) are excellent to help regain your ROM.


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.

 

[InkedMarie]

Tell the PT to stop. It’s your body. You set the rules.

 

[Helizabug]

I agree with everyone else, so far. I can’t imagine how a knee that’s been through what ours have been through is supposed to keep up with the damage that PT person seems to be inflicting on you. Your poor knee and your poor whole self. I’m so sorry.

 

[Jenn3319]

Thank you everyone. I am going to refuse to continue this particular exercise. I can’t and don’t believe that pain to the point of tears (and I have a HIGH pain tolerance) could possibly be helpful or good for long term recovery. Your experience and support means the world!

 

[sistersinhim]

Is there something else I should be doing to work on flexion?

Yes, just walk around and use your knee in your daily activities. That's all it needs. As you feel better, add more normal activities to your day. Listen to your knee, it will tell you when you do too much. PT should never hurt, just be discomfortable. If you have swelling and pain afterwards, that's a setback and you have to recovery from that before you can get back to where you were before those exercises.

You do not have to do painful exercises. Just use that new knee the way it was created to be used, not doing repeated exercises that make no sense.

It's not the exercising that gets you your ROM, it's time. Time to recover, time for swelling and pain to settle and time to heal. One thing that seems to be missing from all the PT's protocols is that all your ROM is there right from the start, just waiting for all 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. Too much exercise is counter-productive and in the early weeks does more harm than good. Normal activity is the key to success.

 

[Wingading]

@Jenn3319 Oh my gosh, do not let PT hurt you! This same thing happened to me at my first outpatient PT appt at week 3 post-op and the PT couldn’t understand why I was crying. She pushed my knee up to my chest with all her weight to get more flexion, then she had another worker help her to push my knee into the bench to get extension! I was crippled in pain the next day. After that somehow they assigned a new therapist to me ( without me asking) and he has been gentle and stops when I tell him. I am now at 7 weeks post-op with Right TKR and making progress each week. Lister you’re all the advice from this site, it will help tremendously.

 

[Jenn3319]

Thank you all. I had a terrible night last night- couldn’t get in top of the pain- and I truly think it was because i abused my knee trying to perform as requested by the PT. Wingading - I shivered reading what your PT did. You must have been is so much pain. Sistersinhim and everyone else- what you say makes a lot of sense. I have another PT apt tomorrow morning and am ready to stand my ground.

 

[Jockette]

I have another PT apt tomorrow morning and am ready to stand my ground.

Picture all of us in the room with you, nodding in agreement and saying “Yeah, what she said!”

 

[Jenn3319]

Therapist and I had quite a discussion about the flexion exercises he wanted me to do. I told him that I was willing to exercise and stretch with discomfort but not sharp pain. He told me that pain was necessary and I needed to work through it. According to him if the pain dissipates within 10 minutes it’s perfectly fine. Rationale for all this? I won’t achieve- or it will be much harder o achieve- full ROM if I’m not willing to push my knee now. Ugh. I just reiterated that I was going to keep doing what I was doing - I.e. not crucifying my knee. Since I had gained a few degrees from the prior appointment he let it go. Thanks for all the info and support on this!

Ive decided to go back to the office for half days starting Thursday and will work the rest of the day from home with my leg elevated and iced as needed. Im going to try that for a week and see how it goes.

 

[sistersinhim]

According to him if the pain dissipates within 10 minutes it’s perfectly fine.

Discomfort is OK, but not pain. Pain is telling you your knee isn't ready for what you are doing.

I won’t achieve- or it will be much harder o achieve- full ROM if I’m not willing to push my knee now.

This is so untrue. Your ROM can improve for years.

It's your knee, not the PT's. You know your body better than anyone else does. Gentle movements are so much better for healing than painful ones.

 

[Jenn3319]

Steri strips removed today. What have you had the most success with with scar minimization? I am doing the manipulation/massage regularly that was recommended by PT.

 

[Mojo333]

Active Skin Repair Hydrogel is a product that is safe and proving to have great results.
You can click on this link to get information on how to purchase.

 

[LD of Michigan]

Yes. I am standing on this regarding my stubborn extension post TKR. I was never the most flexible person in the legs. Mainly happy that I can peddle well for now.

This is so untrue. Your ROM can improve for years.

 

[Helizabug]

I’ll be interested to hear how that Active Skin Repair Hydrogel works for you if you try it.

And I hope you can stand your ground with that PT. More and more, I am learning that things that increase swelling in my knee will inhibit my ROM until that swelling is reduced. (Just like BoneSmart says, if I understand correctly.) And just because the pain subsides in the moment doesn’t mean it won’t increase swelling and inflammation later in the day.

 

[Jenn3319]

Thanks for the recommendation - if I order it I’ll definitely let you all know how it works.

Forgive my long and rambling thoughts. Tough week this week. Ended up in ER until 1 am Wednesday night. My leg was a bit swollen during the day but significantly increased in size late Wed pm. Called and left a message for the nurse and didn’t hear back ( it was admittedly late in the day). I then called the after hours number and didn’t receive a call back. Several hours later I sent a picture to my father ( he’s a physician but not an ortho) who told me to go to the ER to make sure i didn’t have DVT. I grumbled and whined but went in. And sat- with my leg getting larger and larger- for 3 hours until they finally saw me. No DVT - good news. Saw the nurse and my PT yesterday. PT surprised me with a new exercise - which involved him forcing my leg back towards me until I was crying. I made him stop. He then did electrical stimulation. I hate this. I have addressed with him before but was caught off guard with the new exercise. I probably need to find a new PT. Drs office was apologetic - apparently the service did not pass my message to the dr. which they will check into. I’ve been advised that my increased activity is likely causing the swelling and I need to elevate and ice more. I’ve therefore changed my back to work plans so will be doing 1/2 days in the office with the remainder at home for the next 2 weeks. I have been working half days remotely for the last 2 weeks and am doing ok with that.

I am now fully understanding how unrealistic I was before surgery as to recovery needs. Why are medical professionals not more realistic about actual recovery time? My doctor would have been fine with doing my TKR as an out patient and returning to work within a week. I’m also feeling really emotionally fragile which is very unusual for me and generally not how anyone would describe me. I know depression isn’t uncommon post surgery. This isn’t depression though- more that I can’t stand loud noises, unkind words or anything that is not quiet and peaceful. Ugh. Sorry again for this long rambling post. just struggling a bit right now.

 

[Qdogpa]

I am about a week behind you from post op, but I haven’t had any forcing of the knee, let alone some electric stimulation...what was the cause of swelling? Seems odd it happened weeks after surgery, mine was the day after , but while still swollen, nothing compared to day 2-5 post op... I am with you on the peace and quiet, and will add I also just want to be left alone..time is what we need! I find my self a bit better each day, just wish I can get a few hours of sleep...hang in there, all will be fine, in due time

 

[LD of Michigan]

Yes, don't rush going back to work. I went back at 7.5 weeks, but that was ok for me as my job has allowed me to use stools more where I would normally be standing. And I came back on a cane as needed. Even still I had to get into the bed almost immediately when I got home.

And the emotional component is real too. In one of my job settings it can be very loud, and a very social environment and noticed the noise level really bothered me the first few days. I countered that by having my lunch alone so I could have some downtime instead of with coworkers.

All that bending and electronics seems highly inappropriate to me. Your knee is only a month old!

So glad you went into ER! That was a good idea as this early in your TKR caution was best.

 

[sistersinhim]

PT surprised me with a new exercise - which involved him forcing my leg back towards me until I was crying. I made him stop. He then did electrical stimulation. I hate this. I have addressed with him before but was caught off guard with the new exercise. I probably need to find a new PT.

You were doing fine until this, untrained in tkr rehab, therapist caused your extensive pain and swelling. We stress to never let anyone push or pull your knee. Never use bands to force it. The electric stim just angered your knee even more than it already was.

No PT is much better than bad PT. You had bad PT. Now, your knee needs days to recover from this added trauma to it. Stay away from PT until the swelling and pain is back down. You will find that all you really need to do is to use your knee is your daily activities. You can not force your knee to heal any faster than it's going to. But, as you have seen, you can sure set back your recovery with aggressive PT.

Run away from that therapist. If you have to have him, refuse to let him touch you and no TENS on it. Do only gentle movements. Anything else is going to set you back again.

 

[Helizabug]

Definitely find another PT, if you decide to stick with PT. I like PT, myself. My therapist makes me feel like she’s on my team.

But, at this point, if she came at me with a band or something, I’d be like ‘back off boogaloo!’