Good morning new friends

[Josephine]

Mary, if you do ring him, do be prepared for him to come back with the 'threat' that if you only have a window of opportunity of 6 weeks get to 90 and if you don't, your knee will set like concrete and never move again. We've had so many people here been told that by their surgeons and it's absolute tosh and there's more than enough evidence in this forum to prove that! I suggest you just politely say something like "I hear you but if it's all the same to you, I'd sooner try it a less aggressive way and see how it works out." Don't be scared into reversing your decision.

Myth busting: MUAs and the "window of opportunity"
It's never too late to get more ROM!

However, if I were in your shoes, I actually wouldn't ring him at all because he's already declared his approach to rehab. Remember, this is not his knee anyway, it's yours!

 

[maryo52]

Today I've decided to be happy and comfortable, to not worry, to more aggressively go after the swelling and inflammation (on my back with iced knee up). A PT friend told me if it was her knee that's what she'd do, along with ankle pumps and some little gentle stretching routine with the leg elevated. Not calling the ortho -- that's for that advice Josephine -- not because he's a bad guy but because I already know he's kinda like a garage mechanic and as far as he's concerned, the repair was successful and no doubt his attention is focused most on other people's joint which he is good at fixing.

Curious, Josephine, whether your experience and views on recovery and ROM are in harmony with the UK docs you work with or whether your views are controversial (as they would be here).

Best to all of you

 

[Josephine]

My views are not 'mine' but those propounded by the medical profession here in the UK. Quite a few of our surgeons have worked in the US and many have voiced their disagreement with approaches to rehab over there. What I preach is what I've learned from them over the last xxxx years! :whis:

 

[Tykey]

Here's a quotation from the UK's NHS guidelines:

"expert opinion supports the use of home exercise programmes for outpatient rehabilitation"

So it really IS the approach used on this side of the pond.

It's very well established, and we all get well, probably quicker, and certainly with less pain

 

[Jamie]

Be strong, Mary!!! It is an eye-opener to find that sometimes WE know our bodies better than a medical "professional." Not all therapists and surgeons are this way by all means, but there are enough that it pays to keep your wits about you and not be afraid to lay down the law.

 

[maryo52]

Curious about the heel slides . . . they're on the list of at-home PT exercises but I'm not sure the goal of heel slides. Also I notice on the kneeguru website the same kinds of fearmongering as here in the good ol' US of A.

 

[PhoenixS]

The Heel slides are for hamstring work.
I found them quite unpleasant, but they must be done.

After reading your comments, you are having a similar response to your recovery and "caregivers" that I had.

Your doc really doesn't give a rats a$$ about your post op pain. His job is done.
Your PT should not push you. If this persists, fire him/her and let your knee heal in its own time.

I ultimately fired both my surgeon and PT. (long story, it is on here somewhere)

Take your pain meds, do your little exercises, and take it easy on yourself. You will be much happier.
Sandy

 

[Josephine]

Heel slides are also for flexion too - and various other muscles. As you pull your heel closer to your body, the knee bends. It's almost the only exercise (apart from the exercycle) that is recommended here.

 

[maryo52]

Sandy, I notice you joined 12 days after your TKR. Familiar timing . . . I don't know if I need to even fire my PT. Will cancel this Friday and play it by ear. Don't see the surgeon until 12/28, that's three weeks. If I drop off the end of the earth they probably wouldn't notice anyway.

 

[Tykey]

Also I notice on the kneeguru website the same kinds of fearmongering as here in the good ol' US of A.

Kneeguru actually agree with us that you mustn't push too hard, or you'll get inflamed and delay recovery.

 

[leenie60]

Hi Friends - I go in for my LTKR this Friday so I've been poking around all areas here. My OS has said that he doesn't believe people need pain meds beyond 3 months and expects his patients to work 3 hours a day on the gentle exercises over and above whatever I might do with the home PT. I am not a fan of pain so I'm hoping that come 2.5 or 3 months if I have pain he better take care of me. He is highly recommended and the people I've spoken with say his knees are very well done. Fingers crossed. Also, he has prescribed Celebrex in addition to the Oxy IR 5 mg post discharge. Seems like a good combination, time will tell. Continued best wishes to all of you out there.

Aileen

 

[maryo52]

I would've loved a celebrex/perco combo. However, since I'm coumadin for clot prophylaxis, celebrex is out. I can't imagine 3 hours of gentle exercises above PT. I'm recovering from the little PT I did yesterday. I guess the proof is in the pudding.

 

[Kel]

I must have the exception to the rule with the physical therapist that I see. She is gentle and doesn't push me more than I can handle. She told me that her philosophy is to encourage, not discourage, and if she gave me more than I could handle I wouldn't do the exercises at home. She is right too with that!

 

[Josephine]

My OS has said that he doesn't believe people need pain meds beyond 3 months and expects his patients to work 3 hours a day on the gentle exercises over and above whatever I might do with the home PT.

Well, woop dee doo! Bully for him! He obviously never had a knee replacement! Well, you don't have to stick with him once he's done his business. You can go to your GP and get help from him. If he's not compliant, then go to a pain clinic.

As for the exercise thing, again, I disagree (everybody here knows that now) but at then end of the day it's your choice! I've never heard of anyone (who isn't an athlete) spending that much time on PT. Sure way to get a really, seriously inflamed, swollen and painful leg. But again it's your choice. I'd really love it if you did yourself a favour and proved him wrong!

I must have the exception to the rule with the physical therapist that I see. She is gentle and doesn't push me more than I can handle. She told me that her philosophy is to encourage, not discourage, and if she gave me more than I could handle I wouldn't do the exercises at home. She is right too with that!

Now there's a PT I could do business with! Just like our David (kneerus). He has exactly the same approach.

 

[DebR]

Mary, definitely back off on the PT and increase the pain meds. I am 5 weeks post-op from a RTKR. I go to PT times per week and they are VERY gentile. If it hurts, we stop, period. I do some gentile stretching at home and I have to say my knee is coming along very nicely. I have only ad my rom and extention measured once at PT. No one is pushing that, and after all the reading I have done on here, neither am I. Daily activity at this point, is more than enough. I too, had a spinal and my big toe and the one next to it still get numb, more so when the knee is swollen. Some nights I can't even stand the sheet on top of my foot. It is definitely getting better, but at 2 weeks I was taking 1-2 percocet every 4-6 hours. I am still taking 3-4 per day along with alleve which seems to help. Be easy on yourself, elevate, ice and keep those pain meds in your system.

 

[maryo52]

Today my goal was to be comfortable and happy and I succeeded. Was religious about RICE. Spent some time on my back with my leg up and flexed over a small stool with a pillow on it, and some time with the leg simply straight. Just relaxing into those positions and telling the muscles, "It's OK. Just hang out, stretch out, relax. No pressure! When you start to hurt we'll stop." The Kleenex box felt a little ignored but oh well. Tomorrow I'm calling to cancel my Friday PT. Gentle stretching and strengthening got me up to 88. PT got me down to 80. So, hmmmm, what to do, what to do!? Oh yeah. Got some compression hose. At least when I stand up it doesn't feel as if the area around the knee is gonna burst at the seams from the sudden increase in pressure. Kept my time upright to a minimum nevertheless. Plus family doc was more than happy to write me a generous prescription for more percocet.

 

[maryo52]

Deb R, I s-o-o-o-o-o appreciate hearing from another soul who's having the same big toe numbness experience. I can understand where these things might be rare, but I wish they didn't blow them off. I too cannot stand covers on my toe. I wear a sock half on so there's no pressure. Can't go without because, for godssake, we live in Maine and it be cold! So nice to have your input!!!!

 

[susanw]

Not all PT is the same. For example, I went to a clinic that includes neurofascial therapy along with all the other and more usual modalities. It was new to me and seemed a little quirky to start - but it was great. It is a hands-on touching of trigger points that help to release the facia tightness around and attatching to muscles. It was more like massage, but not quite, and it was geared specifically to releasing pain. It might sound a little "new age", but this clinic has masters degree and doctorate degree physical therapists and interns from universities - it is not a "new age" kind of place. So, I had a couple of weeks of that and passive ROM before we moved to exercise and strengtening - then moving on to trying to increase ROM with a little pushing - but not to the point of pain.

To tell you the truth, I don't know what works and what doesn't. I had 115 degrees of flexion in the first week post op - it was just what was there and easy and PT didn't give it to me. Then when I started to out-patient PT weeks later I was at 120 degrees - five more degrees from the fairies. When I finished PT I had about 125 - and I don't know if it was a result of PT or just the time passed and more pennies from heaven.

I did have some nasty IT band issues that definitely were helped by PT. I always felt better and walked more smoothly when I left than when I arrived.

My pre-op PT was a regimented series of strengtening and stretching exercises that became more and more difficult as my knees deteriorated. However that is a rant on a different issue, so I'll say no more about pre-op.

 

[maryo52]

Susan, I would've loved the indirect massage approach. My leg muscles are getting a little gun-shy.

Curious, where did you have your surgery? My mom had a partial at Anderson with Gerard Engh.

Maybe I should get hold of the myofacial release therapist in our area to help my leg feel better.

Thanks for posting your experience!:flwsm:

 

[maryo52]

I got advice from a TKR friend to talk to my ortho, and also from a nurse friend. Both said things don't sound normal. I'm about 80 flexion and it's not getting any better. When I stand up my leg feels tight and stiff. I'm in that week 4 every talks about as being when they turn the corner and I would think there'd be some change. It's hard not to wonder, even with all the reassurances from this forum, if something is wrong. Once in a while when I feel hot I check my temp and it's 99.5. The knee feels hot. The wound is all healed. I see no visible problems. Do I call my ortho? Do I ask for a second opinion? Could this all be attributed to inflammation (my good left knee is almost as unhappy as the right)? Sorry to be such a big baby.