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Revision TKR if at first you don't succeed....<

I am happy to read that things are progressing. It sometimes takes a little time--especially when you have not been able to move well prior to surgery. But things are looking much brighter now. It is still a one year recovery, so there is time for more improvement.
 
I'm glad to hear you're doing so much better, @puppywalker . :yes!::happydance:

The first few weeks are hard, but it's all worth it for the long term improvement.
 
Keep up the good work. It's a roller coaster. And takes time and a lot of patience.


FaithMitchmommy
PKR December.1,2014
TKREV MARCH.2,2015
 
:yes!: Once you can do backward rotations, forward won't be far behind. Great to hear you're seeing improvements.
 
If your hamstrings and calf muscles are tight (meaning in spasm) you might find it helpful to ice at the back of your knee. I had this same problem and ice there was sheer bliss!
 
I can ditto that recommendation. Defiantly helped me a lot when I had tightness. I had mobility issues also do to a brace I wore. So be patient with you rehab, your muscle atrophy is going to affect it. Recover at your pace


Sent from my iPhone using BoneSmart Forum
 
The knee is still very sore today after PT yesterday - the ice at the back of the knee does seem to help - thanks for the tip! I think I'll need to have a wee word with the PT to explain that I think she maybe pushed just a little too hard. On the up side, I managed just a few forward rotations on the exercise bike today! Only maybe a dozen, but I'm learning to celebrate the tiny milestones instead of craving for the big ones that I'm not ready for yet.
 
l think your doing good,,we had our TKR same day,,your ahead of me,,l can't do the bike rotation backward ,forward,whatever,l thought l was in excellent shape before surgery,,lol did not matter l guess ,l started sleeping better again so thankful for that,l waiting on that old saying "time heals all things"I'm sure we will get where we are going just not as fast as others,,at least that's what l am holding out for,keeping it positive,,
 
I'm beginning to think that it doesn't really make all that much difference what kind of shape you're in before surgery - afterwards it's all so totally different to what you expect or what you've ever experienced before, especially the pain! When I was at the PT on Friday she measured my flexion again and it was up to 100, but I'm not all that bothered by the numbers, I just want it to work well enough to let me do what I want to without pain. I think I'm going to take 3 or 4 weeks off PT - she's quite gentle, but every time I go my knee is agony for 2 days. I want to see how I get on with just walking about and doing a few leg lifts and heel slides on my own. If things start going backwards I'm still early enough in recovery ( nearly 8 weeks now) that I'll be able to recover it again. As far as the exercise bike goes, I found I got on better if I did my stretching exercises first - it seemed to loosen things up enough to get the rotations in. It came quite suddenly - one day I couldn't even begin to do it and 2 days later I could!
 
my ROM was 65 on Friday when l was at p.t ,,l stayed a extra week at the V.A hospital for p.t since l lived alone, at that time my ROM was l think 97,,l came home 'it was 5 wks. Before p.t got arranged again because of distance,,l think l did too much on my own when l first came home thinking l was superman,,knee swollen and stiff since,,so don't over do on your own or you might start from square one again,,then again l was earlier in the process when l screwed up,,l still think l could have done it on my own but since l was offer p.t again I'll take it,,good luck,,we got a long haul I'm afraid
 
I'm really not too sure about PT to be honest. My PT is very gentle and doesn't seem to push too hard. (I cringe when I read some of the awful things that are being done to other Bonesmarties!) But even so, every time I go to see her I end up with a knee that is very, very sore for 2 or 3 days and I can't do anything. My knee is still very stiff and I'm still limping badly if I walk around the house without a crutch. I really want to stop the PT because I'm not all that sure that's it's not making things worse, but it's very difficult - the PT has trained for years to do her job and I feel like I really don't have the right to tell her what I should or shouldn't be doing - she's only trying to help after all! One slight bone of contention is that she wants me to use a cane rather than a crutch. I have a really terrible sense of balance due to many ear ops as a child and I just don't feel safe on a cane. I fell twice in the house whilst trying to get used to it and it's shot my not-very-high confidence to bits. I was scared to go out in case I fell again as I can't kneel yet and wouldn't be able to get up. I did give her back the cane on Friday last week and said I wasn't prepared to use it any more, but she really wasn't too happy about it and said that I "must" progress to a cane - why? My gut feeling is that if I use the crutch I'll go out and about and build up my strength to the point where I can just stop using it. My ROM had improved again to 100 flexion and about 3 extension, so I seem to be making progress, although slowly. I'd be really glad if someone could explain why I have to use an aid that I don't feel comfortable with. I'm not trying to be awkward but it just feels wrong for me and maybe if I could understand the reasoning behind it I could get myself over this block.
 
thanks Poppet, I had already read these. I'm an insulin-dependent diabetic so watch what I eat pretty carefully. On the whole, I think I have a fairly healthy diet. Before surgery my blood sugars were stable, but since the op they seem to be on a bit of a rollercoaster. I'm assuming that this is because of the healing that's going on. Although my sugars are a little higher than I would like, they're not high enough to indicate any infection, so I'm not stressing about it, just adjusting my dosage as and when necessary.
 
I'm not going to explain why you need to use a cane rather than a crutch - because I believe that you are right and your PT is wrong! The time to change is when you feel safe with a cane, and not before. In fact, if you are falling when trying to use a cane, trying to use one is downright dangerous.

puppywalker said:
the PT has trained for years to do her job and I feel like I really don't have the right to tell her what I should or shouldn't be doing
Click to expand...
Graduating from a crutch to a cane at X number of weeks may be in the PT's agenda - that doesn't mean it has to be in your agenda. Your knee is recovering in its own time frame, not on some theoretical one-size-fits-all schedule.

This is your knee, your recovery and your life. You have the absolute right to say what you will, or will not do. She may have trained for numbers of years, but has she had a knee replacement herself? I bet not.

Of course you have the right to tell her what you should be doing! She is putting you at risk of having falls, which would be a bad thing.

One way or another (whether paying privately or through your taxes for a health system) you are paying her. You are employing her. You could even sack her, if that is your wish.

puppywalker said:
My PT is very gentle and doesn't seem to push too hard. (I cringe when I read some of the awful things that are being done to other Bonesmarties!) But even so, every time I go to see her I end up with a knee that is very, very sore for 2 or 3 days and I can't do anything. My knee is still very stiff and I'm still limping badly if I walk around the house without a crutch. I really want to stop the PT because I'm not all that sure that's it's not making things worse,
Click to expand...
On the same theme - if you are stiff and sore for several days after PT, it is not doing you any good.

Do you remember this, from BoneSmart's mantra?
- if it hurts, don't do it and don't allow anyone - especially a physiotherapist - to do it to you
- if your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again

At this stage, you really only need to do a few (very few!) simple exercises and walk around the house as normally as you can. Forget about trying to increase your ROM for a while - it's doing OK and will improve gradually all by itself - and just concentrate on trying to walk properly, without a limp, using your crutch to help you. Reading these articles again may help:
It's never too late to get more ROM!
It's worth the wait for ROM

There's no need to rush this recovery. It's a marathon, not a sprint, and it can take a full year to recover completely, although you'll feel much better long before that.
 
thank you Celle! You've just put into words exactly how I feel. If I'm left alone I do my stretching exercises and if I'm having a better day I spend a little time on the exercise bike. I may be a bit uncomfortable afterwards, but ice and elevation soon take care of that - I'm not incapacitated for a day or so. It's all the more frustrating because she's not forcing my knee in any way or causing me any real pain during PT - the pain come a few hours later, so I don't realise it's getting stressed because it doesn't hurt at the time. I think I find it hard to say no to the PT (she's lovely, by the way!) because I have no medical training whatsoever and it seems logical that she must know better than I do, but after reading this site and listening to my knee I just have the growing feeling that I know what I need to do and just need to be left alone to get on with it! I've finally accepted that this is not going to be a quick sprint to recovery and now I feel more confident that I can manage alone. The session of PT last week left me in a great deal of pain - she started using weights on my ankles and a strong resistance band and I think maybe I'm just not quite ready for them yet. A couple of weeks ago I was able to walk round the house on one crutch without any limp at all and I'd been going out and about a little, but I've definitely regressed and I'm not a very happy chappie!
 
Have you explained to her what's happening after the session? When something like that happens to me, my PTs have always made an adjustment to try to make things better for me. It sounds as if yours might, too.

I agree on crutch vs cane. You need to use whatever support gives you stable confidence. If that's a walker, crutch (1 or 2), or cane, that's what you should use.


Jean

LTKR (Stryker Triathlon): 21 April 2015
Right Knee Arthroscopy: 25 July 2006
Left Knee Arthroscopy: 10 February 2005
 
I was only given a cane after surgery and I was ok with it. But if you feel more comfortable and safer with a crutch, by all means that's what you should be using! I can't believe a therapist would encourage and practically insist you use something that makes you feel unsafe! Ultimately, our recoveries are up to us. Others can give us advice (most of the time well-meaning), but we certainly don't have to heed it.


Sent from my iPad using BoneSmart®
 
Continue using the cane if it feels right! When I went back to the OS for my 6 week checkup, I walked in proudly with the cane and he said, "Lose it!". Nah, I continued using the cane off & on for the next couple of weeks.

One day soon you will be out somewhere and realize you forgot your cane at home. Then you'll know that you're free!
 
Hi again, @puppywalker
Your therapist may be lovely, and gentle, but obviously what she is doing is too much for your knee at this stage. She may have had success with other people at this stage, but every knee is different and some need to take a little longer than others. That's nothing to worry about. It just means that you need a programme tailored to your own needs.

I believe it's too early to start strength training, as your soft tissues are still healing. So, weights and a resistance band are not appropriate yet. Ask to postpone those for at least another month.

As you are worried about falling, perhaps you could ask her for a few, gentle exercises to help with balance? They would help with walking properly, too.

:flwrysmile::flwrysmile:
 
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