MUA Is my PT rushing my recovery?

[Tykey]

Hi Snowdog. You and we all know that the aggressive PT is restricting the bend, causing you pain, and delaying recovery.
So why are you putting up with it?
I was discharged after 6 weeks with no formal PT, a ROM of 95 and improving. They sent me off with a message that I'd done brilliantly, and to just get on with my life and the maximum bend will just appear.
And it is doing!!
Kick 'em into touch is my advice.
You know it makes sense!

 

[Jockette]

If you go to water therapy, beware, it can be overdone and cause swelling and pain just the same as if someone was pushing on your knee.

I was sent to pool therapy at 4 weeks post op. The session was 50 minutes long. Yes, 50! Entirely too long, and I was told to do many many bending exercises in that time period. After that when they finally let me get out of the pool they told me to go up the steps foot over foot. I don’t know how I managed that, but I did. I had not attempted foot over foot before then.

I had 3 days of additional pain and swelling as a result of that pool session. I did not go back to the pool.

It was at this point in my recovery that I started googling “stopping therapy” and found Bonesmart. I quickly agreed with the Bonesmart gentle approach to recovery and followed it. I stopped doing specific exercises at home and politely declined some things at PT.

Because they cancelled all my pool sessions, I was left with only one “land” appointment for the next 4 weeks, and I cancelled 2 of them. I was discharged just before I was 8 weeks post op because I was able to do all the every day activities on their check list.

I don’t plan to go to formal PT in a facility next time I have this surgery. I will do my own rehab at home, and I’m sure I will recover just fine on my own, and probably better, because no one will force my knee to bend and I won’t overdo the exercises.

 

[sistersinhim]

I agree that you need to be careful in water. The water adds resistance, which is like adding weights to your movements. It is very easy to overdo and end up with lots of pain and swelling, taking days to recover from. You don't feel the extra stress on your knee when you're in the water but boy, if you aren't careful, it shows up later.

 

[snowdog50]

Hi Snowdog. You and we all know that the aggressive PT is restricting the bend, causing you pain, and delaying recovery.
So why are you putting up with it?
I was discharged after 6 weeks with no formal PT, a ROM of 95 and improving. They sent me off with a message that I'd done brilliantly, and to just get on with my life and the maximum bend will just appear.
And it is doing!!
Kick 'em into touch is my advice.
You know it makes sense!

Hi Tykey, thanks for the reply. PT is scheduled to come by again on Thur. It will be her last visit. I think my OS will be fine with my progress when I see him next Tue. I might do 1 or 2 out patient visits to PT at which point I'll reevaluate. I feel I'm better off setting my own pace for PT and eventually it'll all fall into place.

 

[Tykey]

That's great to hear
I assume your last PT session won't involve any aggression.
Good luck, you'll now recover calmly, gently and pain free.

 

[Motherbone]

@lablover64 :
At three weeks post op for my right TKR, while I was in the middle of an exercise in a physical therapy session, my kneecap fractured into several pieces. The surgeon who had to go in to do the repair (a trauma surgeon, not my original surgeon for the TKR) told me that the patellofemoral tendon was ruptured, as was the internal incision into the joint capsule. As near as I have been able to piece together from bits and pieces of information from the doctors as well as personal research, patellas can become fragile after TKR surgery, and fracture is a rare complication. However, the presence of a rupture along the internal incision line has always suggested to me that an overly aggressive PT focus on "strengthening" before I was fully healed was a contributory factor. I need to have my left knee done and I will approach PT in a much different way after that procedure. My injury was catastrophic and life changing and I hope it serves as a cautionary instruction about the risks of PT. I believe that most surgeons really have no idea of what the PT people are doing to us or asking us to do. They just write "evaluate and treat." Be relentlessly cordial but say no and act on it if necessary. I wish you good fortune!

 

[lira67]

I went to PT and told both therapists that I would do any exercise until it caused pain and would then stop. I also told them I would not permit anyone to forcibly bend my knee. They stammered something about not getting the full range of motion, that there is a small window of recovery and did I realize I might not ever walk without a limp. I said I didn't care. I would recover the knee at my own rate and if I was left with a limp, that would be on me, not them. An older woman they were treating who had had the surgery 10 days before mine leaned over and said "Good for you, dear. That's what you have to do. I told them the same thing."

When they came over with their little measuring devices to see if I had progressed since last week, I shooed them off. They asked whether I didn't want to know if I was getting better. I replied that I didn't need their rulers to tell me anything. If I feel I am bending and ambulating with less pain and stiffness, I will know I'm progressing.

By the time I left, I WAS feeling better. I wasn't in pain, my knee felt stronger and I was walking pretty well with the cane. In addition, I felt like I had made my point. I no longer feel like a victim. I think the term "PT PTSD" is right on the money. I had it last week, but never again.

This is great! I feel like I shake my head in agreement to every post here! I stopped PT after 9 weeks and back to work ft. They have me so freaked out that the stiffness is forever and backsliding. I hated their measuring constantly. Now I’m worried the stiffness when I stand up and some foot pain is a terrible sign. Thanks in advance for any words of encouragement! 14 weeks out. Some clicking still.. but original arthritis pain gone!

 

[mainegirl1]

The stiffness can persist.. Aches and pains come and go. Nothing is forever though even discomfort. Just give it a few weeks. Then try something that you were limited doing but loved pre TKR . Maybe its riding a bike or swimming. Bet you will be surprised. My ROM continues to improve after three years. I can sit on my heel now. I did not work at it.

 

[sistersinhim]

Now I’m worried the stiffness when I stand up and some foot pain is a terrible sign.

I don't know about your feet, but that stiffness is because of your knee's internal swelling and for me, it was the last thing to go. This recovery teaches us to learn patience. This is not an easy thing. What helped me was to look back and see the improvements I had made. That's where Bonesmart is good. Your thread is your own personal diary. Read back through it frequently and be thankful for where you are today.

 

[lira67]

Thank you! You’re so right! I’m loads further than what I was in July! I think my foot is how I was walking, favoring the one side for so long. I really appreciate BoneSmart!

 

[lira67]

I had left TKR on October 7, 2019. I attend PT at a facility owned by my surgeon's practice. I went twice before surgery and have been twice since. I cancelled my last appointment because I couldn't make myself go. Two therapists bent my knee forcibly and I screamed and nearly passed out. They said I am behind where I should be in my recovery and that if I didn't work it harder, I would have scar tissue and never be able to bend it properly. I am doing my home exercises, icing and medicating per post op instructions. I haven't had full ROM of this knee in over 20 years - I don't know what makes them think that I would have it barely 2 weeks post op. I reported this to my surgeon's PA and nurse. The nurse was going to call PT and tell them to ease up a bit. I am supposed to go again tomorrow. I feel sick at the thought. I don't want them touching me again. I want to do my exercises and heal at my own rate until I can go to aqua therapy. Has anyone else had this kind of pressure from PT and how did you handle it?

So sorry you’re dealing with this! I know it too well. Hang in there and speak up for no forcible PT. Geez it seems like it’s everywhere. Slow and steady wins the race!

 

[Carole4815]

@liragirl, I stopped PT after 6 weeks and my recovery after that really sped up.

@mainegirl1, sitting on your heel!!! That is truly amazing and so impressive. Your recovery is coming along really well.

sistersinhim, thank you for explaining that the stiffness is due to internal swelling! I thought it was just old age since I had some stiffness before TKR, when first standing after sitting for a while.

 

[lablover64]

Update: I ended up going in for an MUA. My surgeon changed my PT team and I went every day. The new team was much better. They were encouraging, positive, and didn't try to force my knee at all. They advised me to rest and elevate often and gave me home exercise suggestions. Before I knew it, I was able to successfully ride the exercise bike and they were as thrilled with my progress as I was! They brought me through therapy gradually and I am now walking better, sleeping better, driving better, and have weaned off the pain medication. I am scheduled to return to work at the end of this month.

 

[NewToMe]

By the time I left, I WAS feeling better. I wasn't in pain, my knee felt stronger and I was walking pretty well with the cane. In addition, I felt like I had made my point. I no longer feel like a victim. I think the term "PT PTSD" is right on the money. I had it last week, but never again.

WELL DONE
I had to do this with multiple PT people. Good for you! Gentle works!

 

[sistersinhim]

Fantastic that you now have a gentle PT team and can ride the bike. It sounds like you are doing well. What was the date of your MUA? We'll put that in your signature for you.

 

[Pumpkin]

Lablover,
Happy to hear you are on your way to recovery and will be able to return to work at the end of the month.
We do recommend a Phased return to work if possible.