TKR Jenn’s Recovery<

[Jenn]

@Josephine I’m not sure why. But that’s how it’s referred to me at each visit at or and the home health pt as a negative number. Negative, positive doesn’t matter to me. What matters is that the back of my knee isn’t flat when I’m laying supine and they want that straight as do I. I have been doing more leg hangs and quad sets to push down the knee. My exercises don’t bother me to perform. But, the force of pushing the knee is very painful.

 

[Josephine]

1. Pain level is about 2-3 at it’s worse because of swelling and fluid. For the most part very tolerable

Okay

3. swelling is moderate

Moderate swelling is equal to about a 3-4 score of pain

2. oxycodone/acetaminophen 7.5 mg every 8-10 hrs as needed

Given that you have moderate swelling, you need more pain killers than that. I suggest you don't take the oxycodone any more but take 1,000mg Tylenol 4 times a day instead as you're actually not taking enough oxy to do yourself any good!

4. range today was 107 and -6

Since you said earlier that your doctor isn't very pleased with your extension, it means that you are unable to completely straighten your knee and therefore your extension is PLUS 6 not minus! Did you see the image I left in an earlier post?

5. icing every hour to 2 hrs for 20 minutes each time

You accomplish little or nothing in 20 minutes. Ice for at least 40-60mins and more than 4 times a day.

6. elevate about 30 minutes a day

Same here - you accomplish little or nothing in 20 minutes. Elevate while you ice.

7. I do light housework, laundry, sweeping, dusting

Did you read the articles that were left for you at the start of this thread? Particularly this one Activity progression for TKRs.


Exercise at home twice daily, 4 days/week - once a day and none at all at the weekends
heel slides with strap for 3 minutes, without strap 3 minutes - that's not a good way to do them. Besides which, your flexion is already over a 100 so you don't need them. You also should never use straps
leg hang with 1lb weight for 3 minutes - also never use weights
hamstring stretch 3 minutes - these are okay-ish provided you actually have hamstring pain. If not, stop doing them


PT 3 days a week - stop PT!
Rotating back and forth with stretch on bike 5 minutes - okay
Calf raises, 3 sets of 10 - not needed, your flexion is fine
Small squat 3 sets of 10 - not needed, your flexion is fine
Calf stretch 3 minutes - not needed, your flexion is fine
Low step, 3 sets of 10 - not needed, your flexion is fine
Heel slides, 3 minutes - not needed, your flexion is fine
Heel slides with strap, 3 minutes - not needed, your flexion is fine and no straps, remember?
Kick out with bolster, 3 sets of 10 - not a necessary thing
Leg hang with 1lb weight, 3 minutes - not needed, your flexion is fine
Butt kicks, 3 sets of 10 - not needed, your flexion is fine
Quad sets, 3 minutes - not needed, your flexion is fine
Leg raises, 3 sets of 10 - once you can do these, you don't need to do them any more!
Hamstring stretch both legs 3 min each - same advice as before

Summary:
1. take Tylenol as suggested instead of the oxycodone
2. ice and elevate together and for around 40-60mins and more than 4 times a day.
3. the exercises are far, FAR too much and totally responsible for your poor extension. Stop the exercises and the PT sessions and in a few weeks, your ROM will have improved tremendously!

If you are concerned about refusing to do therapy, you need to read this Saying no to therapy - am I allowed to?

 

[Josephine]

the force of pushing the knee is very painful.

EXACTLY! This validates all I've said in the previous post.

3. the exercises are far, FAR too much and totally responsible for your poor extension. Stop the exercises and the PT sessions and in a few weeks, your ROM will have improved tremendously!

 

[Jenn]

@Josephine on icing, should I only be icing the top of my leg or the backside of the knee also?
All makes sense because when I do t have pt on weekends, swelling seems to get better.

@Josephine I forgot to ask about heat.... should I be applying heat at any point?

@Josephine with all this info, it makes me question american doctors and why do they recommend physical therapy

 

[Josephine]

@Jenn Please don't create a different post for every sentence you post to me. It's annoying when I get three tags for what is really only one post. As you can see I have merged the three posts into one.

on icing, should I only be icing the top of my leg or the backside of the knee also?

All around the knee is best, where the surgery was done.

I forgot to ask about heat.... should I be applying heat at any point?

Absolutely not!

with all this info, it makes me question American doctors and why do they recommend physical therapy

I'd love to know that too!

All makes sense because when I do t have pt on weekends, swelling seems to get better.

I don't understand this sentence. You've written "when I do t have pt on weekends" I don't know if you mean 'when I don't' or 'when I do'. Which is it?

 

[sistersinhim]

with all this info, it makes me question american doctors and why do they recommend physical therapy

I personally think it's a money thing. I believe if it was an umbrella coverage for the surgery and pt together, that some of the doctors wouldn't care if you took pt or not. I was blessed, my OS never asked a thing about PT and the fact that I never took it!

 

[Jenn]

@ Josephine that should’ve been when I don’t have pt on weekends, it feels better.

 

[Jenn]

@Josephine I apologize for annoying you with separate posts. But I don’t know how to copy parts of a message and keep a single post going. I want to thank everyone for the support and encouragement during the most difficult recovery I’ve experienced. I’ll be signing off for good. Thanks again everyone. I wish all patients speedy recovery.

 

[Celle]

@Jenn ,
This article may help you with quoting parts of a post:
How to use the quote feature

I think you also need to read this one:
How to tag another member; how to answer when someone tags you

 

[kneeper]

Hi @Jenn -- I think you're doing fine. Lots of people find that extension takes a while to achieve, but slowly but surely it will come.
I found that PT 2x per week was plenty. I did some of the recommended exercises but not as many repetitions as they wanted. You know your knee and what it will tolerate.

 

[Celle]

I’m not sure why. But that’s how it’s referred to me at each visit at or and the home health pt as a negative number. Negative, positive doesn’t matter to me. What matters is that the back of my knee isn’t flat when I’m laying supine and they want that straight as do I.

I think that PTs in the US tend to express extension as a negative number (-10 etc), as thinking of it being 10 degrees from straight.
But it's really a positive number, as your knee is flexed if it's not straight. So -10 (US style) extension is actually 10 degrees of flexion, and should be written as +10. -10 is hyper-extension.

The image Josephine posted illustrates that:

Jenn, you have plenty of time to achieve full extension, as both flexion and extension can continue to increase for at least a year post-op.

Extension often takes longer to achieve than flexion.