TKR Knee feeling strange

[Celle]

Here it is! It's called "Pain and Swelling Control: elevation is the key".

https://bonesmart.org/forum/threads/pain-and-swelling-control-elevation-is-the-key.7602/

I can't post it as a link, but if you copy it and paste it into the address bar on your browser, it seems to work.

Lots of lovely illustrations about how to elevate, including one about how to use a pillow stack.

I hope this helps!

PS: Oh, I see that it did come through as a link. Great!

 

[Jamie]

This really needs to stop for you. If these ignorant therapists will not follow your wishes, stop going there. They are making things worse! If you can reach 95 at 3 weeks, you're just fine. Many people have less and go on to recover just fine. You will NOT lose what you have, no matter what they tell you. Please, believe me!!! If you stop letting them abuse your tender, inflamed tissues things will improve for you.

You can do gentle bends and stretches at home without anyone's assistance.

As for the icing, you need to be doing much more of it than 3 times a day for 20 minutes. Put ice on your knee any time you are sitting or reclining. Just be sure you have a kitchen towel or something between the ice source and your skin so you don't injure your skin from the cold. It's a good idea to sleep with ice packs too....it actually feels good to most people. And it helps reduce swelling and pain - big time!!!

Putting your leg up on a recliner is not elevating it enough. You need toes above the nose. Here is a photo to show what I'm talking about. You can do the same with pillows if you don't have a foam wedge.

 

[lovebaby8]

So had my surgery September 23rd. And I'm still having intense pain my pain meds are perocet 10/325. 2 every 4 to 6 hours I do take 3 prior to pt but other than that I stick to my two and I still have intense pain and the knee still doesn't feel quite right not sure how to explain it but still a lot of tightness and still has that foreign feeling in it. How long does it take for the knee to feel uniform and where it's not so tight I know recovery takes a year but my PTs keep telling me I'm faking my pain to try to work alot less which isn't true at all. My pain has been a constant 8 and won't go below no mater what I do. Any suggestions? I'm hoping this is just all normal stuff

 

[pdx]

So sorry to hear about your pain. Does your PT know you have RA? You're also only a month out, so even people who recover ahead of the curve aren't running marathons or tap-dancing at four weeks.
Actually, my main suggestion is to call your rheumatologist and see if something else might be going on. I don't know anything about RA meds, but it might be dose/type could use adjusting.
A co-worker of my husband's has juvenile arthritis, which led to an early knee replacement. She basically had no strength in her leg muscles going in and could hardly bend her leg before the surgery, so her recovery took longer than many folks. Part of your pain might be learning how to use dormant muscles. (this is a guess.)
Hope you get the pain under control. I'm sure others will also give this advice: elevate and ice. Often.

 

[Roy Gardiner]

my pain meds are perocet 10/325. 2 every 4 to 6 hours I do take 3 prior to pt but other than that I stick to my two

my PTs keep telling me I'm faking my pain to try to work alot less

PT shouldn't hurt, it's to help healing, not to do training. If they are making you 'work hard' or causing you pain they are getting it wrong, don't go any more.

If PT hurts then you're doing damage, not helping, and your PTs should know this. So you shouldn't (need to) take painkillers prior to PT, it just enables more damage.

- rest, elevate, ice and take your pain meds by the clock
- 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.
- If you won't die if it's not done, don't do it.
- Don't stand if you can sit; don't sit if you can lie down, don't stay awake when you can go to sleep

That 'foreign feeling' does go on for ages -- after all you have an entire new knee joint! -- but does go away. Mine feel 99.9% natural now.

 

[lovebaby8]

Yes the PTs know I have RA I just don't think they understand. I just learned from the site about how pt is making it worse and I told them monday and Wednesday about this site and what I have learned and they tell me that I don't know what I'm taking about I'm giving them one more chance and if I can't get them to listen tomorrow then I'm going to drop PT all together.

 

[Roy Gardiner]

Well yeah they are arguing from authority; unfortunately there's more authority on here than a couple of PTs are likely to gain in several lifetimes (I don't mean me I just talk a lot, I mean Josephine and the real mavens on here).

 

[leejaa]

Too many PTs take it as personal success if they get the pt to do ......by ....... instead of tailoring the recovery and techniques to the patient and their medical conditions. They want to look good on their statistics and are not really looking at success for the patient which can be two totally different things. Do not let them do anything that hurts too much and do not do anything to the point of major pain. They cannot make you do anything and they should not force anything without your consent and permission or it is assault--having a license does not give you the right to do anything and does not make you the only one with expertise.

I was lucky that during both of my recoveries by in home PTs were great and were on the slow and easy and showed me exercises and did some massage when I had muscle cramps that really helped. I did not even go to OP PT with this knee but have continued to do my exercises at home and adding weights at my judgment level and riding my recumbent exercise bicycle and again at levels that I feel I can do and increasing slowly. The biggest help I had from my in home PT this time was the massages on the crampy spots and then showing me how to do some of those myself to certain points that would cramp as well as giving me the exercises and showing me how to do them correctly. The rest, pain meds, icing/elevation that I practiced almost constantly except for my few walks to bathroom and kitchen was the best help in keeping the swelling down so my knee could flex and move.

Good luck with your decision and speak up clear and loud for what you expect from the PT - they work for you. If you feel you need formal PT - are there other places that you could interview ahead of starting PT so that you know what their philosophy is for recovery.

 

[Tykey]

they tell me that I don't know what I'm taking about

Here in the old country we have a saying, "The proof of the pudding is in the eating!!".
Those of us the uk, and many in other countries, just do gentle exercises, and miracle of miracles, we recover very well and are soon back doing nearly everything (sometimes more) than we did before. (Allow 6 months at least). On the other hand, your pt is damaging you, and you are struggling with your recovery and lots of pain.

That tells you a story doesn't it.

So my advice is to kick them into touch, he or she's a plonker from the dark ages. If they argue, I always find a punch on the nose usually gets the message across. These ignorant,arrogant people make my blood boil.

 

[Josephine]

lovebaby8 I merged your two recovery threads. We prefer people not to keep starting new threads for two reasons: 1. they miss the replies they get from others and 2. we end up keep repeating ourselves because what's posted before isn't immediately visible to us. Please read this to know why we ask this One thread for your recovery please.

So having been able to read through all your posts, I can see that you are not being treated well by your PTs and are suffering a lot of excess pain and swelling as a result. That and the fact that you are only 4½ weeks out means that all you are describing is going to be pretty much par for the course. I strongly suggest you quit your PT now and do your exercises on your own with our guidance. It's all in here Some suggestions for home physio (PT) and activity progress.

 

[kneeper]

Yes, it sounds like you need a bit of a break. I agree with Jo--do your exercises at home and ditch these sadists.
As a fellow RA (JRA) person, I do know that other tissues can get inflamed around the joints. TKR is major surgery and anyone's tissues will be angry--possibly more so with RA. I think my recovery was a bit slower than average (if there is such a thing). The recovery process is an individual thing--not "one size fits all." :(
Rest, lots of the day icing, elevating and keeping the knee moving in between is the way to go.
The tight, log-like feeling can last quite a while. But it will gradually get better. And if you're like me, you eventually won't even think of the knee as "artificial."

 

[crystals5]

lovebaby8, listen to all of the veterans on here who have gone before us. I just began outpatient physical therapy and it was very gentle and I got exercises to do at home and the pt said when I get back it will be like true confessions and if I did all my exercises at home I only have to go to pt once a week which makes me very diligent in doing the at home exercises which are very gentle and are really helping me. I can feel the difference after only 3 days of exercises and I'm sure the pt will see it. I would get out of that place fast. Best of luck to you.

 

[lovebaby8]

Sorry I didn't mean to break any rules it was different question then the first one so I thought I would repost but I won't do that again ill keep everything in here.

 

[scaredinCA]

Yep the same exact thing happened to me at pt.. I printed out three little articles from Bonesmart and asked the girl to read it and give me her opinion. Well she said the same as always, I need to do my exercises, period.. And things were never the same between me and all the therapists who worked there. They resent when someone has a different opinion from theirs.

 

[pdx]

Rather than ditching PT altogether, is it possible to switch PT providers? Perhaps ask your rheumatologist and/or your orthopedic surgeon and/or your primary care person to speak to the PT folks, or to refer you to someone else? I don't know where you live, but it would be a shame to throw the baby out with the bathwater.
Yes, it's more than possible to exercise on your own. But it doesn't hurt to have someone show you how to do things and monitor your progress/encourage you.
Again, so sorry you're going through such a negative experience.

 

[kneeper]

^True, you might be able to find a more appropriate PT. I know I liked being able to check in. And my PTs (though I think they were slightly more aggressive than the bonesmart way) added/changed exercises gradually as I progressed.

 

[Pjmc]

Please ditch this PT group find another fast . Just as loudly as they made you scream tell them they failed you and caused you pain . I wish you could report them , at least tell your Doctor .

 

[Merela]

It's funny...the 1st time I read your pt experience I thought 'wow...I would never let my pt get away with that! Then I looked at your age (27) and remembered my experience delivering my daughter as a first time mom. I was 23 and a perfectionist, eager to please, wanting always to get it right. So I allowed the hospital staff to position me on my back, legs up in the stirrups against my better judgement....afterall what did I know? Turns out the 'pop' I heard was my tailbone snapping. That was more than 30 years ago and it still makes me mad. But I learned. It's my body; all rights reserved.

 

[lovebaby8]

Well I don't think pt is in my best interest today. I cooked dinner and all of sudden my ankle swelled really bad. After several hours went to get a shower had to go to a truck stop our shower is too difficult for me right now. And it took 30 minutes to get out of my car when I got home. Because the swelling and my ankle is spasming out of control and its on my right leg so I don't have a leg to stand on hehe. So today I think it's a stay at home a rest day. If I go in they won't take it easy on my ankle because they never do and I'll call around to different PTs around and see what I can do. I have medicare only so not sure if I can switch but we will see. So ice pack on ankle and knee I hope to benefit from this surgery soon lol. Glad to have this place to go to to rant it out. Im afraid when I call in they won't think I'm trying but this ankle is so bad and it wont hold up through the exercises.

 

[Tykey]

Im afraid when I call in they won't think I'm trying

Who cares what they think? A lot of the advice you've already got is not to go at all, abstain from pt for a couple of weeks and see what an improvement you will have.