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MerlinWizard

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@MerlinWizard I think I read about Tylenol causing kidney/liver damage so I was worried about taking such high doses, but after reading here that most everyone has had success with it, I am forging ahead. I had good luck with the Oxy and the Hydrocodone, but the spaced out effects were very uncomfortable for me, I didn't really enjoy that, plus my appetite was affected. What really is troubling to me is the reaction of my knee right now. I didn't realize how sensitive it is to PT exercises and how reactive it is. I wasn't using weights and I wasn't being excessive in my mind, but obviously my knee felt differently.

I think sometimes we read and over inform ourselves. I am definitely guilty of that. I read up on the regimen of Tylenol and it's a "thing" used by orthopedists as alternative pain relief. There are studies that show it works in most patients. As far as kidney/liver damage, I always talk to my primary about medication someone else prescribes me. If she is concerned then so am I.

At some point, we have to be willing to let the doctors be doctors and ourselves to be patients.

I always thought PT was good pain until I got home and things felt horrible. I look back now and it was all good pain, just part of the recovery process. It isn't a pain free experience and I don't subscribe to what some people believe that if it hurts don't do it. We can all endure a certain amount of pain and when the doctor tells you that there is nothing you can damage in there through PT, despite the pain, I believe they know what they are talking about.

That doesn't mean we don't all reach for some relief when we get home though!
 

kneeper

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Every medication has its risks. NSAIDs can cause ulcers. All meds should be used with caution and a doctor's supervision, especially if used long term.
 

Jamie

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I think I read about Tylenol causing kidney/liver damage
This is a warning usually directed at people who have current liver or kidney problems or those who exceed the maximum recommended doses. As long as you have no current liver or kidney issues, you stay within the maximum of 4,000mg in any 24 hour period and your surgeon is aware of what you're taking, you should be fine.

I wasn't using weights and I wasn't being excessive in my mind, but obviously my knee felt differently.
I'm glad you've realized this. During the early stages of recovery, there is no need for weights as you're not strengthening yet. The weights might seem like nothing, but as you've found, the pain or swelling can come later.

when the doctor tells you that there is nothing you can damage in there through PT, despite the pain, I believe they know what they are talking about.
When a surgeon is telling the patient that there is nothing you can damage in your joint by physical therapy, he is referring to the joint itself. The metal implant is sturdy and you will not damage it. But, it most certainly is possible to damage soft tissues with aggressive therapy that creates pain. We've seen patients where a therapist has literally torn muscles or ligaments or the patient ends up with chronic pain issues because they pushed too hard over an extended period of time. So, while I understand and agree with MerlinWizard's point that therapy will hurt, it's best not to allow that "hurt" to go beyond mild discomfort while you're doing it and no additional pain in the 24 hours following therapy.
 
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Reader525

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@Jamie You are so right when you say you shouldn't feel pain, just discomfort. I think back on my PT session on Monday, I was put on the stationary bike for my usual 10 minutes and he put the level on 5 where previously the highest was 3. After about 4 minutes, my leg felt "tired" and uncomfortable. I tried to turn the intensity down myself while still pedaling, but I couldn't figure it out. I decided that if he put it to 5, maybe he knows best, so I kept going until the 10 minutes were up. It was the next day that the back of my knee really got worse.
Shame on me for not speaking up, and shame on me for not speaking up to my husband and telling him I'm not ready to walk the 2 dogs and he should do it.
 

Jamie

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You've got it, Reader! I see the light bulb above your head. :heehee: It's easy to forget this simple recovery fact, but once you realize that listening to your body's signals is the best way to achieve a good recovery, you're in good shape.
 
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Reader525

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@Jamie @Jockette I have a question... Taking into account that we are all different, when do you think is a good time to start strength training in physical therapy. When one is still hurting and sore, should one be doing leg raises and band work? Or should one wait until the soreness is gone. I have not done any PT since last Wednesday due to the inflammation and soreness I developed after doing the above mentioned exercises. I am still sore when I walk and although it is better, I am loath to put myself in that situation again. I sure could use some insight. Thanks!!
 

Jockette

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I would wait until I had healing well under control and had a good handle on doing my daily activities without pain.

Personally, I am not an “ exercise person” so for me, I’d let doing the things I do every day be my strengthening efforts, plus some waking.

I think well after 3 months, if not longer, is better for trying to do actually strengthening exercises. As you said, we are all different, and, your knee has not liked the exercise regime that you’ve done so far, and it needs to recover from being overworked from that, so it may take longer for you to get back to it.

Take your time and, to quote our former nurse director, Josephine, ”Give your knee the privilege of sorting itself out, it will if you give it a chance. The trouble is, most people don't give it a chance.“ As you’ve seen, trying to do too much, too soon, slows down our recovery because we have to recover from the set back it causes.

This is a year long recovery, on average. 2 months is 1/6 the way healed. :console2:
 
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Reader525

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@Jockette Thank you so much for the advice. Today I'm going to PT, 8 more visits to go including today. I don't know how what the reaction will be but I'm going to tell them I need a break. I honestly don't think working as hard as they want me to has brought me anything more than pain. No wonder I can't walk without soreness, all my tissues are screaming at me to stop.
Sunday I vacuumed and mopp d, changed sheets and did laundry, dragging my sore leg around like an anchor. It's not as if I don't do things, but to do leg raises to strengthen my quads seems a little counterproductive to me.
Without BoneSmart I don't know where I would be.
 

Sisterpat

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Stay strong in your resolve and ignore all the threats and dire warnings you’re liable to get from PT. This is YOUR knee, YOUR recovery. Take control.
 
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Reader525

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@Sisterpat I will, and I'm sure I will be met with that face we all know...the disapproving eyes and all. I'll be strong. Thank you!
 

Jockette

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Sunday I vacuumed and mopped, changed sheets and did laundry,
To be very honest, this is a lot for you, with all the pain you have. My husband wouldn’t let me vacuum for months, he helped with the laundry, and changed the sheets. :roseshwr:
I don't know how what the reaction will be but I'm going to tell them I need a break. I honestly don't think working as hard as they want me to has brought me anything more than pain. No wonder I can't walk without soreness, all my tissues are screaming at me to stop.
The reason we go to PT is to help us recover and give our knee movement. You are doing that at home with your daily activities. I was discharged at 8 weeks, which is about where you are now. If all they are doing is keeping you in pain, what’s the point in going?

People are all different, as are the approaches to this recovery and rehab. The key is, “Find what works for you.“ Your doctors, PTs and BoneSmart are available to help, but you are the final judge as to the recovery approach you choose.
 

Jockette

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I realize you are only doing what you think is best for your knee, and like all of us, you’ve trusted your medical team to tell you appropriate things to do to help you recover. The only “problem” with that is, there are many opinions on how to recover.

When we still have a lot of pain and swelling (some is to be expected for a while) that’s when we have to stop and consider our body’s reaction to what we’re doing. The knee is in charge of this recovery, not us, not our PTs and not our surgeon. We need to listen to the one in charge and do our best to keep it happy. To change an old saying, “if the knee’s not happy, ain’t nobody happy!”

I was overworked by my PTs which caused me set back after set back. If I ever do this again, I will do my own gentle rehab at home, and I’ll recover just fine.
 
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Reader525

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@Jockette I wish your husband would give my husband lessons, you are very fortunate. Mine is kind of in a fog about the obvious.
I wish the physical therapists didn't apply a one size fits all approach. I realize mine are employees of the orthopedic surgeons in the practice and if they told the patients we shouldn't do the strengthening exercises, they would be out of a job.
You're right, this knee is the boss and she's miserable right now!
 

Jamie

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Jockette is right. For most people it's best to wait to start strength training until you are at least 3 months out from your surgery. If a person is still having pain and swelling at 3 months, there is nothing wrong with holding off a while longer. Everyone's body heals differently.

Strength training is different from the post-op exercises you do to activate and improve the quad muscle functioning. Strength training would employ the use of resistance or weights at increasing levels. This is what you need to hold off on doing for a while.

There is nothing wrong with doing some basic quad exercises with your therapist now assuming you're watching how much other activity you're engaging in. The exercises should never cause you more than mild discomfort while you're doing them and no pain later in the day or the next day. If you get either of these things, you're not ready for that level of activity yet.

The thing is to add activity and exercises gradually as you recover. Please know that your household chores like vacuuming, laundry, dishes, cleaning, and cooking ARE exercise. Be careful how much of that you do in a given day. If you're "dragging your sore leg" along, you know this is not a good thing. You're just going to get more pain.

It's your call whether you go back to therapy or not. If you do go, just be sure the exercises are done in a way (no weights or resistance, fewer reps in the sets) that your knee can tolerate them without having additional pain. Don't be afraid to set these limits with your therapist. You know your body better than anyone.
 

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I am here to tell you to not overdue the therapy. I have posted on my thread about my experience at my 1st out patient Physio so won’t repeat the details here but a month later I am still recovering from the setback.
I too could kick (if only!) myself for allowing the Physio to be so aggressive which resulted in painful inflammation of the internal soft tissues and tendons. I’ve not been back on my own surgeons advice! You know best and you have to be your best advocate for your healing. It’s your body, your recovery!! Stay strong.
 
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Reader525

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@patriciad How awful for you and i know what that's like. If you read my first posts here you will see I had a nurse Ratchet as my first PT. After a lot of incredible support here, I mustered my courage and went to someone else for my PT.
@Jamie So interesting to realize that daily activities really are exercise. I went to my appointment a little while ago, and I told them my knee obviously is unhappy and that I learned over the last 6 days that I am walking better and that my pain is less without pushing myself to do weights on my leg raises and band stretches for my legs. We decided I would go back after a few weeks to fine tune my walk, but for now, no more.
My question to you is, at home, would leg lifts and standing lifts WITHOUT weights or bands be a good thing to do once my soreness is gone? Does this type of movement build any strength?
 

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Yes, You can start with 3 sets of 10 reps each of these exercises at home. If there is no pain the next day, you can gradually work your way up to 25 reps in each of the 3 sets. Just pay attention to what else you're doing each day you do these exercises. Errands and household chores as well as walking all count.

Quad exercises
 
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Reader525

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@ Jamie Thanks! Should I wait for 100% of my soreness to be gone, or should I perhaps when it lessens?
 

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I quit PT at 5 weeks as it seemed to set me back each time with swelling and pain. (My eyes about bugged out reading about all the exercises they make you do so early in recovery!) I am just getting on with my life, gardening, bee keeping and normal daily things. My ROM is not great but is gradually improving, I go up and down stairs normally unless I am tired. The worst activities are sitting or standing for too long, that makes me stiff and sore for a while. I felt like at 4 months exercises began to feel more "normal" and not painful. I am at 6 months now and still having setbacks when I get over ambitious. I also have some behind the knee pain when bending, I think muscle tightness is a big part of that. Slowly but surely it is getting better.
Take it easy and best wishes.
 

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