PKR Loose implant!

[Archbarn28]

Hi! I had my 2nd mako PKR done on my left knee on October 23, 2018. The right was done about a year ago. My PT pushed me really hard yesterday and even though I let her know that she was hurting me she continued and pushed further. I asked her to stop but she just said that the pain is good and focus on it and overcome it. I was in sheer agony while trying to sleep last night and today I am in horrible pain! Do I call my Ortho doc or should I let this subside on my own? I have another PT appointment tomorrow and hope the pain will lessen. If it helps the part of my knee that was replaced was the inner knee.
Has anyone ever had this happen? I certainly do not remember this happening with my right PKR. Any advise would be appreciated! Thank you!

 

[Larryhg3]

Oh that is completely unacceptable. When it hurt and you asked them to stop that should have been the end of it. I would start tomorrow’s session (if you are recovered enough to attend) by laying down the law. That conversation needs to be very firm and very clear.

I asked her to stop but she just said that the pain is good and focus on it and overcome it.

Is the biggest load of **** ever. I would insist that the PT’s supervisor be part of that conversation. Make it clear that you won’t stay at a practice with that philosophy.

I am sorry that they hurt you because that is NEVER okay. PT is not about pain it is about recovery and the two are mutually exclusive. The good news is that they work for you. You are in charge.

 

[Pumpkin]

@Archbarn28
Welcome back to BoneSmart!

I have another PT appointment tomorrow and hope the pain will lessen.

Suggest you cancel this appointment and let your knee settle down. If you return to PT ask for another therapist, who is up to date on knee replacement recovery and who respects your knee.
You did not have all this pushing, shoving, pain, and swelling, with your first PKR and are doing great. All this pushing and shoving is setting this recovery back, making you miserable, and doing nothing for your long term outcome.
Saying no to therapy - am I allowed to?

Archbarn28,
Please clarify your surgery dates, I noticed for your first PKR you posted this:

I had a partial knee replacement on September 19, 2017.

Your signature lists September 29th. Please clarify your correct date, a moderator will up date your signature for you. Thanks!!

Here is your copy of the recovery guidelines, the articles are short and will not take long to read.

Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest
elevate
ice
take your pain meds by prescription schedule (not when pain starts!)
don't overwork.​

3. Do what you want to do BUT
a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise
BoneSmart philosophy for sensible post op therapy​

5. At week 4 and after you should follow this

Activity progression for TKRs​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs

Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly

Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds


We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery. While members may create as many threads as they like in a majority of BoneSmart's forums, we ask that each member have only one recovery thread. This policy makes it easier to go back and review history before providing advice.

 

[Jockette]

That “therapist” was extremely unprofessional and if it was me I would not set foot in that office again.

Next time I will not be going to PT, I will rehab my knee on my own at home. I have also been hurt by a PT. It’s not necessary.

 

[Celle]

My PT pushed me really hard yesterday and even though I let her know that she was hurting me she continued and pushed further. I asked her to stop but she just said that the pain is good and focus on it and overcome it. I was in sheer agony while trying to sleep last night and today I am in horrible pain!

That therapist was out of line. You asked her to stop and she continued. Technically that was an assault.
If there's ever another time like that, don't ask her to stop - tell her. And if she won't stop, get up and walk (hobble?) away. Remove your knee from her attention.

It's your knee and you have the right to say what happens to it. You are the boss. She works for you and she has to please you, not the other way round.

Pain is never good. It's counter-productive. It will make your knee swell more and may slow down its progress.
Myth busting: no pain, no gain

Do I call my Ortho doc or should I let this subside on my own? I have another PT appointment tomorrow and hope the pain will lessen. If it helps the part of my knee that was replaced was the inner knee.
Has anyone ever had this happen? I certainly do not remember this happening with my right PKR. Any advise would be appreciated! Thank you!

I don't think you need to call your surgeon, but I do think you need to cancel that next PT appointment. Instead, spend that time resting, icing and elevating your knee, to help it recover from the abuse your PT therapist subjected it to.

Unfortunately, there seem to be too many over-aggressive PT therapists and we've had a lot of people treated as you were. It's simply not acceptable and it's bad for your knee.

You can give your knee all the exercise it needs, just in your normal activities of daily living, or you can look for a different PT clinic that will respect you and your knee. You don't have to allow any therapist to treat your inee like that.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

 

[sistersinhim]

Shame on that PT. That pain has set back your recovery. Don't go back. You don't need that kind of treatment. You can interview offices by phone and find one that doesn't use aggressive therapy to rehab a knee replacement.

 

[Rsmach1]

All I can say is when I started my recovery process I blindly followed the PT's lead, and it turned out to be the biggest mistake I've made. In my book PT stands for pain and torture ! Since I started rehabbing the Bone Smart way, and heeding advice given here, I have improved greatly!!

Best wishes, feel better.

 

[Archbarn28]

Hi again!
I am so confused! I spoke with my PT, she said it's my fault it hurts because I'm not moving enough and my gait is wrong. I can't figure out what's worse, moving or not moving either way my knee hurts! It felt better immediately after PT today but within a few hours after sheer pain. I'm taking it easy today but I'm in pain. What to do? Help!!!!

 

[Jockette]

All you can do is try different approaches. You’ve tried the PT approach and have additional pain.

It is not your fault it hurts, you recently had a major surgery that caused major trauma to your leg and now it needs gentle treatment and time to heal.

Try the Bonesmart approach and see if you feel better. Take some time off from going to PT, more than just a day or two, more like at least a week or two, and just move your knee at home, at a comfortable pace, and do your daily activity.

Reread the articles we gave you and take them on board.

I am going to tag @Josephine
our forum administrator and nurse director to address your concerns.

 

[sistersinhim]

If it hurts during or within 24 hours after taking PT, then you are doing too much. Don't listen to that PT. They love to put us on a guilt trip. Your gait will improve as your knee heals.

 

[Archbarn28]

Thanks! I dont have PT until Monday. I'll see if my knee feels better without and let you know!

 

[kmak81230]

I agree with @sistersinhim. You have plenty of time to work on your gait. You are still in the early stages of healing. It will be hard to have good walking gait if your knee is so swollen and inflamed from painful PT. I was too aggressive with my first TKR in the first 4-6 weeks which I think set back my recovery. With this one I am taking the gentle approach - I go to PT but my PT does not believe in aggressive therapy (just gentle stretching) and we are not yet working on gait. Hang in there

 

[Celle]

Don't listen to that PT. They love to put us on a guilt trip. Your gait will improve as your knee heals.

sistersinhim is so right! It is not your fault that you are hurting.

You are hurting for only two reasons:

1. It's only just over a month since your knee had major surgery. It is wounded, not lazy, and it's still healing.
2. The exercises you were told to do are too demanding for this early stage in your recovery.

With that attitude, I don't think this particular PT therapist is the right one for you.

It is your body and your knee and only you have the right to say what will happen to it. In this situation, you are the boss. You have to speak up on behalf of your knee.
You don't have to please your therapist - she has to please you.
You have the right to choose the type and amount of PT you will have and your therapist has to respect your wishes.
Saying no to therapy - am I allowed to?
CONSENT: what it means and how it can be used

 

[Josephine]

Listen to all my staff - they know what they are talking about

a) because they've been there also
b) because they know
c) because they've also been taught by me!​

It's right that your PT is telling you you're being caught between two extremes, doing too much and - in her eyes - not doing anything. There is a happy medium, the BoneSmart way!

 

[Larryhg3]

Jumping onto the band wagon. Your PT is absolutely Wrong. It may be time for you to find a new one, you realize you can at any time right? You are very early in recovery and need to be gentle on that baby knee. Therapists like yours give them all a bad name. My therapist for Lefty proudly declared that she was very aggressive. I found BoneSmart a week later and she soon found that I am very resistant to aggressive. After a candid discussion with her and her boss we changed my recovery plan. For Righty I have a therapist who is right out of school and he uses the newest methods for TKR. Yup you guessed it they are now taught to use a gentle approach with TKR. I think Josephine and the admins wore them all down.

 

[Lefty57]

First knee I threatened to kick my Pt when it got to hurt,, I meant it,, second knee I rehabbed myself at home..
Don't let them hurt you,

 

[Archbarn28]

I am so achy, tired and depressed! I cant figure out what's worse if I do nothing I'm afraid it will freeze up and need more surgery ...thanks to PT telling me so! Even if I just do gentle things at home such as rock n roll on bike, knee slides and quad stretches I'm just hurting! Right now I'm an 8 and I can't think straight! Bad or no sleep is killing me! Sorry to complain ...I'm a mess! I do have an ice machine that's just great but PT says that studies show that anything after 10 minutes is mute. Helppp I'm losing it! I don't remember going through this with the right knee...I think?

 

[Mom2Lucy]

@Archbarn28 , that PT sounds like a freak who enjoys inflicting pain, telling you that pain is good
If you actually go there again, tell her you’re reactive physically to pain, then kick her a good one and tell HER that pain is good and she needs to focus.
I’m willing to bet my life that she doesn’t receive pain well!

 

[Jockette]

Please find another PT facility or consider rehabbing at home. All you have to do is gently move your knee at this early stage and go about your day doing your regular daily activities.

The PT you are seeing is not the right one for you. There are others out there that will be caring and have respect for you.

Also, she probably has not had a knee replacement herself. All of us here have, so we know the approach we recommend does work.

Read again the articles Pumpkln left for you.

 

[Archbarn28]

Ha ha.. yes she says it means that things are working inside and I should embrace the feeling knowing that my body is in a healing mode. I cant believe I am putting up with her. I actually refuse to use one of the exercise assistants because she is such a witch with a Capital B ! I think i'm going to do this on my own!