Manipulation this week--a little scared!

[texassissy]

I am very curious as to what the protocol is for manipulation. I saw my dr last week --I am appx 8 weeks out.. and when I read of the progress y'all are making here.. because I have not accomplished at all what u have i am -6 and cant remember the other number but seems he said 15 degrees off 120 or so... at what point do they throw their hands up and say.. ok this is it... manipulation time! Just wondering .. doesnt sound like much fun!!

 

[Nursepair]

Saw my OS at 8 weeks, he's talking about it for me too, I am 11 weeks and only at 90 at a push. My PT thinks I am doing OK though, I still have a lot of swelling. Let us know what he decides for you. Sue

 

[Josephine]

I am very curious as to what the protocol is for manipulation. I saw my dr last week --I am appx 8 weeks out.. and when I read of the progress y'all are making here.. because I have not accomplished at all what u have i am -6 and cant remember the other number but seems he said 15 degrees off 120 or so... at what point do they throw their hands up and say.. ok this is it... manipulation time! Just wondering .. doesnt sound like much fun!!

One of those things there's no particular protocol for and it differs greatly from surgeon to surgeon. Some will accept what others think is unacceptable. Just one of those things. There's also the input from the patient. If someone says with some conviction "Well, hey, doc - how about giving me about 2/3/4 weeks to see if I can do it on my own." He might be inclined to say ok or he might say "Absolutely not! Now is the time." Just depends.

 

[kath]

Jen G,
I had 2 weeks in home PT. Now I have 2 months out. I think it may have something to do with your insurance. My in home PT is very nice, but to be honest I really don't get all that much from her. I think I gain more on my own. She comes one more time then I am out. So next week I start the real deal PT. They are doing my newest knee and then also continuing what they can on my old new knee until they are more even and then some when I am more equal in both knees.

 

[ladyblue]

I have never had in home PT..Started PT the next day after surgery and then 1 week after I came home from the hospital. Since I am going everyday now for the next two weeks--I wonder how much more therapy that I will have to go through before I am over and done with all!! Yesterday and today have been very painful for me (worse than after both of my surgeries!)but there are things that I have to do so I must keep on pushing. My PT that I have to do at home is to lie on my stomach on my bed with my legs hanging over the edge with weights on the TKR ankle (starting at 5 lbs.)for at least 5-10 minutes. Next is the heel slides pulling back with a rope or towel for more leverage. I just hope that this works.

 

[Jamie]

Ladyblue....I have done that weights on the leg thing too. It was last year after arthroscopic surgery that went bad and I couldn't properly straighten my leg. It really worked wonders and I liked it because the pain was not as bad as if someone was pushing my leg down. My only recommendation would be to do these exercises every day, push yourself even if it hurts a little (you are in control), and ice, ice, ice afterwards for swelling. Sending you a virtual hug cuz you deserve it! Write often....there will always be support for you here. ....Jamie

 

[JenniferG]

I did the weights when lying on my back with leg up and drop at the knee to stretch the tendon thing attached to the quad that goes over the knee cap. Then would do the lifts, min of 3 sets of 10. Started at 2 lbs then 3 then 4. PT supervised. I did this before the surgery to gain as much stretch as possible going in.

 

[NewKnee@44]

I'm glad it all worked out. Mine is on Wednesday. My ROM is stuck at 105-110 and my flexion is at 5. My doc and I both agree that I want much more flexion (maybe 130) at 44 years old. Six previous surgeries may have contributed to scar tissue building.

Steph

 

[beachcomber]

Steph,
Good luck to you! You definitely want more ROM at your age and everyone on here who has had the MUA has gain more ROM afterward with hard work. Keep us posted!

 

[Jamie]

We'll be thinking about your Steph! At your young age, you want all you can get! Good luck and let us hear from you soon.

 

[Doug]

Ladies,
After reading this last page please let me give you some practical advise, and experience.
You aren't through working out, and you aren't through stretching.
All of the resistance training you've done in therapy will start degrading when you stop training.
Much of the flexibility you have gained will slowly go away when you stop stretching.
You may not choose to hit it hard but you are going to have to do something to have an active lifestyle.
I hate to say it and am fighting it myself but we aren't getting any younger.
Our bodies naturally loose muscle mass as we age.
I was slapped in the face with reality today.
I've slowly gotten away from training so hard on the bike. I had added another exercise, arc trainer, that works the leg, butt, and heart harder.
Today I decided to get on the bike and drop the seat lower...It hurt. I had to back it up and warm up more. Then I got it down. But I was tight.
I've always had great flexibility due to doing thousands of kicks in all directions in karate. It goes away if you don't keep working it.
I'm not saying you have to keep at it with the intensity of the post surgery times but I would encourage you to at least do the hot bath stretches and bends we've talked about.
We have all put too much into these new knees to get lazy and stop!! O.K.?

 

[Jamie]

Good advice, Doug.....the old "Use it or lose it!" philosophy. For me, keeping up an exercise routine is harder than watching what I eat. I fight it constantly even knowing the exercise is the best thing in the world for your body! Glad to hear you caught your slight loss of flexibility before it got worse, though! It's a good lesson for ALL of us! I don't know what the price of everyone's surgery was (the price on the bill BEFORE insurance and all), but mine was mind-boggling.....around $30,000 for the one knee for everything associated with the surgery. That's a serious investment in a person's future!

 

[Doug]

I'm the reverse. Exercise is much easier to me than watching what I eat.
I worked out, now I'm frying some turkey and watching me eat it!! With twice baked potato and salad.

 

[referee54]

I have to agree with Doug---the surgeon began the work--it is up not to finish it---but to maintian it. One of the reasons that we had TKR's was that we could not enjoy an active lifestyle. IT IS TIME TO BE ACTIVE!

Remember--there are two kinds of pain; the first is your body falling apart; the second is a good kind of pain as you are re-assembling your body as well as your life.

How much life you get back is directly correlated to how much work you put into rehab. I have to be active---it is not only the way I am, but I will gain three pounds just by driving by a pizza shop and smelling the aroma!

Tim C

 

[Doug]

Then you should smell my turkey frying!!!

An old athletic saying regarding working out,"pain is weakness leaving the body"!

But do something you enjoy. Most aren't in training for a sport.

 

[referee54]

I was never big on buying Indians or Browns or Ohio State stuff---that means you watch them play. I like to be in the middle of stuff---striped shirts and blue shirts and those kind of things---watching or doing--that is the difference in my lifestyle. Don't just do the PT---become involved in the middle of your own rehab. Savor the pain of pushing yourself to do something a little longer or more intensely than yo did before. Enjoy biking or walking or eercising of some sort---take control of your life and your life's activities.

Tim C.

 

[beachcomber]

Yup, I agree. That is why I have chosen to continue PT past the minimum needed to regain ROM. I know my new knee isn't and never will be as good as my own knee--- but I want to maximize it's functionality.

My quandary right now is the wear and tear from thousands of steps on concrete floors in my job every day plus the PT seem to be causing too much inflammation. After resting my swollen, inflamed knees this weekend I noticed that my ROM has decreased as I was stretching and bending in the hot tub this morning. I need to find the right balance for me.

I love to walk and bicycle and am learning to enjoy my pool therapy. It feels so good to exercise again that I sometimes go too long. Again--- gotta learn balance. Exercise and healthy diet--- all in moderation.

Let's go girls!

 

[Jamie]

Beach, your concerns are the same thing I was hearing from my doctor this past week when I saw him. He said my ROM was great, but I still had (and would continue to have for some time) some swelling. I was to start outpatient PT this coming week and he told me I could go or not - my choice. It wasn't necessary if I kept active and pushing myself. But, he said if I did go, to be assertive and make sure they didn't try to push too hard. He said if you have PT and then have a day of swelling....it's too much and not doing you as much good. I decided to go ahead and meet with the therapist tomorrow since I already had the appointment, let him assess me, and then talk over what he might be able to do. It may be that he just gives me some things to work on. At this point I think time and doing my normal activity plus biking and walking are probably as good as PT. We'll see.....but it was nice to know the doc thought I had progressed enough to go on by myself. There is a cost factor too.....even with my great insurance, it still costs a copay with each therapy visit. So I have to feel like I'm really getting something from it. I'm looking forward to my meeting with the therapist tomorrow and having a plan that works for me. Cuz I completely agree with Doug and Reg that ya gotta keep moving! No lounging around the house watching soaps and eating bonbons!!! Not that anyone in THIS group would....we're a bunch of fighters!!

 

[beachcomber]

Yup, I agree. That is why I have chosen to continue PT past the minimum needed to regain ROM. I know my new knee isn't and never will be as good as my own knee--- but I want to maximize it's functionality.

My quandary right now is the wear and tear from thousands of steps on concrete floors in my job every day plus the PT seem to be causing too much inflammation. After resting my swollen, inflamed knees this weekend I noticed that my ROM has decreased as I was stretching and bending in the hot tub this morning. I need to find the right balance for me.

I love to walk and bicycle and am learning to enjoy my pool therapy. It feels so good to exercise again that I sometimes go too long. Again--- gotta learn balance. Exercise and healthy diet--- all in moderation.

 

[beachcomber]

Here's what I have experienced with continued PT.
Productive:

• Their evaluation of my knee and setting up a customized home PT program for me and making sure I am doing the exercises correctly.
• The use of some specialized equipment there that I do not have access to at home or through any of the local gyms (Nu-Step especially)
• The use of their therapy pool where I am the only one in the water and can do low/no impact exercises to benefit both my knee and back with aqua therapy equipment like aqua shoes and float suit
• E-Stim at the end of the session provides wonderful pain relief
• Occasional treatment with massage therapist is incredible with all the other muscles that get out of whack when you are recovering from 2 major surgeries.
• My insurance pays at 100% now because I have surpassed the stop-loss point.

Not-so-productive

• going to therapy and having to do my exact home program in front of them that I already did once that same day. Seems like a waste of time and therapy session. Fortunately that has seldom happened.
• Some weeks if I have PT early in the week it seems to set me up for a bad rest of the week by increasing my inflammation and swelling and then I spend the rest of the week in increased pain at work and can't seem to feel better until I rest all weekend. Then it starts all over again.

I have dropped down to 1 session per week for now with an emphasis on setting up something I can do long term on my own. I am not to the point where I would trust a trainer at a gym to set up a program for me because I think it is too soon since my surgeries and I trust my PT more. BUT I do think they can get over-zealous and you gotta make sure they keep it real.