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TKR Minnes new knee and MUA

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@gr82cu2 My OS kept telling me don't lay around, get up and walk, use the knee, etc. He told me prior to surgery to stop in home PT after 2 weeks and get to outpatient so they can really work on my knee. That :yikes:me. I will speak to OS tomorrow about his expectations for outpatient PT and see what he says. But no matter what OS and I will have to agree to disagree when it comes to aggressive PT if it involves pain as I will not let them hurt me.

@Yorkimom my quad isn't painful thank goodness, but it is tender and sore.

@tiredwife I can't feel any knots but rubbing it does relieve the soreness a little. I remembered reading that you had done that to Steve's leg and so I tried it.
 
@Minnie's knees Hubby had huge knots (bigger than egg size). Every night I would rub them and they gradually went away. The tourniquet does leave some bruised muscles even if it doesn't bruise on the outside. TKRs cause a lot of trauma to your whole leg. It takes a long time to heal from that. Glad you aren't going to let the PT hurt you.
 
@Minnie's knees Well, he may have meant to not be a complete slug. It is important to move around some which you have. There's no need or desire at this point to get out and walk a mile but short trips to the potty, kitchen, etc. are good and help ward off blood clots. Out patient PT will have equipment that you don't have in your home or that they can't carry with them that is beneficial but it doesn't mean they will torture you with it :) As long as you don't allow them to hurt you you'll be fine. Sometimes you don't even feel the hurt or soreness until after you've left so you need to be sure to let them know before they have you do that particular exercise again especially if you feel it set you back. My PT always asks how I'm doing when I go in and I never hesitated to tell her if I felt a certain activity had caused problems and she would either skip it that session or cut back on intensity. Like that time she had me leg press 110#. Yeah, we didn't do that one again, LOL!!
 
@Minnie's knees I wouldn't worry about outpatient PT. I've had three different physical therapists and they were all gentle and told me to let them know when enough is enough. I wouldn't want to be paying them good money as being the experts in this field if I couldn't trust that what they recommend is good for me. I'm not paying them then going in ready to fight with them. But on the other hand, if I ever got one that's too rough I'd simply ask for another one. They are supposed to help, not do more harm.
 
Some PTs are really helpful, some a bit less so. I think that what is important is to establish your ground rules from the start. Tell her/him that you will not allow them to hurt you and that when you say Stop they are to stop. MOst will accept that, but if they don't, then ask for another therapist who will respect your wishes.
There's no need to be fearful of PT.
 
@gr82cu2, @Minnie's knees, @Celle, tiredwife, Friday our neighbor invited us for dinner. She had invited a few couples and thought it would be good for me to get out. One guy that was there had a knee replacement several years ago and I had thought I remembered him telling me before that he went to the U of D PT. That's where I went the first week and they were way too aggressive. Anyway, he said yes he went there. They had called him to be part of a study. Therefore, he didn't have to pay for his therapy. They had called me with the same deal when I had my first surgery, but they closed for a week over the Christmas holidays and I didn't want to miss that much time, so I did't take them up on their offer. Anyway I was telling him how aggressive they were and that I only went there for a week this time and went back to my old PT. He said yes they were very aggressive. He said that he had to sit on the side of the table with his leg hanging and would have to kick it out straight and hard. If he didn't kick it hard enough they would shock him with a poke until he kicked hard enough. I couldn't believe it when he told me this. I didn't say it to him, but there is no way I would let someone do that to me,free or not!!!! Talk about therapy from hell!
 
Kathy @Minnie's knees

In Ireland most OS & PT's have both post THR & TKR patients after day 3/4 walking with crutches or walker or cane for 5 minutes three times a day and gradually work up to three 30 minute walks each day by week six post-op. It usual to stay in hospital 5 to 7 days post-op.

While still in hospital, begin gentle bed PT exercise on day 2 post-op and one or two sessions each day in the hospital PT room.

At home PT is a rare option and it's out patient PT for the vast majority, usually 1-2 each week for the first 3-4 weeks and then once a week for a few weeks and then every second week. I'm going now every second week.
In my case, my insurance pays 40% of the PT costs for 7 visits in any 12 month period.

After the 7 visits, I pay for my PT in full.

I had several PTs in the hospital and also attended an additional Hospital group PT session for 6 sessions that was not covered by insurance, and I paid bout $200.00 for those 6 sessions.

I have out patient Physiotherapy with a PT that I have been attending for over 15 years for various problems. And the cost is €60/ session or about $72.00/ session.

With the very many PTs in the hospital and my own PT, I have always felt that they have been on my side and were providing their expertise to aid in my recovery.

At times, on the BoneSmart site we are warned not to let PTs hurt us or cause us pain. And these thoughts enter our heads even before we have our first PT session. There seems for some to be "the TKR patient against the PT".
And this is not necessarily the case.

Of course, there must be a dialogue between the patient and the PT and guidelines and expectations to be agreed. And unfortunately, some on BoneSmart- a very few have told of a PT session that they felt caused pain.

What I'm trying to say, is to start your PT session with an open mind and understand that they share your TKR recovery goals.

Cathie :flwrysmile:
 
@Minnie's knees See it comes when you least expect it I am still struggling with swelling and pain You are so lucky not to have black and blue I was covered my thigh and calf It was a relief to get the staples out I am not using walker using cane, I have great difficulty getting out of chair ect It just takes time and I try to let the knee be my boss but had to take charge for this week end and now will let my knee be boss again
 
@Yorkimom I just wonder if "shock him with a poke until he kicked hard enough" was actually using electronic stimulation of the muscle to help the quad to work better to lift his leg. I sat on the side of the bed and was told to "kick it straight out" but they didn't really mean kick, just lift and straighten it. If PT was torture you'd think there would be an awful lot of reports, law suits, and investigations. Sometime when people are afraid and nervous they don't really understand the treatment and their translation of it can be very different from what really happened.
 
@ConnieJOS, that might have been what they did. But all he remembers is the shock when he didn't do it as they wanted. I would not go back to someone like that!
 
@ConnieJOS, I talked to Christine, my therapist, a out it today, and she said there are two different kinds. One they makes the muscle feel good and one that stimulates the muscle and it feels like a shock. That must have been what they did.
 
Anne @Yorkimom
I used the "KneeHab" while in the hospital PT and then bought a unit for use at home.

The large cuff wraps around the knee and thigh and then you slowly increase the contraction intensity and the quadricep muscle contracts for 3 seconds and then rest for 5 seconds for a twenty minute treatment. You can also change the contraction and rest phase.

I use it now every second day for 20 minutes to continue to build up my quadricep muscle.
And it can be described as a little "shock" , but you control the intensity to a level that is comfortable, but also effective to get the muscle to contract.

Cathie
 
@marmora, I have never used anything for my quad and find all of this so interesting. I have been very fortunate that my quad muscles have been fine. Right after surgery I had no problem engaging my quad muscle to do leg lifts. I was very lucky in that aspect.
@Minnie's knees, I been anxiously checking to see how your appointment with your OS went today. Please let us know! Anne
 
Yes, that's what I had. It really is a shock, I'm sure. They turn it up and it starts to tingle. Today I didn't tell them "enough" quickly enough and it hurt a little, but she just turned it down as soon as I asked. Each time I feel the tingle, I Lift my le. Then when the tingle stops and pauses I rest. They had me do quad sets and short arc quads with the e-Stim today.
 
Sounds like your quad is waking up. :thumb:
 
Today was interesting. Went to OS, staples are out, x-rays look good, there does not appear to be any ligament damage from the pop I felt last Friday. Quad is waking up slowly, OS had me walking the hall without the immobilizer. Quad is holding the knee but needs to continue to strengthen (only use immobilizer as needed when knee feels too weak). Then about 1/2 way back down the hall I got very light headed, nauseous and sweating. I came close to passing out. Left OS office in a wheel chair. Got home ate a snack and slept for awhile. Maybe too much activity, nervous walking on new knee 1st time without the immobilizer, pain meds, sugar levels, who knows but it scared me. My OS and his staff were very supportive when this happened. I feel better now just very tired. I will continue home PT this week and then switch to out patient. Discussed goals without pain. I will have next follow up visit in 4 weeks.

I am very glad to have the staples out and being able to walk without the immobilizer. Two big steps on my recovery road.
 
Wow I bet that was scary! At least your OS witnessed it and if it happens again maybe he will show it the attention it deserves. Were you in a lot of pain when it happened? It may have been one or more of the things you listed. Try and take it easy and maybe only do very short walks without the immobilizer until you get used to not having it for support. Build up strength a bit at a time. Hope you feel better!
 
@gr82cu2 No I was not in pain when it happened thank goodness. I had the x-rays and felt a little light headed and then it just hit a few minutes later. I think it was just everything cumulative. I like your suggestion on the immobilizer over next few days. I have been up a couple of times tonight without it but trying not to over do it.
 
@Minnie's knees,Kathy I'm sure that was scary for you. Did the OS have any theories? I'm curious as this has happened to me a couple of times in the last couple of weeks. I'm sure you were nervous walking with the immobilizer with the doctor watching you. Try to take it easy the next day or so and like Janet said just go for short spurts not using the immobilizer until you feel confident without it. Anne
 
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