TKR Montecresto’s Recovery

[Montecresto]

I’m really worried about not getting back my ROM and particularly full extension…Not sure how I’m going to get there, but it seems not in the direction I was heading…..

Please don’t worry about regaining your ROM. Yes, you will regain it, even if you never go to a PT office again. Right now swelling is blocking your ROM, as the swelling goes down, and as you heal, your ROM will improve by default.

You are wise to cancel your appointments at this location, as they are giving you inappropriate PT. They have you in ”training” mode, ignoring the fact that you are in “healing“ mode.
Saying no to therapy - am I allowed to?

This early in recovery all you need are gentle bending movements to give your knee mobility. Short walks in the house are fine. You need lots of rest, ice and elevation. Check our Recovery Guidelines for articles about those.

Thank you! I did read all that, it’s what lead to our decision to suspend PT….

I get lots of gentle bending with the CPM machine and I’m walking in the house and some in the yard. I’m doing ice therapy and keeping my leg elevated.

Thanks for the encouragement.

 

[Layla]

Then my wife found this forum. And we’re calling the PT clinic Monday morning and canceling until further notice.

Bravo! Walk away and you should do just fine. You can always return at a later date if there’s something specific you feel you need to work on.
Heal first, lots of rest, ice, meds, TLC needed to heal from the controlled trauma your leg just endured.

 

[Montecresto]

Have you tried suppositories? They helped me have a 'breakthrough'. After that, I took fiber laxatives until I got back to normal.

The PT you had has really set you back in your recovery. It's a shame you have to recover from PT before you can get back to your knee's surgical recovery. You are doing the right thing by canceling it. I wouldn't even bother calling your OS and telling him. It's your knee and your decision, not his.

I was blessed to have a surgeon that never pushed PT. He gave me a prescription for it, which I threw away and never went. When I went for my 3 return checkups, all he was interested in was to see what my knee would do and never measured. He never even asked about PT! Of course, he knew I was a single lady that had to take care of myself and obviously trusted that I would not be just laying around all the time.

After 12 knee surgeries, I know that I do not need formal PT, and neither do many others if they do their own daily activities and not just sit around all day and night. My knee recovered just fine all on its own with only my daily activities. I didn't have the terrible swelling or agonizing pain that so many have after taking formal PT. I knew the Bonesmart way worked before Bonesmart was even thought of. My knee surgeries started in the early 80s and I never went to PT even back then. I just didn't see the need for it. Bonesmart was formed around 2004. By then I had already had 6 knee surgeries and rehabbed the Bonesmart way!

Wow, you’re quite the veteran and an asset to the community….

Yes, suppositories are part of my regimen. Making some progress. I’m confident I’ll get this in control.

To the PT, I’m almost shocked by the attitude here concerning it, all I had drilled into my head by what I read was PT and my commitment to it is as important to my complete recovery as the experience and care of the surgeon who performs the procedure….

 

[Montecresto]

Walk away and you should do just fine.

With my walker right…….

 

[WFD]

Smooth Move tea works great for constipation.

 

[Montecresto]

Smooth Move tea works great for constipation.

Orally????

 

[Layla]

yes…you drink it.

 

[Jockette]

To the PT, I’m almost shocked by the attitude here concerning it, all I had drilled into my head by what I read was PT and my commitment to it is as important to my complete recovery as the experience and care of the surgeon who performs the procedure….

Yes, unfortunately this is the opinion of the majority.


This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."

It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

 

[sistersinhim]

To the PT, I’m almost shocked by the attitude here concerning it, all I had drilled into my head by what I read was PT and my commitment to it is as important to my complete recovery as the experience and care of the surgeon who performs the procedure

We are finding that the younger PT and surgeons who have been trained recently are ordering the gentle PT as the best way to rehab a joint replacement. As you read more and more threads, you'll see how many are actually having the gentler therapy.

 

[Montecresto]

To the PT, I’m almost shocked by the attitude here concerning it, all I had drilled into my head by what I read was PT and my commitment to it is as important to my complete recovery as the experience and care of the surgeon who performs the procedure….

Yes, unfortunately this is the opinion of the majority.


This is what one of our members, TortiTabby, experienced:

(Just so you know, ADL means Activities of Daily Living.)

“At my six week appointment this is what my OS wrote in my visit summary: "She reads an online website called Bone Smart which states to not push through pain following knee replacement. If she were to follow this direction, she will have to learn to live with a knee that only reaches to 85 degrees of flexion. I believe this website is very misleading."

It has now been 20 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks (where I am today): 110
I am so thrilled it keeps improving and improving and I know now that I will get to my goal of 120 (or even better, dare I say!)
So, if a OS or PT bullies you into thinking your ROM will not improve over time they are wrong. By the way, I haven't been back to see the OS since that horrible appointment at 6 weeks, but I sure am going back when I reach 120 just to say, "Ha! You were wrong, BoneSmart was right!" “

And,

“Just an update for those who are apprehensive about gaining ROM:
It has now been 26 weeks and all I do is ADL and this is what my ROM has done:
3.5 wks: 75
6 wks: 85
7 wks: 90
10.5 wks: 95
14 wks: 100
17 wks: 105
20 weeks: 110
26 weeks (where I am today): 120!!!
I did it! My goal of 120! No "pushing through pain", no PT after the first 3 visits, and most importantly to me: No MUA! My surgeon who said I would never get beyond 85 ROM without pushing through pain was wrong, wrong, wrong. I'm excited to see if it gets even better. “

Hmmmm, well that’s amazing to be sure, and just as amazing that our surgeons are these educated and experienced people capable of doing this amazing procedure and incapable of seeing that therapy, at least in the early weeks of recovery, is not beneficial…..

 

[Montecresto]

To the PT, I’m almost shocked by the attitude here concerning it, all I had drilled into my head by what I read was PT and my commitment to it is as important to my complete recovery as the experience and care of the surgeon who performs the procedure

We are finding that the younger PT and surgeons who have been trained recently are ordering the gentle PT as the best way to rehab a joint replacement. As you read more and more threads, you'll see how many are actually having the gentler therapy.

Ah, ok. My surgeon is 72, has done 25,000 of them, works 50 weeks a year, and prays with you in the pre op room….old school dude and intense….

 

[Montecresto]

yes…you drink it.

Well, you big kidder you. Glad you got a chuckle….

 

[sistersinhim]

My surgeon was probable around 40 years old and never pushed PT. I was so blessed to have found him. It took a lot of research to find one that I was happy with. If I have to have the left one replaced, I'll go back to him.

 

[InkedMarie]

Someone else recommended Smooth Move Tea. One Cup at bedtime was all it took for me to move LOL!

I like your wife.....smart lady. I’ve had both knees done and I did PT but on MY terms. When I say stop....we stop. I had the same PT, by choice and I reminded him after my second knee, eleven weeks ago, that my arms work and so does the other knee.

I‘d say I was just kidding but if I said no or stop, and he didn’t, I can say I would use an appendage to get their attention. My knee, my recovery, my insurance pays.

Marie

 

[Montecresto]

My wife has a call in to the PT facility, left a message for the manager/owner. Going to tell him what happened after PT Friday and that we’re suspending PT for this week.

Got my swelling down enough that my pain medicine is more better managing the pain. I have the ice machine on with 20 minutes on and 40 minutes off.

Constipation still an issue with minimal progress. Still taking max dose of stool softener, Miralax, suppository as able and drinking another round of magnesium citrate now….

 

[Layla]

Hello and Happy Monday!
I wish you’d give it more than a week, but that’s your call. Maybe after spending more time on the forum, seeing progress and reading others threads you’ll decide to stay away longer, or permanently. You can ice for longer than 20 minutes and we recommend at least 45 minutes, several times per day, targeting at least 4 times.
Doing some research on this topic awhile back I learned that icing for up to twenty minutes only is what most of us have heard or been advised to do following an injury. Following joint replacement, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort for as often and as long as you're comfortable doing so, always placing fabric between your skin and the ice source. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit.

Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or preventively keep pain at bay. You may find relief through icing for weeks to months post op.

Please understand I’m not trying to be contrary. I’ve learned a lot through personal experience and reading here for years. We want to see you have the best recovery possible with the least amount of stalls, or setbacks. Naturally in the end, the choices are yours and I only wish you the best. I hope today is a good one!
@Montecresto

 

[Montecresto]

Hello and Happy Monday!
I wish you’d give it more than a week, but that’s your call. Maybe after spending more time on the forum, seeing progress and reading others threads you’ll decide to stay away longer, or permanently. You can ice for longer than 20 minutes and we recommend at least 45 minutes, several times per day, targeting at least 4 times.
Doing some research on this topic awhile back I learned that icing for up to twenty minutes only is what most of us have heard or been advised to do following an injury. Following joint replacement, ice is a critical part of pain management and should be used not only on the joint, but any surrounding areas of discomfort for as often and as long as you're comfortable doing so, always placing fabric between your skin and the ice source. Icing helps bring relief from the soft tissue trauma and internal swelling. Icing is a great natural pain reliever and best of all, it's free. While some care providers do put a maximum time on icing, others suggest you ice as often as you see fit.

Icing after therapy, exercises, or prolonged activity that challenge ROM and endurance should help ease any discomfort, or preventively keep pain at bay. You may find relief through icing for weeks to months post op.

Please understand I’m not trying to be contrary. I’ve learned a lot through personal experience and reading here for years. We want to see you have the best recovery possible with the least amount of stalls, or setbacks. Naturally in the end, the choices are yours and I only wish you the best. I hope today is a good one!
@Montecresto

Happy Monday to you as well

Oh you’re not offending me with your advice on icing. I have no disagreements with that at all. In fact I’m glad I was able to get back into the ice machine today. Had to put it up for a week as it was just too uncomfortable….that left me with the ice packs again and having to trouble my wife for regular exchanges, and it left me without any ice for long periods during the night. My wife is already stretched thin with all that she’s having to do for me, and being kept away from our office to try to keep our business afloat from home while taking care of me…….

So with the ice machine now, I can turn it on and off as I need it. I think this way I’m going to have much better results with swelling mitigation.

As for PT, I have to say that I’m catching a WHOLE LOT of grief from friends and family over my decision as it is. Receiving all manner of links from people on the warnings of not doing PT and testimonials from people who skipped it and are now suffering bad results because of it. Their experiences seem as valuable to me as anyone else’s….

So this is very hard, fear and anxiety of going to PT, fear and anxiety of not going to PT, pressure and information for and against PT from all sides.

 

[Layla]

As for PT, I have to say that I’m catching a WHOLE LOT of grief from friends and family over my decision as it is. Receiving all manner of links from people on the warnings of not doing PT and testimonials from people who skipped it and are now suffering bad results because of it. Their experiences seem as valuable to me as anyone else’s….

I’m sorry. You’ll figure it out, maybe for now you can pacify those that are for PT by telling them that you plan to engage, just not this minute…and maybe you will return to PT soon. There are PT’s that are gentle, not pushy and effective. I think it’s key to lay down the law from the beginning of who is in charge (you) of what you will and will not do. You should never be pushed to the point of tears due to pain, not even close. A good majority of those that give up PT are those that were pushed by a therapist and are sidelined trying to recover from PT, as it seems you are doing. You’re certainly not going to receive any less support here if you return to PT. I’m sure between you and your wife, who sounds like a very loving and attentive caregiver by the way, you’ll make the decision that is best for you.

 

[Montecresto]

As for PT, I have to say that I’m catching a WHOLE LOT of grief from friends and family over my decision as it is. Receiving all manner of links from people on the warnings of not doing PT and testimonials from people who skipped it and are now suffering bad results because of it. Their experiences seem as valuable to me as anyone else’s….

I’m sorry. You’ll figure it out, maybe for now you can pacify those that are for PT by telling them that you plan to engage, just not this minute…and maybe you will return to PT soon. There are PT’s that are gentle, not pushy and effective. I think it’s key to lay down the law from the beginning of who is in charge (you) of what you will and will not do. You should never be pushed to the point of tears due to pain, not even close. A good majority of those that give up PT are those that were pushed by a therapist and are sidelined trying to recover from PT, as it seems you are doing. You’re certainly not going to receive any less support here if you return to PT. I’m sure between you and your wife, who sounds like a very loving and attentive caregiver by the way, you’ll make the decision that is best for you.

Yeah, I have a call in to the OS’s office, it may be that they want to see me now to see if there’s any particular issue with my knee. As I posted at the beginning, my surgery went beyond his typical hour and 15 minute procedure due to discovery of excessive scar tissue from a career in construction, occupational injuries to my knee and two previous laparoscopic surgeries to this knee…and the extra work that had to be done in the back of my knee because I arrived at surgery with a leg that could not achieve full extension already….

The PT manager already suggested that I still come in, that he has a gentler protocol to follow, a “tens unit” for my knee and modified reps to follow….

I have to say I’m very frustrated…..

 

[Layla]

It is easy to get frustrated in the early weeks, where you are now. My best advice would be, IF you go to PT make it crystal clear that you refuse to push through any pain and if they’re okay with that, proceed, doing only what you’re comfortable doing, no more. You are the one that has to recover from the pain afterward, not them. Ice preventatively afterward also.

Feeling conflicted is understandable when you have well meaning friends, family, us, coming at you from different sides. Let your body be your guide. You‘re working to heal and you are healing, just allow yourself the TLC you deserve. Enough of my ramblings for now.
@Montecresto