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Moving Forward On Two New (Conformis) Knees
- Thread starter PoetryChef
- Start date
United States
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PoetryChef
senior
Tonight at work a regular customer stopped by my cooking station to inquire about my upcoming surgery. She is a PA at a local orthopedic practice. I was speaking with her about physical therapy and she stated that there is basically a six week window to gain a range of motion between 125 and 130 with a 0 extension. She further said you need to work very hard in physical therapy to gain this ROM. She said to follow the recommendations of my OS because he is the one following me through recovery.
I have read so much on this site about PT, the good and not so good and how incredibly insensitive some therapists can be.
It makes complete sense to allow the body to heal after such a surgery. I guess my question for you is what is acceptable when dealing with physical therapists? I need to know the no-no's. I do not know what many of the exercises are when listed for Josephine's questions. I think I am becoming increasingly concerned about the physical therapy side of recovery.
I have read so much on this site about PT, the good and not so good and how incredibly insensitive some therapists can be.
It makes complete sense to allow the body to heal after such a surgery. I guess my question for you is what is acceptable when dealing with physical therapists? I need to know the no-no's. I do not know what many of the exercises are when listed for Josephine's questions. I think I am becoming increasingly concerned about the physical therapy side of recovery.
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The most important thing to remember about physical therapy is that they are your knees and you are the only one who has the right to say what will happen to them. Other people, including your surgeon, his PA and your PT therapists, can advise, but it is your right to choose whether or not to accept that advice.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?
The PA who spoke to you is misinformed. It may be what she was taught, but it is wrong. There absolutely is no magic "window of opportunity".
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
Also, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
There's no need to work hard at exercises and pushing through the pain will only upset and irritate your new knee, making it more inflamed and swollen:
Myth busting: no pain, no gain
Go to PT by all means, but set the rules for what you will allow - no excessive exercises and no pushing or pulling on your knees.
PT or exercise can be useful BUT take note of these
If you happen to have a PT therapist who will work with you and follow your wishes, hang on to her/him - those therapists are like gold dust and you can work well with them. If you have one who is insistent on you doing everything their way, on a rigid time frame, then leave.
It is possible to rehab a knee without any PT - many of us (including me) have done it. Your normal activities of daily living (ADL) are sufficient exercise.
CONSENT: what it means and how it can be used
Saying no to therapy - am I allowed to?
The PA who spoke to you is misinformed. It may be what she was taught, but it is wrong. There absolutely is no magic "window of opportunity".
There's no need to rush to get ROM (Range of Motion) because it can continue to improve for a year, or even much longer, after a knee replacement. There isn't any deadline you have to meet:
Myth busting: the "window of opportunity" in TKR
Also, it's not exercising that gets you your ROM - it's time. Time to recover, time for swelling and pain to settle, and time to heal. Your ROM is there right from the start, just waiting for all that to happen, so it can show itself.
There's no need to work hard at exercises and pushing through the pain will only upset and irritate your new knee, making it more inflamed and swollen:
Myth busting: no pain, no gain
Go to PT by all means, but set the rules for what you will allow - no excessive exercises and no pushing or pulling on your knees.
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.
b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.
PT or exercise can be useful BUT take note of these
If you happen to have a PT therapist who will work with you and follow your wishes, hang on to her/him - those therapists are like gold dust and you can work well with them. If you have one who is insistent on you doing everything their way, on a rigid time frame, then leave.
It is possible to rehab a knee without any PT - many of us (including me) have done it. Your normal activities of daily living (ADL) are sufficient exercise.
OP
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PoetryChef
senior
SusieShoes
Former BoneSmart staff member
This term “locking up” is what my Mom called “freezing.” “Your knee will freeze and you won’t be able to bend it,” she would say to me. It’s bogus. Her doctor told her that and because her TKR’s came out okay, she’s sure it’s true.
Are there definitive no’s for dealing with PT? I can only give you my opinion based on what worked for me. I applied the BoneSmart mantras, sometimes to the letter and sometimes making my own exceptions. The PT no’s I applied absolutely were those my OS also said to not do in recovery:
* no machines (aside from riding a bike, and that only was permitted later, not at the start)
* no weights (such as those strapped around the ankle)
* no manually pushing on the knee joint itself
* don’t do anything that causes pain (but discomfort was to be expected)
My OS prescribed PT and wanted me to do it, but stated his goal was not so much ROM as balance, mobility and gait. The goal was not ROM but to get me walking without a cane by six weeks. It was up to me to select the PT place, though, and I selected a place that was convenient for me. The therapist I was assigned to wanted to get good numbers.
I ended up in a friendly battle of sorts with my therapist. I told him what I would or would not do. Sometimes I tried an exercise on his insistence, only to find that it hurt, so I would nix it for another week. He tried to get me to do leg presses (machine). I never did them. One time he had me stand on a thick foam pad and try to balance on one leg. NEVER AGAIN. I didn’t even finish the exercise—it hurt and I could tell already I would pay for it later, so I stopped—and my knees were swollen and painful for days after.
My ROM did not improve significantly at PT. What did improve was my balance, gait, and confidence. I was walking without a cane at my six weeks check up and my OS released me from PT.
If you can find a therapist who is in tune with the BS mantras, that would be ideal. Mine wasn’t, but I simply stood my ground. My knees told me what was working and what was not. The PT guy had no idea what my knees were telling me. How could he? But I knew, and I listened to them. They never steered me wrong.
Are there definitive no’s for dealing with PT? I can only give you my opinion based on what worked for me. I applied the BoneSmart mantras, sometimes to the letter and sometimes making my own exceptions. The PT no’s I applied absolutely were those my OS also said to not do in recovery:
* no machines (aside from riding a bike, and that only was permitted later, not at the start)
* no weights (such as those strapped around the ankle)
* no manually pushing on the knee joint itself
* don’t do anything that causes pain (but discomfort was to be expected)
My OS prescribed PT and wanted me to do it, but stated his goal was not so much ROM as balance, mobility and gait. The goal was not ROM but to get me walking without a cane by six weeks. It was up to me to select the PT place, though, and I selected a place that was convenient for me. The therapist I was assigned to wanted to get good numbers.
I ended up in a friendly battle of sorts with my therapist. I told him what I would or would not do. Sometimes I tried an exercise on his insistence, only to find that it hurt, so I would nix it for another week. He tried to get me to do leg presses (machine). I never did them. One time he had me stand on a thick foam pad and try to balance on one leg. NEVER AGAIN. I didn’t even finish the exercise—it hurt and I could tell already I would pay for it later, so I stopped—and my knees were swollen and painful for days after.
My ROM did not improve significantly at PT. What did improve was my balance, gait, and confidence. I was walking without a cane at my six weeks check up and my OS released me from PT.
If you can find a therapist who is in tune with the BS mantras, that would be ideal. Mine wasn’t, but I simply stood my ground. My knees told me what was working and what was not. The PT guy had no idea what my knees were telling me. How could he? But I knew, and I listened to them. They never steered me wrong.
Josephine
NURSE DIRECTOR EMERITA
You've been given excellent advice by these two good ladies - I think they'll soon be doing me out of a job!
But read it all carefully and you cannot go wrong.
One other bit of information that might help is you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)
But read it all carefully and you cannot go wrong.
One other bit of information that might help is you read my recovery thread to see how little exercising I did for either knee! Knee recoveries UK style Parts I & II (Josephine)
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PoetryChef
senior
Thank you all for your great insight into the pt dilemma. Josephine, I'd be willing to bet a months salary that you are irreplaceable here. Susie and Celle, a debt of gratitude to you both.
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PoetryChef
senior
Oh, my, goodness. Twenty more days until I leave for South Carolina, twenty two until my right knee and twenty four until my left. In twenty five days I will be resting and well medicated in your recovery area. Lord, help me through this.
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PoetryChef
senior
“Always – but especially when suffering - surround yourself with those who inspire you to lose yourself more honestly, to love others more thoroughly, to live life more fully, and to trust God more wholly. Huddle with those who care for you and those who are exemplary in their encouragement, patience and understanding of others. Hang out with those who strive to put God and faith at their center. Pray for peers, friends and mentors who will not only encourage you to be your best independent, strong, and vulnerable self all at the same time – but also sincerely humble. Pray that their angel dust will transcend you when even the smallest flecks of their contagious warmth and permeating beauty fall upon you. Then ever pray that you may have the opportunity to likewise ease and nurture others in such authentic ways; thus honing such a charitable, other-oriented nature of your own, – a miraculous healing balm – a buffer of pain if there ever was one. Know this is the most powerful antidote for fear and sorrow; the most effective – and addictive – cure-all known in all of creation; an elixir for that otherwise, elusive kind of happiness – the kind that weathers, endures and remains in all seasons and conditions.”
-Connie Kerbs, Paths of Fear: An Anthology of Overcoming Through Courage, Inspiration, and the Miracle of Love
-Connie Kerbs, Paths of Fear: An Anthology of Overcoming Through Courage, Inspiration, and the Miracle of Love
Red's Mom
graduate
Greetings and well wishes as you head into the two new knees phase of your life. I am exactly a year ahead of you. Machu was installed 11/1/16 and Picchu followed on 11/28. I am a retired nurse. The BoneSmart mantras made sense to me. My OS was comfortable with me directing my recovery and never set any expectations on my ROM. Although no recovery is a straight forward trajectory mine was quite manageable. I continue to gain ROM even now. My personal goals far exceed functional. My L heel in two finger widths away from my butt and my R knee is a fist away. I had some gentle PT at home in the first weeks and went to three outpatient sessions. The outpatient sessions each created setbacks and pain so I stopped going.
You know your body, follow its lead. If it hurts or creates setbacks just say no. If your motivated to get on with life and do your heel slides your going to do fine. The BoneSmart mantras work and have given me my life back.
The journey won't be easy but it is totally worth the end result! I wish you an uncomplicated operative experience and good pain management during the immediate post operative phase. Promise to trust your own judgement and don't get cajoled, manipulated or pushed to do anything that seems excessive or is painful.
You know your body, follow its lead. If it hurts or creates setbacks just say no. If your motivated to get on with life and do your heel slides your going to do fine. The BoneSmart mantras work and have given me my life back.
The journey won't be easy but it is totally worth the end result! I wish you an uncomplicated operative experience and good pain management during the immediate post operative phase. Promise to trust your own judgement and don't get cajoled, manipulated or pushed to do anything that seems excessive or is painful.
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PoetryChef
senior
I was just looking at canes on Amazon. In home PT recommends the Hurrycane. One question, I am having both knees done. I guess I could ask Susieshoes but one cane to manage two knees??? Omgosh, I am such a newbie at the new knee thing. 
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PoetryChef
senior
Red's Mom, thank you for such a lovely and inspiring post. Last night I began to read your recovery thread. Time seems to be passing so quickly now. I am looking forward to moving through the recovery phase. I would very much like to return to Paris. A couple years ago my sister and I went. We walked for 10 miles per day. That is the goal--that and a return to happy knees. 
SusieShoes
Former BoneSmart staff member
One cane worked for me. On my recovery thread, I received several comments saying I should use two canes. I was willing to try, as I have two canes, but my PT guy said one was all I needed. As I was walking well with just one, I stayed with that until the day came I no longer needed it.
@PoetryChef - you will see that I have moved your post from Teri59's recovery thread to your own thread in the Pre-Op Area.
By putting the above post in her recovery thread, you were disrupting her thread, which should be about her own recovery.
Forum etiquette: being polite when posting
Please post any questions about your anticipated recovery in the Knee Replacement Pre-Op Area. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you
Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
By putting the above post in her recovery thread, you were disrupting her thread, which should be about her own recovery.
Forum etiquette: being polite when posting
Please post any questions about your anticipated recovery in the Knee Replacement Pre-Op Area. We will see them there, as someone checks all the new posts every day.
If you need an urgent response to a question, just tag a member of staff.
How to tag another member; how to answer when someone tags you
Just in case you couldn't find your thread, here are the instructions on finding your thread,
How can I find my threads and posts? . Many members bookmark their thread, so they can find it when they log on.
Josephine
NURSE DIRECTOR EMERITA
I actually used a pair of elbow crutches for each of my knees but only for a few days, after that I changed to one.
OP
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PoetryChef
senior
Time is surely passing quickly now. Just yesterday I went and spent a king's ransom on pajamas and snuggly things to recover in. No proper Southern woman goes to the hospital without new nighties. ;)
Just one more series of blood tests and a follow up meeting with my primary then I am good-to-go regarding my knee surgeries.
This too shall pass, the good and bad alike.
Just one more series of blood tests and a follow up meeting with my primary then I am good-to-go regarding my knee surgeries.
This too shall pass, the good and bad alike.
OP
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PoetryChef
senior
Here at work thinking that in two weeks from today I will set sail from this place for twelve weeks. I fully expect a good year to maneuver my recovery. Lots of reading and planning so far. I try to pace myself and to not worry so much. Concerned about the surgeries and managing post op pain. On a positive note, there will be time for rest, Thanksgiving dinner not cooked by me, Christmas trees and more cheesy Hallmark movies to watch than I ever thought I would. I thank God in advance for watching over me and guiding me through this. With him, I can.
I had my Revision TKR on December 9th one year. It was one of the most restful Christmases I have had.
I organised Christmas presents on line - all the women had flowers delivered, the men had various items for travel, and the children received books and toys, already gift-wrapped.
I sent Christmas cards before I went into hospital.
My husband and son cooked Christmas dinner, while my son's partner and her daughter made dessert.
I just got out of bed for the meal, and retired to bed again afterwards, leaving the family to deal with the dishes.
I fell asleep watching a Christmas movie in the afternoon.
I should add that I prepared my family well in advance for our Christmas Day. We discussed menus and suggested meals that they could cook. It wasn't the usual Christmas fare, but we all enjoyed it.
I organised Christmas presents on line - all the women had flowers delivered, the men had various items for travel, and the children received books and toys, already gift-wrapped.
I sent Christmas cards before I went into hospital.
My husband and son cooked Christmas dinner, while my son's partner and her daughter made dessert.
I just got out of bed for the meal, and retired to bed again afterwards, leaving the family to deal with the dishes.
I fell asleep watching a Christmas movie in the afternoon.
I should add that I prepared my family well in advance for our Christmas Day. We discussed menus and suggested meals that they could cook. It wasn't the usual Christmas fare, but we all enjoyed it.
jeffm1955
junior member
I had a LTKR with a Conformis knee on Aug.31 and I have been very happy with my recovery. The whole process was a lot better than I was expected. I'm getting ready to go back to work Nov.13 where I'll be on my feet most of the 8 hours,and I think I'll be ready. I think you made a good choice with the Conformis knee and a good surgeon. Best wishes for a fast and pain free recovery. We will be following your progress.
Sent from my SM-G955U using Tapatalk
Sent from my SM-G955U using Tapatalk
OP
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PoetryChef
senior
Thank you, Jeff. I followed your recovery and hope mine goes as well. Many thanks for your good wishes.
